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ARE YOU A SUITABLE CANDIDATE?
* First of all you should be above 18 years of age with a stable spectacle power between -1.0 to -25.0 or +1.0 to +8.0 and cylinder from +/-0.5 to 6.0.
* There is no upper age limit but generally only distance vision or constant use numbers are recommended to be corrected.People needing only near or reading glasses(presbyopia) are not suitable.
* If you have significant post operative refractive error following I.O.L.,cataract surgery or keratoplasty.
* Provided that you do not suffer from corneal surface disorder,keratoconus,dry eyes,unoperated cataract,glaucoma,significant retinal pathology,diabetes,connective tissue disorder etc.
* CONTACT LENSE USERS ARE ADVISED TO DISCONTINUE LENSES BEFORE CHECK UP.It is preferable to wait for at least 1 week in case of soft contact lenses while RGP(semi soft) and hard lens users are advised to wait for 2 and 3 weeks respectively.
What if I move my eye during the laser treatment?
While the treatment is performed, you will be asked to look at a light under the laser. You are required to look steadily at the light throughout the operation, since this keeps the eye centred under the laser. However, if you temporarily look away or lose the ability to look at the fixation light, do not be concerned. The laser is equipped with a special eye tracker that tracks the eye at 200 times a second throughout the proced
I have kerataconus and I would like to know if I am a candidate for laser eye surgery.
Laser vision correction is not suggested for patients with keratoconus. However, it is important to treat this condition to prevent it from progressing. Our very sensitive topolyzer grades the keratoconus and gives us the right treatment plan, which may include collagen cross-linking ( C3R-CSO Vega) to prevent further progression, and fitting rigid contact lenses. For more information on keratoconus, see KERATOCONUS AND CORNEAL COLLAGEN CROSS-LINKING.
How much involvement of the doctor is required? Is the procedure manual or automatic ?
Our LASIK Experts Dr. Rohit Grover & Dr.Sujata Grover are involved in the entire process of consultation and do all the LASIK specific tests themselves. This is one of the reasons for our excellent outcomes. The LASIK procedure is also performed by him / her only. The process is automated. The Wavefront maps are also analysed and accepted through our laser software. Our laser also has one of the active eye trackers, so even if you move your eyes during the treatment, the laser shot falls where it has to, as the tracker tracks your eye at 200 times a second!
Will I be able to get rid of my glasses completely?
That is our aim too. The only thing that we prepare our patients for is the event of needing a touch up or re treatment as they call it. This is sometimes because, in spite of having done our best and taken all predictable objectives, we still cannot predict wound healing. However, this is treatable and we offer to re-treat this number free of cost. Hence, it only means that in RARE cases LASIK may be in two steps. The rate of this re-treatment or fine tuning in our center is less than 1% which in most centers is above 5 %.
The success rates of each center differ and that is because success depends on a combination of doctors experience, technology the doctor is using and the general practices of sterilization, disposables etc.
What exactly are the other vision problems removed by the wavefront technique?
Higher order aberrations, decreased contrast, haloes, glares.
Is Intralase LASIK or All laser bladeless LASIK safer ?
In the procedure of LASIK, before the laser shoots off the numbers we need to make a flap. The flap is created with a microkeratome. The thickness of the flap to be taken is determined during your evaluation process. Many centres faced problems in LASIK not because of the laser but also because of poor flap technique. The best laser in the world still does not compensate for a poor surgical technique and a good pre-laser work-up data. That is why we stress that the success is dependent on the combination of doctors skill, laser technology and strict hygiene.
To quote another expert, It's like Tiger Woods and a weekend golfer who both use the same top golf clubs.
Who do you think will get better results with the same golf clubs?
Intralase / Ziemer / Femtosecond LASIK or Bladeless LASIK as it is marketed was designed to overcome flap complications. In many countries where many doctors are jumping into LASIK practice with little experience there are more chances of flap complications and USA has decided to address it with the intralase laser technology. The intralase uses a technique of air bubbles expanding to make the cut for the flap instead of a microkeratome blade. This would be more useful for doctors who are LASIK beginners and not so important for experts using modern high precision microkeratomes. Femto / I-Lasik makes the procedure costlier without increasing the safety or accuracy of results. Most importantly, currently, the technique of intralase makes the corneal bed uneven before the LASIK treatment and also makes the flap edge less clean than a flap cut with the microkeratome, hence the healing of the cornea is uveven and prolonged in many cases. Epi-K, Moria-CB & M2 Micro-keratomes are used. To make you understand better, just think why don't F1 racing cars use automatic gears to compensate for the drivers skills.
After the laser, when could I return back to work ? Can I also start working extensively on computers ?
For the first 7 to 10 days, you may need to go a bit easy by taking frequent breaks and resting with eyes gently closed for short periods. Many patients undergoing lasik are computer professionals or call-centre workers and thay all carry on their regular jobs after lasik.
Since I am used to head bath every day , hence after how many days could I go for a head bath? Is one suppose to wear sun glasses for a long period?
You are advised to avoid hair bath for three days post LASIK, but a body bath can be taken the next day itself. This is a precaution to avoid the chance of having shampoo enter your eye and make you rub or itch hard. The sunglasses (dark, light coloured or photochromic sun-sensors) are also eye protection form dust and wind (foreign particles) or accidently rubbing your eyes in the first week when your eyes are still healing. After that we hope it becomes a habit to wear good sunwear for UV protection.
