Tips and Questions about LASIK
Q: What is refractive eye disorder?
A: A situation where the image of distant or near objects (in close proximity to work) does not fall clearly on the retina.
Q: What is the difference between myopia and myopia?
A: In myopia, one does not see distant objects well and clearly. But they usually have no problem seeing objects nearby. The more severe the nose, the shorter the distance one can see accurately. But in camera people do not see good objects nor close objects.
Q: Why do the people close to the camera and the camera neither see far nor near?
A: In close-ups, the refractive power of the eye is greater than usual, or the size of the eyeball is larger than normal, so objects in the image fall far ahead of the sensitive (retina) curtain. As the objects get closer to the eye, the image is pushed backwards, so in terms of the myopia of the objects from one point to the nearest eye is seen, but in the camera people objects fall far behind the eye and the closer objects fall As the image gets farther from the eye, no camera is visible in any area.
Q: What is it like for people with astigmatism?
A: In these people, the cornea or lens is not completely spherical and one-handed, so the image of each dot does not form a dot so one does not see any dots clearly. Astigmatism can be with myopia or a combination of myopia or The two will be together.
Q: Why do people have refractive disorder?
A: The most important cause of disorders in individuals is race and inheritance. Some, however, believe that fine-tuning in the long run can cause myopia. However, traumatic injuries and some inflammatory lesions of the cornea and lens displacement are not affected by refractive disorders, especially astigmatism.
Q: How can the development of refractive disorders (myopia, hyperopia or astigmatism) be prevented? Is the regular use of glasses or adherence to a particular diet effective or preventing its progression?
A: No, unfortunately, no effective action has been taken to prevent the development of these vision problems. Regular use of glasses as well as diet have been ineffective in this regard.
Q: How is myopia divided by eye score?
C: Myopia can be divided by eye score from mild to very high, according to which the glasses score is less than three diopters, mild, between three diopters, moderate, between six and ten diopters, high and more than ten diopters. Reads above.
Q: Apart from the blurred vision, does any other problem threaten those close to them?
C: People with simple myopia (usually less than 6 diopters score) are not significantly different from normal people, but those with progressive myopia (usually more than 6 diopters) cause an increase in score. The glasses are a gradual enlargement of the eye so by increasing the size of the retina over a thin and stretched time it can increase the chances of retinal detachment. In addition, the glaucoma patients have a higher chance of developing black water than the normal population.
Q: How can myopia be corrected?
A: The correction of myopia is done in two ways: 1) Non-surgical procedures such as: glasses and contact lenses (hard or soft) 2) Surgical procedures that include: diamond knife surgery (called PRK) Includes intraocular lens implantation, intra-corneal ring implantation and laser excimer.
Q: Can the same be done with Astigmatism and the camera?
A: Except for the insertion of the intra-corneal ring and other RK measures, albeit with minor differences, can be used to correct these two complications.
Q: Which surgery is most commonly used today and why?
A: Oxymeriser is used more often than ever to correct refractive disorders. The reason is simplicity, accuracy and low performance.
Q: What is a laser excimer?
A: Eximer laser is an English word that stands for Exited Dimer Eximer. Oxymerizer has many different types, namely its constituent atoms. The laser used to correct refractive disorder consists of two argon atoms and a fluorine atom. The wavelength of this laser light is 193 nm, which is characterized by high laser power at a small surface area and very low thickness. So that it can exert its effect on a surface as small as only one micron of the cornea. This laser does not affect the tissues around the cornea and inside the eye.
Q: How do they operate with lasers?
A: There are several ways to correct a laser refractive disorder. But the two methods are more popular than the other. One of these methods, which is especially popular in Iran, is called PRK, in which, after removing the corneal lining with razor or alcohol, a laser is applied to the surface of the corneal tissue to match the score of the glasses. Alternatively, with a mechanical device or a special laser device (femtosecond), a layer of corneal surface is temporarily removed below the laser and after removal of the laser, the removed layer returns to the first place. This is called LASIK.
Q: How long has the laser been performed?
A: The first similar examples of human LASIK were performed in 1963. This method has gradually improved and improved. Laser excimer has been in use for over 25 years now for “PRK”. But LASIK operates in an advanced, modern form since 1991.
Q: Which laser method is more appropriate?
