My eyes are suitable for the Lasik surgery or not?

How do you know you are the suitable candidate for LASIK surgery or not?

  1. Am I suitable/eligible for LASIK surgery?
  2. What are the indications and contraindications of LASIK surgery?

LASIK (Laser-assisted in situ keratomileuses) is a surgical procedure that corrects the refractive error of the eye.  LASIK corrects the common refractive error like Hypermetropia, Myopia, and Astigmatism. Also, LASIK surgery is available for treatment of presbyopia. The main aim of the LASIK surgery is to completely eliminate the dependence of spectacles or contact lenses. It is safe and around 10minutes painless surgical procedure done by laser rays. Most of the cases vision completely recovered within 24 hours.

What are the criteria for a good LASIK candidate?

The surgical eye should be suitable for the surgery. Following things are included in LASIK exam

Age: – Patient age must be 18 years. Less than 18 years of age is not suitable for the LASIK surgery because of the chance of increase refractive error up to 18 years of age, especially Myopia. There is no age upper limit for LASIK surgery. Even at the age of 40 years also monovision LASIK surgery can be done which helps for reading also without glass. Few doctors suggested that 21 years age is good LASIK surgery.

Refractive error stabilization: – Surgery should be done after stabilization of refractive error. Only 18 years of age is not the green signal of LASIK surgery. The power of the glasses will be stable for at least one year if not then the patient may need glasses after few days of surgery.

Healthy Eye:- Eye should be disease free especially any kind of conjunctivitis, allergies, dryness, history of remarkable internal injury or corneal scarring which can influence the surgery. Most of the patients are worried about the dryness after the surgery. After the LASIK surgery, the number of sab-basal and stromal nerve fiber bundle decrease around 90%. Corneal nerves take 2-3 months for regeneration after LASIK surgery. So any kind of dryness of the eye should be treated before doing the surgery.  

The family history of keratoconus: – Though there is no long term study on this but a family history of keratoconus should be avoided for surgery.

Previous history refractive surgery: – If any kind of refractive surgery done in the eye then the surgery should be avoided. Patients need to inform surgeon before surgery.

Pregnancy: – Pregnancy is the contraindication for LASIK surgery.  LASIK surgery should not be done at the time of pregnancy.

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Risk factors & Precautions:-

Recurrent conjunctivitis can cause corneal infection which may be lead to complication after surgery.

Any kinds of a retinal problem should be treated first if required.

Diseases like recurrent HSV (Herpes simplex virus) or Herpes Zoster infection around the eye or involved in the eye should take extra precaution because it delays healing procedure after the surgery. 

Blepharitis can spread the infection after surgery. So it should be treated before the surgery.

Diseases like Glaucoma, Glaucoma suspect, Ocular hypertension, and Diabetic retinopathy should be taken extra precaution and avoided surgery is better. But again it’s depended on the surgeon because experience surgeon can take extra care and perform the surgery.

Thin Cornea: – Thin cornea is one of the contraindications of LASIK surgery. Less than 480 microns corneal thickness is not suitable for LASIK surgery. High refractive error more than -4.00D refractive required good corneal thickness. For this reason borderline, corneal thickness with healthy cornea is suitable for PRK (Photorefractive keratectomy).

Steep Cornea: – If the cornea is too steep and near the border line of keratoconus, then LASIK should be avoided. Because in future, it can lead to corneal ectasia.

Large pupil: – Size of the pupil should be evaluated in dark or semi-dark room. Generally, the surgeon looks for the pupil size at undilated aberrometry report. If the people size is too large at dark or semi-dark condition then flap size should be bigger than that. If the flap size is small such condition patient will be experienced with glare, halos, ghost image etc at night time. The patient often complaints about difficulty at night driving. Due to large pupil sometimes doctor denied for the surgery.

Any doubt about LASIK then please consult with your local LASIK specialist.

 
Krishnendu Mandal
Optometrist, Blogger, Blogging since Jan 2016

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