The only make up I do is an eye make-up, is there a restriction here?
This needs to be avoided for about 2 weekS since the eye drops are also being used and the eyes are still healing
How long will the examination procedure take?
Upto 2 hrs or more depending on the time taken by your eyes to dilate. You cannot self drive the day of the check up as your eyes are dilated.
How soon would the test results be available after a thorough examination is done?
Immediately after the check up Dr. Grover will inform you if you are fit for this procedure.
Would Dr. Grover personally conduct the eye-tests along with the surgery?
Yes, and that is one of the reasons that we have excellent results
I understand Wavefront-guided LASIK is what is being carried out recently by taking a 3D map of the eyes in order to customise the treatment to each person. I believe this is best for better night vision and the absence of glare and halo effects. A friend of mine had glare and not so great night vision. Have any of your patients had any issues with night vision and glare ?
Wavefront-guided LASIK or custom LASIK is the most advanced LASIK method today. But it can be performed using various lasers. The speed of the laser and its application are very important in delivering results. Today, we use one of world’s fastest lasers. Many older lasers are only upgraded for Wavefront-guided treatments whereas the Nidek EC-5000 CXIII is built from scratch for incorporating wavefront principles. That is why our laser has near-zero night vision problems like glare and haloes, which may still occur with other systems. We also check your pupil size to ensure a more customized treatment zone. We have no recorded night vision problems, one of the reasons why many of our patients are from other countries. This laser is available at very few centres in the US.
Further, the US-FDA has stated the Wavefront laser to be the only laser to improve night vision.
I also wanted to be clear that in both LASIK and Wavefront-guided LASIK, the eyes are kept gently open with a clip and the microkeratome creates a “corneal flap”. The cornea is reshaped with a laser and the flap is replaced or repositioned on the new corneal curvature. Which means a flap has to be created...?
Any procedure on the eyes needs the eyes to be kept open. In LASIK the anaesthesia is in the form of eye drops. The eyes are kept open with a clip. This does not hurt. Some do feel a 'kind of stretch' on their lids for a few seconds. There is no pain. You are able to keep the eyes open without feeling the urge to close your eyes due to the effect of anaesthesia.
What makes LASIK; was invented 20 years ago is the LASIK flap. It is created with a microkeratome before the laser removes the numbers. The thickness of the flap to be taken is determined during your evaluation process. We work best with the Moria M2 microkeratome, a completely automated and very safe device for creating the flap.
At what stage would the strength of our vision be determined e.g. 20/20 ? Is it right after surgery or can this be determined prior ?
You are asked to come for a check the next day, wherein you will be examined for complete healing and 20/20 vision. In very few patients healing takes longer, sometimes weeks. A simple check determines if there is any number that needs fine tuning or enhancement.
For how long roughly do we have to put all the various drops initially ?
You are given a kit containing antibiotic and anti-inflammatory eye drops to be used for a week only. Lubricating eye drops are used for a month or two, after which it is need-based.
Do eyes feel very dry after surgery? Although, this varies from person to person, how long could this last for (max period) ?
We check every patient for dryness before the surgery (during your LASIK evaluation). If you have severely dry eyes, LASIK is discouraged until the dryness is treated. If the dryness is mild, EpiLASIK is the choice. However, temporarily for some days to some weeks (upto 6 weeks) one can feel 'dry'. Using lubricating eye drops decreases dryness for those sitting on the computers for very long hours [computer vision syndrome].
Is the sensitivity very uncomfortable? Does it hurt? How long does this last for?
Your eyes may water or burn. You may feel a poking and pricking sensation for only a few hours after LASIK, between 2 hours to 6 hours. Keep your eyes closed for most of those hours or 'sleep it out'.
Do the eyes get more sensitive to light than before - e.g. glare of the sun? How long does this last for?
This is only for the first day and probably very bright sunlight for a week (which happens to all people). Hence you must use good UV-protective sunwear for a few days after LASIK which is any case a good habit for the eyes to prevent UV damage.
Do eyes get tired/strained easily after LASIK, e.g. after long hours on computer, or out till late?
This happens for most only in the first week or two. Hence our advice is to get back to work, but work with frequent short few second breaks between computer uses.
This feeling of eye strain is sometimes described by patients to be the kind that people get when they have change of spectacle number and they have to get used to a new pair of glasses.
What would you say is the maximum recuperation period? From what I read, it only takes few days to a week/10 days, but it’s best to take care for upto a month. I guess it depends from person to person.
Yes, on an average most people recover after a week to 10 days. Some take longer, even upto about 6 weeks.
No rubbing/ knuckling or touching the eyes – for how long? Is it just the 1st week or the first month?
No touching the eyes for the first day, we give you a protective eye wear to help you through with that. No vigorous rubbing for a month, but you can gently clean and touch your eyes, rub the corners gently from the next day.
What happens if we accidentally touch and/or rub the eye(s)?
If you just touch and it does not scratch the cornea, its fine, but if your eyes are open and it scratches the cornea, it can disturb the healing process. We advise you to wear the protective wear in the first 6 hours during which time the flap heals. After that it takes a vigorous amount of rubbing to displace what we have done.