A: The methods vary with each individual, one using PRK better and the other using Lasik. This is determined by the score of the eyewear and the thickness of the cornea. In the past, PRK was not recommended in high numbers due to the likelihood of reversibility as well as the stigma sometimes present on the cornea, but nowadays the complication is minimized with the use of intraoperative medications, resulting in a greater tendency to do so. There is a PRK procedure.
Q: If the laser excimer device itself performs myopia correction, what is the role of the eye surgeon?
C: Careful examination of the eye by various devices, giving accurate information on the position of the eye to the computer system of the laser device, selection of appropriate resection pattern, preoperative, intra- and postoperative eye control as well as removal of the corneal surface layer by mechanical method It is up to the eye surgeon.
Q: Who is the best laser excimer?
A: The laser is suitable for a wide range of myopia or myopia with astigmatism as well as in low-resolution (usually less than 4 diopters) cameras alone or with astigmatism.
Q: What is the time for laser surgery?
A: The total laser operation time, according to the procedure for each eye, is usually about 5-10 minutes.
Q: Is laser surgery painful?
A: With anesthesia drops, laser surgery is performed with minimal pain. Although after LASIK, there is a burning sensation and foreign body and tears in the eyes, but usually no analgesic is needed, and most of the day after surgery can be returned to daily work. But after PRK, pain intensity and duration are higher, which is used to control more painful analgesics. The duration of the pain can sometimes exceed three days.
Q: Can two eyes work together?
A: Yes, studies have shown that the outcome of surgery is not significantly different if the two eyes are operated in a single session. Most physicians and patients prefer to have both eyes operated on in one session.
Q: Who can laser?
A:
1) Don’t be single-eyed.
2) Be over 18 years old (except for special cases).
3) Glasses score should not increase by more than half a point during a year.
4) Glasses score can be adjusted.
5) One should not have severe laziness of the eye.
6) Not be a person with keratoconus.
Comment: Other Recommended:
There are no general illnesses such as advanced diabetes.
No severe dry eye.
There is no advanced glaucoma.
There are real expectations of the capabilities and capabilities of laser surgery.
Do not be pregnant or breast-feeding
Not treated for malignant diseases
Q: How old can the laser be performed?
Q: Why laser?
A: The tendency to reduce or eliminate the dependence on glasses for daily activities can be a good reason for laser action. If you would like to wake up in the morning, watch without glasses, wear glasses, work at home or at work, or like to enjoy water sports without the use of glasses and contact lenses, and Or you would like to be able to protect yourself and your family in emergency and emergency situations without the lens or contact lens. These and many others are reasonable and accessible goals in refractive surgery.
Q: What is the probability of the laser eye number returning?
A: It is highly unlikely that the eye number will return before surgery. If the candidates are well selected and no unexpected happens, usually the result of the operation is known within about 3 months and within one year the number of eyes will be fixed, though there are few people with near-eye progression. It has never stopped, increasing from 0.5 to 1 number per year, but more. It is important to know that the laser is not able to prevent the progression of the eye number, and after the procedure, the amount of myopia or glasses score will change every few years, which should not be considered as a reduction in the laser effect or the return of the disease. (Usually laser surgery is not recommended for these patients)
Q: Is it possible to reactivate people who are already laser?
A: Yes. If the corneal thickness is appropriate, after the first operation the remaining number of the eye can be corrected by the next procedure. The complications of the second operation are similar to those of the first operation and have no greater risk. Of course, in some cases, despite the number of eyes remaining, the patient is satisfied with his / her vision and merely requests zero action to zero, which is obviously not scientific and reasonable.
Q: How may refractive surgery not be appropriate?
A: If you expect an ideal result. There is no one hundred percent confidence in the ideal outcome for any surgeon and your ultimate goal cannot be guaranteed.
Q: Does it take more than one operation to get the right result?
A: Of course, anyone who accepts a refractive correction must also accept that he or she may have to undergo surgery two or more times to achieve the desired result.
Q: Should I have to re-pay if it needs to be rescheduled?
A: Under existing terms, payment is solely related to consumables and there is no charge for the operation itself.
Q: When does the vision become almost complete after the procedure?
A: In most cases, postoperative vision recovery is rapid. But it is not a surprise, especially in those with more than 5 myopia scores, this time may take 3 months or more, so one should not expect a final vision in the first weeks after surgery.
Q: Does the laser get a better view of the glasses?
