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How to Care for Your Eyes Post LASIK Surgery
Along with preoperative, post operative care is also important to ensure success of the surgery. You doctor will obviously provide you with all the instructions required, but it will only help if you know beforehand.
There is bound to be some discomfort and you will face the following symptoms:
• Mild pain, irritation and itching for a few days after operation
• Blurry or hazy vision and sensitivity to light for about a week after the operation
• Halos, glares, starburst are also quite normal for up to 4 weeks after surgery.
• Fluctuations in vision for up to six months after surgery.
In some cases your doctor might prescribe a pain reliever to give you some relief. It is important that you do not scratch or rub your eye as this will damage the flap and not allow it to heal. It is obvious that you might not be able to go to work and your routine will also get disrupted. During this time, it is advisable to have help at home and preferably get someone to drop and pick you up from the clinic.
If your symptoms get worse instead of better you need to visit your doctor immediately without waiting for the scheduled visit. Regardless of your symptoms, you must visit your doctor within 24 to 48 hours of the surgery.
Your eye will be quite sensitive for a few months after the surgery, and is susceptible to much damage by any strenuous activity. Hence it is imperative that you do not:
• Indulge in any kind of sport for 3 weeks after surgery
• Indulge in any strenuous or contact sports (sport that involves direct contact with face) for 4 weeks
• Indulge in swimming or use a whirlpool or hot tub for 8 weeks
• Use make-up, creams or lotions around the eye for about two weeks after surgery
It is important to realize that vision stabilization will take a few months, and during this period halos and glares will persist. Hence you need to wait for at least six months before going in for enhancement surgery. Also note that although enhancement surgery will improve vision, it is unlikely that symptoms of glares and halos will improve. Another point is that the FDA does not conclusively state the safety or guarantee of any enhancement surgery.
What Happens During the LASIK Procedure Part 1
LASIK is an ambulatory procedure, which means you walk in to the surgery centre, finish the procedure and walk out again. Yet when you step in for the operation, you are bound to get a little overwhelmed by all the apparatus. In order to remain relaxed, it will help if you know what most of the instruments are called and what they are used for. We willl take you through the names and functions of all the equipment first and then explain the procedure in detail, so you can stay relaxed during the surgery.
Equipment:
Speculum: An instrument used to hold your eye lids apart
Suction ring: A ring placed around the cornea to apply pressure and create suction
Mechanical microkeratome: A blade device used to cut a flap on the cornea
Laser keratome: A laser device that is used to create a flap on the cornea instead of the mechanical device
Laser: The actual laser used to vaporize the tissue under the cornea. This laser is attached to a computer which determines how much of the cornea is to be reshaped.
Procedure:
Step 1: The surgeon will ask you to lie down on a reclining chair. The laser will be placed above your head. This laser will be attached to a computer screen and a microscope.
Step 2: A numbing drop is placed on the eye. The doctor might also administer a mild oral sedative. The speculum will hold your eyelids open. This will not cause any discomfort.
Step 3: (for mechanical microkeratome) - If the surgeon is using a mechanical microkeratome, the suction ring is placed over the cornea. This will apply high pressure around the cornea and you might experience some discomfort. The microkeratome is attached to the suction ring. This blade device will slide over the suction ring and cut a flap on the cornea. This flap is too thin for you to be able to see it. The keratome blade is to be used only once and then thrown away. After the flap is cut, the suction ring and mechanical microkeratome will be removed
Alternatively, if a laser keratome is used then Step 3 will vary slightly.
What Happens During the LASIK Procedure Part 2
Step 3: In case of a Laser keratome, a plastic plate is used in place of the suction ring over the cornea to flatten it. You might experience some discomfort due to the pressure. A laser light is then focused inside the cornea and thousands of gas and water bubbles are created that connect and expand to separate the layers of the corneal tissue. This creates a flap on the surface of the cornea.
Step 4: The flap will be hinged on one end, and the doctor will open it to expose the inner layer of the corneal tissue. The corneal tissue is dried before the laser begins its job. You will now be asked to focus on a spot of laser light directly above your head. It is important to note that if you cannot stare at one spot for 60 seconds, you might not be a good candidate for LASIK. The surgeon now starts the laser. The laser emits ultra-violet pulses of light which begin to painlessly vaporize parts of your cornea and reshape it. The computer is pre-programmed by the doctor with the correct specification required for reshaping your cornea. You might hear a clicking noise as the laser starts working. There will also be an acrid smell like that of hair burning which is caused due to vaporizing of the corneal tissue. The surgeon has complete control of the laser and can turn it off anytime.
Step 5: Once the corneal tissue has been vaporized according to specifications, the laser will be stopped and the flap will be put back into position. The doctor will ask you to rest for some time before beginning work on the other eye. Some even prefer doing the second eye a week later.
After the surgery is complete, a shield is placed over the eye to protect it from any foreign matter and to allow the flap to heal. You will experience very mild discomfort and some amount of itching, but keep your fingers as far away from your eyes as possible. You will need to arrange for transportation to and from the clinic. You might even want to take someone along. The entire process will not take more than 20 minutes.
How to Find the Right LASIK Surgeon
Finding a LASIK surgeon is not difficult, however, finding a good one is. Most of us feel intimidated by doctors and are shy or hesitant to ask frank questions, afraid we might offend them. However, when it comes to your well-being and safety, everything else is secondary. As a patient you have every right to not only ask but demand information. In case a doctor is not willing to share information, you know he is not the right kind to share your eyes with.
Where to look
The obvious answers would be advertisements, yellow pages, internet, or asking friends. These however, leave much to imagination. More credible sources would be –
GP- Your general physician or even your eye doctor (ophthalmologist or optometrist) will give you referrals. Take his suggestions into considerations, since he is already aware of your medical history and what kind of refractive surgery you require.