I understand that hair should be washed the on the day of surgery and then not until after the next 48hrs. How soon after the surgery can we wash our eyes, face? I believe a shower can be taken the next day itself?
The logic is the same, as shampoo entering the eyes can lead to an urge to rub the eyes hard, hence avoided for 2-3 days. The face may be washed the next day itself.
What if water gets into the eyes?
The water may sting your eyes as it would even otherwise. It is however, not a good idea to purposefully wash your eyes or splash water in your eyes. It is questionable that tap water is free from bacteria. It also washes away your natural tears which protect your eyes. You are advised not to splash water into eyes for about 3 to 4 weeks after lasik.
How soon after the surgery can one have a facial?
After about 10 to 15 days, keeping in mind to tell them not to rub over the eyes.
How soon after the surgery can one start applying mascara, eye shadow, eyeliner, eye cream/mask? What is the maximum time we would have to wait for? I need to be sure that I will definitely be able to carry on applying eye makeup etc as normal. I know that none of these should be worn for at least 2 days prior to LASIK but was not sure what happens thereafter.A
You may start all these after about 10 -15 days with make up you were using earlier to be sure that it is not allergic to your eyes.
How long do we have to refrain from the gym? I understand that swimming and other physical/contact sports must be avoided for at least a month.
Yes, swimming is to be avoided for about a month, unless after 2 weeks or so you want to swim with swimming goggles on the surface of the pool. This is permissible after your post procedure eye examination with the doctor who will give you clearance for the same.
Gym may be started after 2-3 days where you can use treadmills, exercise equipment, but no sauna or steam till about 15-20 days or so. The eyes may be sensitive to some aerosols or aroma oils. Avoid games or situations where you are lilely hit on the eye directly.
How soon after the surgery can we start watching TV, reading, using PC?
Next day itself. However for a week like mentioned earlier, it may be in short spans and moderate work.
I know you had mentioned you can make arrangements for your patients’ stay, if need be. What sort of accommodation do you offer?
You can be provided a room in the hospital itself free of cost for one day. Extra stay if needed in the hospital is very nominal. Moreover Sector 35, Chandigarh (within 1.5 km. of the Hospital) has almost half of the entire city's hotels, so generally accommodation here is not a problem.
Are there any other risks involved with LASIK? If so, what are they?
I do appreciate your concerns about the procedure. These are your healthy normal eyes we are talking about! That is why we use the finest technology and deliver successful results! What may help is visiting some sites like the US FDA website. This will help you at least identify centers with older lasers and you can learn more about the laser technology and how success rates differ for each type of technology. With our strict protocols and way of working we have never had any case of infection. Complications of LASIK include those from the technology like night vision problems. Since our laser system is most advanced it has near zero night vision trouble. In fact with our experience and reputation we have corrected complications of other centers. Other complications are more consequences of doing LASIK on an unsuitable candidate such as one who has dry eyes. So, dry eyes are another problem that you will read about. Again in our center, we check all patients with a special dry eye test. If any patient is found to have dry eyes, then depending on the severity appropriate treatment is advised to the patients. For mild to moderate dry eyes we suggest Epi LASIK.
I am about to be married and therefore do need to be sure the LASIK is safe and I need to be able to look into a camera flash ?
You can face lights the same way that you can face them now. We recommend not facing harsh lights or bright sunlight for a few days.
Are there any other restrictions apart from the ones mentioned in your leaflets?
These may be specific to your lifestyle which can be discussed during your visit.
Someone mentioned that after pregnancy, due to hormonal changes, her number came back and therefore it is better to do LASIK after having kids. Does that happen in certain cases?
No, the glasses number never reverses totally, in very few people some slight number (-0.5 to -0.75) may come, not due to decrease in laser effect but due to increase of the inherent number. Hormones not only in pregnancy but sometimes even higher doses due to hormonal imbalance like in hirsuitism etc can lead to slightly fluctuating numbers. However, this does not happen to everyone, and neither is there any predictor in whom it may happen. Studies indicate that those on hormones, even oral contraceptive pills and pregnancy can have slight variation in numbers. In our practice we have not seen this happen. The possibility of needing an enhancement or re treatment has to be then explored. Though we do not recommend having Lasik during pregnency or till three months after delivery, numbers coming back after pregnency are as uncommon as glasses number increasing after each pregnency. We have had only 2 such cases in past more than a decade. These too were retreated free of cost by Lasik enhancement.
What is the advantage of performing LASIK with the 90 microns disposable kit?
The US FDA gives a baseline of 250 microns cornea to be left behind after the laser treatment. Our centre believes in leaving at least 350 microns. Your calculation will be done during evaluation. It should leave at least 350 microns behind on the cornea after the laser treatment is completed.
The cornea is like the door to your eye and the stronger or thicker the door, the better it is for you.
The Nidek CX-III laser which we use has its advantages in this respect of corneal saving as this laser saves upto 40% of the cornea compared to other lasers. In simple terms it means that another laser would remove far more corneal tissue to remove the same number. Also, when creating a 90 micron flap, it leaves even more cornea after the procedure. This is its only advantage, a great advantage for people with high numbers or people which other laser centres cannot treat.