A: If your spectacle or lens score is correctly prescribed, postoperative vision is usually equivalent to vision with glasses. Because laser surgery only removes your glasses number. Therefore, in most cases the visual acuity does not change and the vision improves with the use of an accurate and accurate spectacle, but as the field of vision increases, the visual quality improves.
Q: Does laser surgery cause color blindness or color blindness?
A: Night Blindness and Color Blindness are usually hereditary diseases and laser surgery does not cause such diseases. However, during the first few weeks after surgery, there may be problems with night vision, such as glare or Halo Vision seeing objects around the light, etc. Of course, these problems are less common with new devices. it happens.
Q: Can a conventional color contact lens be used after laser and LASIK surgery?
A: Yes, but it is best to postpone use for three months after surgery.
Q: Why is LASIK not performed near the very nose?
A: To correct any number of glasses, some corneal thickness should be shaved. And because the thickness of the cornea is limited, so the number of adjustable glasses is also limited.
Q: What happens if a large amount of corneal tissue is removed by laser surgery?
A: There is a possibility of over-thinning and keratoconus.
Q: Does laser surgery make the eye more vulnerable to trauma?
A: It has been demonstrated that corneal stiffness after laser surgery (PRK, Lasik) is not significantly different from traumatic corneal stiffness. But we should know that close eyes are inherently more vulnerable to trauma than normal eyes due to the thin retina, and this has nothing to do with laser action. However, long after laser surgery it is possible to move the corneal flap in the trauma.
Q: Can fasting or eating a special diet be effective as a result?
A: No, no positive or negative effect of any diet has been proven.
Q: Does laser surgery make the eye more vulnerable to trauma?
A: It has been demonstrated that corneal stiffness after laser surgery (PRK, Lasik) is not significantly different from traumatic corneal stiffness. But we should know that close eyes are inherently more vulnerable to trauma than normal eyes due to the thin retina, and this has nothing to do with laser action. However, long after laser surgery it is possible to move the corneal flap in the trauma.
Q: Can fasting or eating a special diet be effective as a result?
A: No, no positive or negative effect of any diet has been proven.
Q: How is the physician appointed?
A: Each applicant must have his or her physician identified prior to surgery as it is very difficult to obtain a change in the physician’s file after the procedure is completed and requires the consent of the primary care physician.
Q: What is Customized Laser?
A: Some people have problems due to the irregularity of the corneal surface or the conditions and problems that are expected to occur following a laser with usual features. To prevent or treat these problems, which can affect the quality of vision or night vision, changes to the laser radiation pattern are made by some software to minimize the chance of these unwanted effects. This is called laser customization. This tool, of course, is also used to adjust the angle of laser irradiation with rotating eye movements to correct astigmatism.
Q: How is the physician appointed?
A: Each applicant must have his or her physician identified prior to surgery as it is very difficult to obtain a change in the physician’s file after the procedure is completed and requires the consent of the primary care physician.
Q: What is a Customized Laser?
A: Some people have problems due to the irregularity of the corneal surface or the conditions and problems that are expected to occur following a laser with usual features. To prevent or treat these problems, which can affect the quality of vision or night vision, changes to the laser radiation pattern have been made by some software to minimize the chance of these unwanted effects. This is called laser customization. This tool, of course, is also used to adjust the angle of laser irradiation with rotating eye movements to correct astigmatism.
Explanation:
Q: Do insurers pay for laser excimer costs?
A: Since different insurance coverage conditions vary, each applicant is required to obtain information about the terms of payment from the insurance they cover. Obviously, the center will issue the necessary approvals upon request.
Q: How many times has the person performed the visit and how long does it take to pay and does it pay for the visits?
A: The number of visits may vary depending on the physician, but usually within the first four or five days, the examinations are close together, but the follow-up visits are one month, three months, six months and one year later. For a fee, a visit to the Ophthalmology Center is free for one week and is then charged as usual.
Explanation: Those who wish to follow-up in the private system must first consult with their physician. Obviously a visit to the office is usually done in accordance with current standards.
Q: What are the preoperative recommendations?
A:
A: Do not use contact lenses from examinations until the laser is performed.
B: If pregnancy is likely. The postponement of its deterioration is postponed.
A: Avoid eye and face makeup twenty-four hours before surgery.
D: Carefully wash baby shampoos with eye shampoos at night and in the morning before surgery.