Organizations- There will be many refractive surgery centers in your area. You will also come across many associations of medical surgeons on the internet. These will mostly provide you with credentials and ratings of eye surgeons. Try the American Association of Ophthalmologists or the Fellowship of American Surgeons.
What to ask
Once you have picked out at least 2-3 surgeons, you will set up a consultation visit with each. Before the visit, it is best if you think up as many questions as you can and even write them down if required. Then ask each and every question (without batting an eyelid). Some questions that you just cannot ignore are:
• Years of practice (at least 3)
• Number of surgeries (minimum 500)
• Number of refractive surgeries that are exactly like your requirements (minimum 100)
• Number of patients that achieved 20/20 vision (generally should be 65%)
• Contact numbers of past patients
• Affiliation to any medical society or association (note down the name and look them up)
Apart from asking questions you can also judge the surgeons competency by his demeanor. If he answers even tough questions politely, offers additional literature, or informs you about various procedures apart from LASIK then you know he’s versatile and competent.
Although we tend to trust a doctor’s credentials in most cases, LASIK is big business. It’s a very lucrative money making option for most surgeons, and you do not want to be treated as just a customer. Take as much time as required while deciding on a surgeon, lest you regret your choice later.
Covering the Costs of LASIK Surgery
The cost of LASIK is probably the only deterring factor to your decision. What complicates matters is that there is no standard cost of LASIK - it differs from clinic to clinic. This is because the FDA (Food and Drug Association) of America is not authorized to regulate prices. However, because of its popularity prices are quite competitive.
The cost of LASIK can range from $499 to $2500 per eye. The cost will differ depending on the surgeon’s credentials, the location of the clinic, and what type of equipment is used for the surgery. For example using a laser keratome instead of mechanical microkeratome or technology like wavefront or custom LASIK can cost up to $500 more. Along with this many other components are part of the cost of LASIK and affect the price. Mainly the components are:
• Any royalties that the surgeon might be paying to the company that manufactures the lasers.
• Cost of purchasing and maintaining the equipment.
• All disposable materials used only for your surgery (gloves, masks, etc)
• Medications (including anesthesia) that you will be given pre and post surgery
• Rent/Lease charges
• Additional staff salaries.
• Charges of evaluation before and for 1 year after the surgery.
• Any enhancement you might require after the treatment
The other matter of concern is that LASIK is classified as a cosmetic procedure by most insurance companies and hence they will not cover it (grossly unfair, we know). However, LASIK can still become affordable with financing options. You can check with your surgeon the facility of paying in installments. You could also look for healthcare financing companies that offer loans for procedures like LASIK. There are companies that offer financing especially for LASIK through a variety of plans in which you can pay over three months to five years. However, before applying to such a company for a LASIK loan, ensure that you check with your surgeon. Not all companies work with all surgeons and it is best to clarify this beforehand.
You might have to submit certain personal details like age proof, driver’s license number and at times medical history. Ensure your papers are in order and read the fine print before signing any forms. If you are filling up an online form, ensure that the website is credible by checking with people who might have used it before. Also check the URL for ‘https’ as opposed to ‘http’ which means you are on a secure server and your personal information has been encrypted.
Selective Chemical Skin Peeling For Clearer Skin
Skin peeling was the rave because it not only promised clearer fairer skin, but also followed through with its promise. But many shy away from the procedure because of the drying effects; which could take more than a week to subside for most procedures. Typically, your face will redden and peel out in a matter of days. Depending on how strong the chemical was used, you will end up with a blotched face for at least a week. When your face returns to its normal state, all the blemishes should have lightened and the acne should have subsided. But you might have to go in for more than two sessions before your skin clears out totally.
What most people don’t know is that their whole face doesn’t have to be “burned”. Selective skin peeling is done by most dermatologists and only on the problem areas on your face. A standard peel consists of your whole face being subjected to chemicals; but this is not needed for some patients. For those with slight pigmentation and acne problems; only the areas that need treatment are patted with chemicals.
The chemicals usually used are Phenol, AHAs (alphahydroxy acids) and TCA (trichloroacetic acid). Depending on the person’s need, the formula may be changed. Some dermatologists will use stronger solutions for extreme cases, while others prefer lighter ones especially for sensitive skin.
TCA Procedure:
- Mainly used for blemishes, pigmentation from sun exposure and surface wrinkles.
- Recovery period is about 7 days.
- The effects of a TCA peel are not always that dramatic, and short lived, so patients may have to go in for more than 1 session.
Phenol Peel:
- Provides a deep skin peel.
- Used to treat coarse wrinkles, damaged or blotchy skin due to excessive exposure from the sun, as well as pre-cancerous growth.
- Phenol treatment is not always advised as it will lighten some parts of your face. The bleaching effect may not be desired especially for those women who have darker skin coloring.
AHA Skin Peel:
- Dermatologists use this chemical for acne, scarring and light skin pigmentation.
- A very mild peel recommended for those who would like to recover faster, but it may take a few sessions to get desired result.
- Recovery period doesn’t last for more than a few days.
These chemicals will produce a slight stinging sensation during and after the procedure. The patient’s face will redden and become blotchy. It’s not advisable that you wash your face or put on any kind of medication after the peel. Use sunblock to protect your skin, because you are more at risk from sun exposure since your skin has somewhat thinned out. An umbrella is also a good idea, as well as a hat to cover your face.
Patients have to remember that only certified professionals should be applying these chemicals. Do not endanger yourself by going to run of the mill clinics, because the solutions being used for chemical peels can be dangerous at some point; especially for your sensitive eyes.