Using this kit does not mean any faster or better visual recovery.
Is there a temporary loss of vision i.e. blackout during the procedure?
When instruments come in and out of your vision, at times you do not see the green light we ask you to focus on. When the microkeratome is also applied for a few seconds you cannot see the focus light. ‘Black out’ sounds more like unconsciousness which it is not. In our centre the procedure is very smooth and soothing. There are no shocks or surprises. Dr. Grover is in conversation with you throughout to make you feel comfortable during the process.
What is the worse case scenario?
Again differs from centre to centre. In our centre we have the longest experience with wavefront-guided LASIK in India. We have one of the most advanced technologies in the first and only eye hospital in India to be given JCI accreditation. We prepare you for just one thing. Less than 1% of the time to max 2% of the time, the treatment may need fine tuning. This is called enhancement. We use all your eye maps to predict all your number to have been removed. However, we cannot predict corneal healing a 100% and sometimes there is a small refractive error of say 0.50 D upto 1.00 D that needs a touch up.
The FDA website does mention quite a number of risks and complications which are frightening... What is the percentage of such cases?
Like I mentioned earlier, it will depend from centre to centre. Some use old technology, some have inexperienced surgeons, some centres reuse disposables, hence, its always best to visit the centre you feel more comfortable with and go through the process of research and get your queries answered.
Rubbing of the eyes: Once the initial recovery period is over – say 1 month, it is but natural that we would be touching our eyes (washing, using eye makeup, threading…), swimming and rub them when they itch sometimes. E.g. sometimes, when the wind blows, a few strands of our hair can get into our eye. Would all that be ok and normal rubbing as long as it’s not such vigorous rubbing? If Lasik is meant to give us a new pair of eyes, it should not affect in the sense that our eyes should still be normal and healthy eyes after the 1st month, right? How quickly does the flap heal?
The flap heals overnight. Then it takes vigorous amount of rubbing to displace it, which most are careful about. We have never seen a case of displaced flap. We also give protective eye wear for the immediate post procedure period.
Rest, you can wash your face, gently clean the eyes from the next day itself. In some, microscopic healing goes on for a couple of weeks.
After the one month visit, when is the next visit? 3 months? In the case where patients live overseas, what happens and where would they carry out routine checkups - at the opticians or with an eye surgeon/ophthalmologist at a clinic?
Our overseas patients visit their optometrist at the end of 3 to 6 months and definitely as their annual visit, nothing special.
Should coloured contact lenses be avoided for at least the first 6 months?
The doctor will guide you after the procedure. However, on average, 3 months is fine using a good quality coloured lens.
What happens if someone has cataract later in life? I understand patients who’ve had Lasik can still be treated for cataract?
All you need to do is inform the cataract doctor who will need to calculate the power of the lens to be implanted accordingly. The cataract surgery itself does not differ.
I have a thin cornea
This may not pose a problem for us as we have a two-fold advantage of a laser which saves 40% cornea compared to most others and using a special kit which saves 90 microns more or performing Epi-LASIK or Epi-C-LASIK. If the cornea is very thin as per your number you may be rejected.
I have high numbers
We can treat numbers as high as -14.00 D but even say 'no' to smaller numbers as the suitability for LASIK is not just dependent on numbers alone.
For the thin cornea, and the power I have, do you recommend EPILASIK and whether 100% correction can be obtained post EPILASIK or should I wear any glasses after the procedure?
We can answer the part of suitability for your eyes when our doctor has examined you. However, in all the patients we have done, whether EpiLASIK or LASIK, we achieve what we aim for, rarely; this has to be done in two steps, which is less than 1% of the time.
If I clear the above conditions, whether the procedure is safe and does not pose any problems in my future life. What is the life of this procedure? i.e. do I need to wear any glasses in future?
The LASIK procedure does not have any long term effects from all studies so far done. Any event in your life which would have changed your optics such as getting a cataract in your 50's or a retina problem due to age, diabetes etc. would affect vision. But these events would have happened even if you did not do LASIK. These are events which happen inside the eye, while in LASIK and EpiLASIK we work on the surface.
Is there any danger which can lead to squint or blurriness or losing of eyesight?
This has never been faced in our Center. We are very strict about not only our protocols, using complete disposable kits and tight infection control, we also use very sensitive tools which help us screen the candidates thoroughly.
I work for a software company and required to see the monitor for at least 8 hours in a day. Will I be comfortable working?
A Most of our patients are computer users for many hours. Yes, you will be able to work well. For the first few days you may feel a bit of strain, which will settle. However, to avoid getting a shift in getting any number you will be taught how to sit correctly in front of the PC. There is more about Computer Vision Syndrome.
If 100% correction is obtained, will it stay through out my life or in future any power will add in?
The reasons for numbers ‘coming back’ are many, depending on technology and expertise. Older technology or unsuitable patients for that particular technology may result in having some numbers ‘coming back’ or ‘left behind’. This does not happen with advanced treatments with good expertise, hence we make all our enquiries aware that the results will not be the same in all LASIK centers and hence to research and choose well. In fact, we use specific Aberrometer, Topo-Link customized treatments for such patients to re treat them. However, other factors like use of a computer indiscriminately or poor visual habits or hereditary factors which affect eye sight are not in our control. If you pose a high risk for any of these, you must discuss the same with the doctor to clarify your specific doubts. Some visual changes in your life would be independent of the LASIK procedure as it could happen in some part of the eye which has no correlation to LASIK, eg Cataract, Retinopathy etc.