E: If a person develops a fever and an infectious disease, it is necessary to postpone the operation to ensure that the disease is healed.
D: Laser surgery is prohibited in people with eyelid or peripheral eye infections.
And: The day of the operation is required to accompany a person’s friends or acquaintances.
A: Usually one hour before surgery, a sedation pill is given by one of the laser personnel. Avoid self-medication to prevent complications or drug interference.
Explanation: Laser surgery during menstrual cycle is not prohibited due to necessary health issues
Q: What should be noted during laser operation?
A:
1) Keep in mind that these actions are not painful and that your cooperation plays a very important role in achieving the right result. So keep calm and follow your doctor’s instructions during surgery.
2) During the operation, look at the flashing red or green light and avoid moving the eyes and head.
3) Laser Time Depending on what type of laser is used, it is usually less than one minute, so do not move the eye while you are listening to the laser sound.
4) Don’t worry about blinking during surgery because your eyelids are held together by a device that is best to avoid pressing the eyelids and frowning in order to prevent pain.
5) During the procedure, your eyes are rinsed several times with a syringe containing the serum. Injections do not worry.
6) Do not bring your hands close to the operating environment, as they can cause contamination and affect the operation.
Q: What should be done after laser surgery?
A. Immediately after the operation of the prescribed medication
B: Operated people (especially after PRK) move to a quiet, low light location.
Explanation: People who have LASIK are advised to have a permanent shield for the first 24 hours after shielding. And then use it at night for a week at night.
A: The physician’s instructions for medication should be strictly followed and the instructions on the next page of this booklet should be followed if no specific instructions are given.
D) If the contact lens left at the end of the operation is left out of the eye, do not attempt to reinsert it at all, without having to worry about referring to the center where the operation is performed.
E: Avoid facial wash for up to one day after removing contact lenses (unless specified by your physician).
And: Because ultraviolet radiation affects the process of corneal remodeling and repair, it is advisable to avoid exposure to direct sunlight for six months and to wear appropriate sunglasses for days.
Comment: You do not need to wear sunglasses indoors.
A: Long-term, eye-catching work is not recommended until the eyes are completely relaxed (about three weeks). Using LCD monitors after one week is not prohibited.
K: Avoid makeup around the eyes for at least two weeks after surgery.
L: Many post-operative visual changes of PRK are due to normal corneal repair and should wait approximately three months for final vision.
M: The older a person’s age and initial modified number are, the greater the likelihood of a blurred vision in the first months. Of course, this problem can be solved over time. However, it is necessary to explain that in the old age of the eye (usually over forty years) after laser surgery, the use of study glasses is often necessary.
A: He can study in good condition from any time he feels comfortable.
Q: What are the postoperative medications?
A:
1) Diclofenac drops (dicloptin or biofenacs) every 8 hours, one drop for 2 days
2) Chloramphenicol drops every 4 hours for one week
3) Betamethasone drops every 6 hours for 2 weeks
4) Flucourt drop (FML) starts from the third week instead of betamethasone drops and continues as follows:
Every 8 hours for 4 weeks
Every 12 hours for 4 weeks
Once a day for 8 weeks
Artificial tear drop:
Every 4 to 6 hours a drop for 4 weeks
According to the need and then the doctor’s order
Note:
Drug prescriptions may change according to your doctor.
Thanks for your attention in reading this booklet.
How to use eye drops correctly.
Bend your head slightly backwards.
Pull the lower eyelid downwards.
Drop the Drop Here (No Eye Drop or Eyelid Contact)
Close your eyes for 3 minutes, then blink.
After opening your eyes, dry the tear or unabsorbed drop with a clean cloth around the eye.
If the physician prescribes more than one type of drops at a time, they should be used within 5 to 10 minutes.
Almost everyone who is undergoing surgery wants to know what the chances of getting a satisfactory result are. For low to moderate myopia (up to -7D), about 95% of patients without glasses receive 5.10 to 6.10 or more and 85% chance of vision without glasses 8.10 to 9.10 Or better. This means that people’s dependence on glasses is greatly reduced, but they may need a smaller number of glasses to perform more precise eye tasks, such as driving, especially at night. For high myopia (above 7-diopter), about 85% of patients get 5.10 to 6.10 or better without glasses and 70% get glasses without 8.10 to 9.10 or better.
Author: Dr Mohammad Reza Rouhani (Anterior Segment Fellowship)