LASIK or laser surgery to correct vision gives a lot of people freedom from glasses, but it is not an option for everyone. People with higher powers, thinner corneas and irregular or steep corneas are usually refused LASIK as it is not safe for them.
However, new techniques allow give such people an option to reduce their need for glasses. The most popular technique is blade-free lasik or iLASIK, in which a femto-second laser is used to create the corneal flap instead of the blade used in conventional surgery.
The laser has much greater precision and safety and can be used to create very thin flaps — micron flaps, as compared to 160 microns in conventional LASIK. A thinner flap leaves behind greater amount of corneal tissue for vision correction. An iLASIK procedure for both eyes costs between R80,000 and R1 lakh for both eyes.
Another laser correction option for people with thin corneas is Epi-lasik or surface ablation, which costs between R 40,000 to 50,000 for both eyes. Vision recovery may take 2-3 days more but the final results are excellent.
People with very high powers that cannot be treated with lasers at all can opt for Implantable Collamer Lens (ICL) implantation. Using a procedure lasting 15-20 minutes, a barely visible, bio-compatible lens is placed behind the iris, it is possible to correct powers as high as -25 diopteres. The cost is ranges between R 60,000 and R 70,000 for each eye.
Another complication is thin, irregular or steep corneas associated with a condition called keratoconus. This progressive disorder leads to an increase in power and a corresponding fall in vision, causing complete vision loss due to scarring in some cases. Though laser procedures are not possible in this condition, a process called C3R (collagen cross linkage) is effective in arresting vision loss. It uses a combination of Riboflavin drops followed by ultra-violet radiation to increase the strength and rigidity of the corneal fibres. A few moths later, intra-corneal ring segments (ICRS) implantation can reduce dependence on glasses. While a C3R costs between R 40,000 and R 50,000 for both eyes, ICRS implantation adds another R 75,000 per eye.
All these are day-care procedures that do not need hospitalization. Recovery for most procedures takes 2-3 days, with most people going back to work in 4-5 days. Complete vision stabilisation may take a few weeks but improvement is felt in the first couple of days.
Dr Mahipal S. Sachdev if the chairman of the Centre for Sight Group of Eye Hospitals.