I have been considering the IOL surgery, but I feel that in a few years the technology will be improved. Is it possible to have the laser treatment now and sometime in the future still be able to have IOL if I decide, or does one preclude the other?
Yes, even today the IOL surgery has changed, not so much for the surgery part, but for the implants used. Today we can offer Multifocal lens implants for patients of cataract and even the same for people with glasses over the age of 40 years even if they do not have a cataract. This is called PRELEX or Presbyopis Lens Exchange. The suitability of what is best is usually done by our cornea and refractive surgeon who performs both the procedures. MULTI-FOCAL LASIK IS BEST SUITED FOR SUCH PATIENTS. We are the pioneers and leaders in this techique in North INDIA.
To answer your query of the possibility of undergoing IOL surgery after LASIK....nothing changes, the surgery would be the same. The only point to remember would be to inform your doctor doing the IOL surgery that you had undergone LASIK. This is because the IOL also has a certain power, measured specific to your eye. Today's implants are aiming to not just treat a cataract alone, but also correct the numbers, so the calculation of what implant goes in depends on the measurements taken by the doctor who will need to adjust the same considering you have undergone LASIK. Besides this, the recovery etc remains the same as for anybody else.
Now, coming to monovision...
Over 40 years of age everyone gets reading glasses, no one is exempt of it. Some people get this 'plus' or 'reading glasses' after 50 years, hence this depends from person to person, different race, heriditary factors etc. But all get it at some point, if this happens after 40 years it is an acceptable natural change in the optics of your eyes, called 'Presbyopia'.
If one has myopia (minus numbers for distance), it helps you push the need for reading glasses behind by a year or so. Hence, if a Myopic who is not using glasses for reading were were to do LASIK today, yes he/she would need reading glasses, depending on when they would have naturally got them.
Now, the reading glasses is something that one can never avoid completely, so eventually it Myopics will need to use bi- focals.
Monovision is an option wherein we correct myopia completely for one eye and leave behind a minor number in the other. It sounds odd, but over time one learns to read the distance with the eye good for far vision and reads near for comfortable print by the eye left behind with a small number. This is accepted by most who wear contact lenses where their optician has given them this monovision trial in their lenses, ie. one lens has the actual number so you read clearly with this and the other lens is slightly undercorrected so you read near with this. Now, when one wants to do extensive near reading it may be a strain. So, we recommend them to use near glasses as per what is required for their age when they are doing near work for a long time.
When we have performed monovision for people who have never undergone the monovision trial, we have found that they are neither happy for far, nor happy for near.
As explained earliar MULTIFOCAL-LASIK IS THE BEST OPTION for such patients. Many times even younger patients undergo multifocal LASIK to avoid near glasses at a later age.
I am on medication for TSH (Thyroid) imbalance. So am I eligible for the treatment?
Our refractive consultant will be doing specific tests for LASIK to check the effect of the thyroid problem and its medications on the eyes such as dryness, Glaucoma, Proptosis, changing numbers etc.
In the absence of which you may undergo the procedure, if found suitable for the same. We can also perform EpiLASIK in certain situations like Dry eyes. Also, you would know if your numbers have changed drastically over the years that you were diagnosed with this condition, hence please bring along your records. The eligibility depends on the tests that are done, just a history of hypo or hyper thyroidism does not make you unfit.
Do Floaters affect the eligibility or outcome of LASIK?
No, LASIK is performed on the cornea which is a superficial part of the eye. The floaters exist in the vitreous (inner part of the eye) and hence no laser surgery on the eye can help the floaters. LASIK can be performed if you have no other indication which deems you unfit. However, one must keep in mind that the floaters may not improve after LASIK and if they worsen, it again has no link to this procedure.
For Out Of Town patients:
There are special queries that our patients from other parts of India and from abroad raise. We have tried to address most here. If there is anything that we have missed or something more that you would like to know from us kindly contact us on info@c-lasik.org, We will try and make you comfortable doing this procedure with us.
How many days can I expect to stay in Chandigarh ?
We usually advise you to reach at least a day before the procedure so that the evaluation and examination can be done. This examination procedure takes about an hour and the only important instruction you need to follow is to be off soft contact lenses for about a week before the examina tion and off hard or semi soft contact lenses for about 2-3 weeks. We do Lasik almost every day, but it is always better to fix an appointment before coming.
The procedure time is about 10 minutes per eye and you are sent home soon after.
We need to see you for a post LASIK check up the next day and once again 3-4 days later.
Do I need any follow up when I leave INDIA / reach my hometown?
You can travel anywhere after 3 days of the procedure (5 days if Epi-Lasik) and need not be seen by us again unless convenient to you. You will be asked to follow up in your own city and give us a detailed report of the same. Follow can be done at an eye surgeon as a consultation, that too after 3 months of the procedure.
I.O.P. (Intra-Ocular Pressure, eye pressure) by non-contact (air-puff tonometer) should be checked after 3 weeks and 6 weeks. I.O.P. recorded should be less than 18 mmHg for most patients. The regular follow up schedule if convenient to you would be … the next day, after 7-10 days, after 3 months and then after a year.
