Some questions about refractive surgery and Lasik
Yes, the laser treatment with the Multispot laser beam makes a combination of the several refractive defects to be treated possible, such as myopia or hypermetropia together with astigmatism and this at the same time.
Both eyes can be operated the same day but it is your ophthalmologist who decides if this is indicated in your personal case.
After surgery the patient should rest for 24 hours. The next day, most of patients have enough good sight to be able to work or drive a car.
According to the number of dioptres and type of refraction to be treated, the recuperation is done slower or faster. In general, the vast
majority of patients can start their normal activities around 48 to 72 hours after surgery.
he patient is around 15 to 20 minutes in the operating theatre. The surgery itself doesn’t take longer than a few minutes.
Nowadays presbyopia cannot be corrected with lasik or lasek or PRK treatment. For patients over 40 years old your ophthalmologist should decide to treat one eye to plano and the other eye to undertreat (the recessive eye) with which the person should be able to read without glasses after surgery. This is what we call monovision technique.
Patient should use eye drops after surgery prescribed by the doctor. It is totally contraindicated to rub the eyes for one month after surgery, preferable even for six months. It’s also contraindicated to use make-up during the first month. Swimming is forbidden for one month. For other sport activities, please discuss it with the ophthalmologist.
Lasik surgery is not a painful technique neither before, during or after surgery. Most patients only feel during surgery a sensation of pressure due to the instruments used to fixate the eye; after surgery they can complain of rubbing sensation during the first hours postoperatively.
Most of the patients are very satisfied of the result of the lasik surgery. Like every kind of surgery there are also some risks attached to it. It is very important to know the limits and the possible complications of surgery before taking any decisions. We make a difference between complications that permanently diminish the eyesight and complications that do not permanently diminish the eyesight.
Complications or secondary effects that do not diminish the eyesight:
* Rests in the refractive defects:
overcorrection – undercorrection – astigmatism
Not all eyes see 10/10 without correction after surgery. There could be an overcorrection or an undercorrection or some astigmatism after surgery. This can always happen without distinction of the preoperative defect before surgery. If this rest refractive defect after stabilisation is still bothering, it can always be retreated with laser. Otherwise a very light glass correction be given, for example for driving at night. If reading glasses were needed before surgery, the patient will probably still need them after Lasik treatment.
* Secondary effects:
The following alterations happen regularly during the stabilisation period. They have the tendency to diminish progressively through the next weeks after surgery but sometimes some of them could stay:
- higher light sensitivity;
- halos around lights specially at night time;
- diminished eyesight at night or a slower adaptation from dark to light;
- variability in eyesight;
- dry eye, which normally gets better through use of artificial tears.
* Cornea flap problems:
During surgery we can see sometimes that the cornea flap does not have the desired form, that the flap is too thin or that the flap has an irregular thickness.
In this case the laser treatment is not performed and the flap is again put back in its original place. After 3 to 4 months the surgery can take place again.
Complications that do have a permanent limitation in sight:
An infection of the cornea with a correct use of the prescribed eye drops, happens very rarely. When an infection occurs, the possibility to cure this problem is very high with intensive treatment of antibiotics.
If the infection leaves a scar form or gives a at the interior structures of the eye, than the eyesight will be reduced. This by chance happens very seldom.
* Complications due to the cornea flap:
After surgery the cornea flap can give problems:
- The flap can move or wrongly attach.
- The flap can give faults or wrinkles after surgery.
- An infection process can sometimes give swelling of the flap and therefore eventually a kind of scars.
- Epithelial cells can sometimes grow under the flap.
When one of these problems happens, they produce low complaints. Sometimes simply with intensive drop treatment this visual problem can be prevented. Sometimes an intervention to replace the flap or remove the wrinkles is needed and sometimes we need to lift the flap again to remove the epithelial ingrowth under the flap. After this kind of retreatments the eyesight should be perfectly regained, but this is not always the case. Problems with the corneal flap can sometimes leave a limitation in eyesight and can not be treated with contact lenses or glasses. In rare cases we could advice to change the flap operatively.
After surgery the eye stays during some period more sensitive to some kind of pressure, like squash ball or a tennis ball or a scratch with a fingernail. Due to this problem the flap can sometimes be displaced and therefore the eyesight can be reduced.
* Decentration of the laser treatment:
When the laser treatment does not treat the centre of the cornea, we speak of a decentration. Due to this problem the cornea can cause a trouble sight and sometimes double images. With glasses this problem cannot always be corrected but it can be well treated with contact lenses. Most of the time with a laser retreatment it can be solved. It is also probable that due to the decentration some patients can have a reduced eyesight. This is also not be ameliorated with glasses, contact lenses or surgery.
Nowadays the lasers have an eyetracker which controls the fixation point very accurately and delivers the laser beam automatically to the right point of the cornea. Therefore decentration seldom occurs and can be avoided.