LASER Eye Surgery or refractive surgery, involves use of laser to remove full/partial refractive error (Spectacles/ Glass number). This procedure reshapes the cornea to enable light entering the eye to be properly focused onto the retina for clearer vision. LASIK
(Laser assisted in situ keratomileusis, PRK (Photo Refractive Keratectomy), SMILE (Small Lenticule Extraction) are some of the techniques to remove eye power or spectacle number.
People who are > 18 years of age with stable refraction (Glass/spectacles number) and who wish to be less dependent on glasses can undergo Laser eye surgery.
Your refractive surgeon will perform certain scans (Corneal Topography and Pachymetry) to ascertain your corneal shape, thickness and corneal power. This is followed by a thorough retinal examination to see for any treatable lesions. Finally your refraction (Glass/spectacles number) is confirmed. The doctor will give his final decision whether you are fit to undergo laser eye surgery or not.
Most Laser eye surgeries take 20-45 minutes to complete. The recovery time is shortest for LASIK 1-2 days, followed by SMILE 2-3 days and then PRK 3-5 days. Recovery time should not be the only parameter to choose the type of Laser Eye Surgery for yourself.
LASIK surgery involves creation of corneal flap followed by application of excimer laser to reshape the cornea. The flap is then put back into its original place and procedure is completed
Normal LASIK: Corneal flap is made with microkeratome (blade) and the amount of laser required to decrease the refractive error is given after lifting the flap. The flap is repositioned back in after the procedure. Cost of Normal LASIK is Rs 25000-35000 in NCR.
Custom LASIK: Before LASIK surgery, advanced scanning of the eye is done to make a customized laser delivery pattern, the rest of the things remain same as normal LASIK. Cost of Custom LASIK is Rs 40000-50000 for both eyes in NCR.
Blade free / Bladeless LASIK: Instead of Using blade to cut the cornea, a highly advanced femtosecond laser is used to cut the same, followed by LASER delivery in normal or customized pattern. Cost of Bladeless LASIK is Rs 70000-90000 for both eyes
Wavefront Optimized LASIK: Normal or Custom (WF guided) LASIK can lead to problem of glare sometimes. WF optimized LASIK overcomes that and is one the most commonly used Ablation Techniques for removal of glass number. Cost of Wavefront Optimozed LASIK is Rs 45000-55000 for Both eyes
Contoura Vision LASIK: Most advanced form of LASIK technique with extreme level of precision and accuracy. Cost of Contoura Vision varies from Rs 65000 to 90000 for both eyes.
PRK involves removing the superficial layer of cornea (epithelium) followed by laser delivery to remove the glass number. This is the only procedure approved for people who want to join armed forces or defense establishments.
Normal PRK: removal of superficial epithelium using scraper or alcohol solution followed by LASER to reshape and remove the spectacle power on the cornea. A thin Bandage contact lens is place on the eye, which is removed between 3-5 days once the epithelium regenerates. Costs Rs 30000- 40000 for both eyes
WF Optimized PRK : Same as Normal PRK with WF optimized lasers used to decrease the incidence of glare. WF Optimized PRK Costs Rs 50000-55000 for both eyes.
Contoura PRK / Topo Guided PRK: Next level of personalization with 20000 data point from the cornea fed into the laser machine to give extreme level of accuracy and precision to the PRK treatments. Contoura PRK / Topo Guided PRK costs RS 60000-65000 for both eyes.
TransPRK or Touchless Bladefree or No touch Eye Laser Treatment: Most Advanced Surface ablation with faster recovery and significantly less discomfort after the surgery. Cost of TransPRK is Rs 75000 for both eyes.
SMILE is a bladeless and flapless procedure involving removal of precise amount of corneal tissue (lenticule) painlessly from the cornea. Results are similar to LASIK for log term with less incidence of Dry Eye after the procedure. Cost of SMILE procedure is Rs 1,20,000o for both eyes.
The refractive surgeon can assess you for Phakic IOL (ICL) in which a very thin lens is implanted in front of your natural lens so that the light is focused on the retina.
Treatable lesions in the retina have to be dealt with before proceeding with refractive surgery. After they have been Lasered (Retinal Laser), a gap of 2-3 weeks is usually given as healing time, after which one can proceed with refractive surgery.
Dry eye is the most common after/side effect of LASIK which requires prolonged use of lubricating eye drops. Some patients complain of glare, which is most common in patients undergoing normal LASIK. Some people may develop Post LASIK Ectasia which requires corneal collagen crosslinking.
Dry eye is commonly seen but is less than that seen post LASIK. Minimal haze after surgery and delayed recovery are also reported, which can be resolved by use of appropriate eye drops. PRK has least incidence of Post Surgery Ectasia amongst all laser eye surgical procedures.
The prices of the procedures depend on the experience of the surgeon and cost of equipment. One cannot comment on the expertise but Low cost surgery is only possible with older machines with older technology or refurbished equipment. The other aspect is reuse of instruments within patients by which the surgery cost is cut down.
Please make sure that the surgeon has post graduation from reputed institute with Fellowship in Refractive surgery or anterior segment or cornea from good Institutions.
Dr Vishal Arora, is a cataract and Refractive surgeon with >10 years of experience in field of Laser Eye Surgery. He has done more than 1000 LASIK, PRK, Topo Guided PRK, ContouraVision with excellent results. He is a post graduate from AIIMS, New Delhi and has done his long term fellowship in Phacoemulsification and Refractive Surgery from Narayana Nethralaya, Bengaluru.