Can I travel within India on a holiday ?
Yes, as told above you can travel anywhere after 3 days of the procedure, go on a nice vacation WITHOUT glasses! Usually, most people prefer to do the LASIK procedure before their vacation, so that they may enjoy the same. Also, since most come back to Chandigarh/ Delhi/ Amritsar before flying out, they get a chance to come for a follow-up check up again. However we leave it up to you to plan your procedure during your trip and would help you schedule the dates for the same. Many of our patients go to Himalayas and other places in India after LASIK.
What precautions do I need to take, dos & dont's after LASIK on my trip ?
The precautions are fairly simple and would be similar to all irrespective of LASIK done. The fear is of catching an eye infection or disturbing the flap by rubbing the eyes accidently. The first week after LASIK you will be on eye drops which are antibiotics so that aspect is anyways taken care of. However, some general and basic rules of hygiene such as not rubbing your eyes, carrying a hand sanitizer to keep the hands clean etc helps. We ask you to wear a pair of good UV protecting sunglasses when outdoors to protect your eyes from dust, strong sunlight and allergens. Only swimming is to be avoided for a few days.
Is it safe to do this procedure in India ?
The success of laser vision correction or LASIK depends on a multitude of factors, primary being the expertise of the doctor along with a good laser technology in an International standard of care with stringent eligibility criteria.
Many doctors today budget the LASIK and discount LASIK prices esp in India. This is only possible if one can cut costs, but that would be at the cost of compromising quality, working with older cheaper technology etc. These lasers do not have wavefront technology either. In the USA the FDA has even proven that most complications arise in discount LASIK centres.
We are proud to say that, with strict protocols of medical care and with Wave-front Nidek EC-5000 CXIII Quest laser system using wavefront or custom LASIK technology, we offer a far superior, safe and reliable technology at affordable comparable prices.
How different are you from other laser / LASIK centres?
Dr. Rohit Grover & Dr.Sujata Grover at the GROVER EYE LASER & E.N.T. HOSPITAL, Chandigarh have both academic distinction and several years of experience in LASIK and are among the country's longest-standing users of the benchmark 'flying-spot' and 'scanning slit' laser technology.
Wavefront LASIK or custom LASIK C-LASIK is the most advanced LASIK method today. It can be performed using various lasers. The speed of the laser and its applications are very important in delivering results. We use the world's fastest laser system with wavefront technology. Moreover it has 6 Gaussian Laser Spots of 1mm each along with scanning slit thus combining advantages for both flying spot and large beam lasers. The best advantage is that it uses least corneal tissue even for high numbers and has shortest possible treatment time, thus combining safety, accuracy and speed.
Wavefront technology has been around since 1998. It is specifically for those patients who would end up unhappy if a standard LASIK procedure is done on them. These patients are detected during their LASIK screening and evaluation, by certain specific indications which would arise on the topography and aberrometry tests. It is also a technology for those who have undergone LASIK on poor obsolete lasers or have undergone PRK or RK [other techniques for removal of spectacle numbers] and are having problems.
We believe in the best, having always stood for distinction in eye care.
Earlier lasers without wavefront technology can only correct the spectacle number, which arises from the curvature irregularities of the cornea. Our laser can treat the entire optical system errors. Further, when we treat these optical errors by doing wavefront, some patients actually gain lines of sight, better than 6/6 OR 20/20.
Then again, that is not our aim alone. We want to give quality of sight. By which I mean good contrast sensitivity and good night vision. In the night the pupil expands or dilates to let in more light for visibility. If a laser treats a zone, which is smaller in diameter than the diameter of expansion of the pupil, then what you have is an untreated rim of cornea, which in the night is going to disperse light in various directions resulting in haloes or glares of light. This is the problem most of the West ie. USA is facing, because most of their lasers treat a 5 mm zone only and because of lighter colored eyes, their pupils [in US] can dilate upto 7 mm. Our laser can treat wide pupils and has a near zero percent of night vision problems in our experience.
A unique Iris Pattern Recognition programme matches the eye tested with the eye treated, compensates on-line for any rotation (cyclo-torsion) of the eye from sitting to lying down position in addition to keeping the cylinder axis of treatment accurately aligned to the eye.
There is a lot more of this laser, which helps the patient and the doctor. We can now treat higher numbers with more accuracy, re- treat earlier laser unhappy patients to get better night vision etc. and include patients who would have been poor candidates for earlier technology. This is why our success rates have been good from the beginning, as we have been thorough in our patient evaluation and stringent in our eligibility criteria.
Would you buy a discount life jacket?
If you are considering LASIK, there are certain things that you should consider for successful treatments. Be wary of hard-sell and deep discounts. We are talking about your eyes, not eggs or boxes of soap. LASIK is a surgical procedure not some form of commodity that warrants celebrity branding!! These are your only pair of eyes which are not replaceable.
How long has the surgeon been working with this technology?
You must find a place with sufficient experience. You don't want to be someone's first case, or even their fiftieth!
The levels of risk and benefit vary not only from the laser technology but also from surgeon to surgeon depending on their level of experience with that particular laser. With new lasers entering the market rapidly, be aware that it generally takes approximately 200 to 500 LASIK procedures before a nomogram is reasonably well developed. The nomogram defines the formula that the surgeon enters into the excimer laser's computer for performing your procedure. It is based on a series of measurements performed at the time of the preoperative exam, as well as on the surgeon's technique and the laser used. A well developed nomogram allows the surgeon to more accurately program the laser for each patient, decreasing the probability that an enhancement procedure will be necessary.
What is the surgeon’s experience?
Numerous studies have shown that surgeons experience a learning curve with the LASIK procedure. It has been shown that surgeons who have performed over 300 procedures have a lower complication rate than those who have performed fewer. Moreover,
Watch out for misleading advertising claims.
The most important decision you will make when considering laser eye surgery will certainly be the choice of doctor who will perform your laser. This is more important than whether or not to have the surgery done. An ethical and conscientious surgeon will advise you as to whether or not laser correction is right for you. This must be based upon your own particular eyes, health and situation. It is a unique decision and you need the best advice as to what is right for you.
Like a formula 1 racing car, anyone can get it round the track but it needs special skills to make the machine perform at its best.
What percent of his/her patients read 20/20 or better with Snellen Uncorrected Visual Acuity (UCVA)?
The answer should be over 97 %. Be wary of anyone saying 100%!
Determine who will be doing your preoperative and postoperative care: the LASIK surgeon or his or her assistants?
Many a times the pre operative work us is done by an assistant and not the main surgeon himself. This is a cause for concern at times because the data which is collected at the time of examination is what is fed into the laser and has to be accurate. Hence, it is best left in the hands of the expert.
The most advanced form of LASIK is wavefront-guided LASIK. It takes great experience to accurately procure, read, form treatment profiles and execute to perfection. Our surgeon is an international instructor for wavefront-guided treatments
Your results depend on what is fed into the laser computer. Remember GIGO garbage in, garbage out.
Find an experienced LASIK surgeon who will make the commitment to you to take full responsibility for your LASIK result, who will meet you prior to surgery, and who will be actively involved in every aspect of your LASIK procedure.
Be sure you know who is actually doing the procedure. Ask who will be doing your follow-up. Ask about their qualifications. Find out how many procedures he or she has done. While higher volume does not necessarily imply a better surgeon, you will want someone who has done at least several hundred surgeries.
Determine for yourself whether the LASIK surgeon has a kind, compassionate staff to help support you emotionally throughout the LASIK process.
Have you had any complications?
Beware of any surgeon who says never! The surgeon who does not operate never has any complications !!
Surgical success means more than knowing how to avoid complications; it means knowing how to handle difficult situations before they arise. Identifying problems early and dealing with them in a timely manner is the hallmark of excellent surgeons. All surgeons have complications, but that does not mean that anything was done wrong. What is important is that the surgeon has a low complication rate and that the ultimate visual outcomes be good.
REASONS TO UNDERGO LASIK
Some of the common reasons why people undergo LASIK or get rid of their spectacles and contact lenses are : contact lens intolerance, cosmetic reasons, social (marriage), tired of wearing glasses, and lifestyle activities that are inhibited due to glasses or lens wear such as outdoor sports like golf, football, water sports or hiking. In some careers such as Merchant Navy and Airways it is a requirement to have 20/20 or 6/6 vision. LASIK helps tremendously here.
Spectacles are cosmetically unappealing for some. There is a degree of distortion when looking through the periphery of the glasses, the field of vision is reduced and on leaving a cold room moisture can fog the glasses and blur vision for a few minutes. Hence glasses are unacceptable for certain careers. Contact lenses require motivation with great attention to hygiene during insertion and removal, failing which sight - threatening infections may result.
LASIK overcomes all these disadvantages.
PRINCIPLES OF WAVEFRONT IMAGING
Light falling on the cornea [the front surface of the eye] has a smooth curvature- referred to as a "wavefront". As this smooth wavefront shape courses through the various optics of the eye, ocular aberrations [imperfections] are induced. It results in an irregular wavefront curvature reaching the retinal surface, which degrades the retinal image quality. An aberration-free eye would result in a smooth wavefront image on the retinal surface. Wavefront-guided customized LASIK, also referred to as "customized ablation" or custom LASIK performs corrections based on individual wavefront measurements.
Current refractive procedures such as traditional or standard LASIK correct lower order aberrations such as spherical and cylindrical numbers alone. However, higher order aberrations affect the quality of vision and may not significantly affect the vision as read on the chart. It is these subtle deviations from the ideal optical system, which can be corrected by wavefront procedures, and thereby improve image quality.
CONSULTATION
The consultation and LASIK work up will be performed by Dr. Rohit Grover, our LASIK surgeon at Gover Eye Hospital, Chandigarh, India. He has large experience with LASIK and even trains doctors worldwide on wavefront [Custom LASIK] measurements.
A complete eye assessment is required to check a patient's suitability for LASIK.
Tests include refraction, contrast sensitivity, pupil size, pupil reaction, slit lamp examination, retinal examination, tonometry, pachymetry, aberrometry, topography and tests for dry eye amongst others. These tests would take about 60-90 minutes as it includes pupillary dilation.
For your own safety we request you to not self-drive home after the tests as the vision may be slightly blurry for a couple of hours.
A customized treatment plan is developed and pre-procedure instructions are handed over.
THE LASIK PROCEDURE
This is an outpatient procedure that usually takes 10 minutes per eye. The actual laser treatment usually takes a few seconds. First you will lie on the motorized bed. The eyes are anesthetized with eye drops only. no injection is needed. The head is positioned under the laser. A soft clip keeps the eyelids gently and comfortably open without blinking during the treatment. You will be asked to look at a fixation light during the entire procedure to keep your eyes straight. No eye patch is given after the laser. Only protective glasses are used to protect the eyes without touching the eye.
A post - procedure eye examination is performed and eye drops are prescribed. There may be mild discomfort for a few hours after the procedure.
INSTRUCTIONS
Pre Procedure Instructions
If you are a contact lens user, please ensure that you have stopped using your soft contact lenses a week before, or semi-soft [rigid] contact lenses at least 3 weeks before the procedure date.
Do refrain from wearing any form of eye make-up for 2 days before the procedure. If possible thoroughly clean the eyelids and lashes of remnants of eye make-up.
Avoid wearing scented lotions, perfume, cologne, hair spray, eye liner or any cosmetic around eyes, mousse or gel on the procedure day as these may adversely affect the outcome of the procedure.
You may take a hair bath the day of the procedure, as washing of hair is not permitted for 48 hours post-procedure.
you can have your usual meals on the day of the procedure. You will need to have somebody accompany you to understand the post-procedure instructions and escort you home. You will not be able to drive home after the procedure.
You can expect to be at the clinic for approximately 2 hours for your laser vision correction procedure.
Post Procedure Instructions
It is crucial to the healing of your eyes and your visual recovery that you follow all of these instructions exactly as directed:
DO NOT rub or touch your eyes and DO NOT squeeze your eyes.
Follow the eye drop doses and put in your eye drops exactly as instructed. Please wash your hands prior to instilling your eye drops, preferably by someone else. Shake the eye drop bottle before use. Artificial tears may be used as often as required.
Try to rest the whole day. For 6 to 8 hours after the procedure expect irritation, redness, tears, light sensitivity and slight swelling. For the most part of the day your vision will be hazy.
It is important that you protect your eye for the day. In order to prevent inadvertent rubbing of the eye, be sure to wear eye goggles while sleeping or napping.
The next morning the functional vision is usually restored. However as the healing is happening in the line of sight, there may be some days when the vision is slightly fuzzy and other days when it is very clear. This fluctuation typically lasts about 7 to 10 days.
Wear sunglasses while outdoors for a few weeks. Should you experience severe discomfort, pain, discharge or sudden haziness of vision, call your doctor immediately.
Please do not try to do the following until instructed to do so by your doctor: showering, bathing, exercising, tanning, reading, computer use, driving and applying eye make-up.
Avoid "knuckling" the eyes and swimming for a month.
Your post-procedure appointment schedule: You will be seen the next day and if in Chandigarh, after one week. Visits upto three months are included in your LASIK package. If you have any questions, you are free to call the hospital and make an appointment.
RECOVERY
An improvement in vision is noticed within 4-6 hours with restoration of functional vision by the next morning. However, complete recovery may take upto 48 hours. Some people get back to work the day after treatment. Two or three days are suggested. For a few days after LASIK, patients may experience blurriness of vision. This is part of the healing process and this blurriness usually clears up in a few days.
LASIK is a permanent treatment. However, patients who are 40 years and above, may require reading glasses. During your consultation we will give you can an idea of the procedure and the level of vision you can expect. Millions of patients worldwide and thousands with our doctor have had an Excimer laser refractive procedure done on them successfully.
CONTRAINDICATIONS
The treatment should not be performed and the doctor informed
if you suffer from any of the following
- uncontrolled vascular disease or with autoimmune disease
- are immune-compromised or on immunity-suppressing drugs or have a previous history of keloid formation
- pregnancy, nursing, expecting to become pregnant within six months following the LASIK procedure or on hormone therapy for gynaecological dysfunction
- have residual, recurrent, or active eye disease(s) or abnormality except for myopia [or hyperopia] in either eye
- have any active or residual systemic disease(s) likely to affect wound healing capability
- had herpes infection of the eye in the past
- have unstable or uncontrolled diabetes
- have progressive myopia or hyperopia [unstable spectacle power]
- amblyopia (lazy eye); glaucoma; severe dry eye
RETREATMENTS
Our Laser, especially because of its unique corneal tissue saving feature, enables us to re-treat corneas, which would have been otherwise too thin to work upon.
Some people who have already had LASIK with earlier technologies and experience night vision disturbances can be helped with our customized topography-guided treatments.
Wavefront measurements of LASIK patients with such quality of vision complaints may demonstrate a high magnitude of higher-order aberrations.
Studies demonstrate that topography or wavefront LASIK retreatments can reduce these aberrations as well as subjectively improve these night vision and contrast sensitivity problems. Each patient needs to be individually assessed to make proper suggestions.
Post-op Refractive Surgery Complication Management: Refractive surgery complications can be divided into those which are surgically induced and managed and those which are healing or ablation related and typically require further laser retreatment.
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