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| Grewal Eye Institute, the premier eye care centre in the city is pioneer in iLasik surgery. Equipped with the fourth generation Allegretto Wave Laser machine are used to perform these sophisticated and specialized surgeries.
iLasik one of the most accurate and safe vision correction procedures in history is performed at our institute with the expert hand of surgeons. |
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| At Grewal Eye Institute, we strive for 'Quality Eye Care Service' for every one of our patients. The staff is highly qualified and motivated to provide counseling and personal care that you need. We are meticulous in what we do at every step of the way, before and after treatment. A Screening program, exclusively at Grewal Eye Institute, analyzes the possibility of iLASIK for all persons interested in seeing clearly without glasses. It provides access to latest technology in the field of ophthalmology. Our aim is to provide quality service that people except and appreciate. |
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| iLASIK is a procedure to correct nearsightedness, farsightedness and astigmatism. It utilizes the microkeratome to create a corneal "flap" of about one-third of the total corneal thickness. The excimer laser is then used to reshape the exposed middle layer of the cornea. The flap is finally put back to assume a new shape created by the excimer laser. |
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| Advantages of iLASIK |
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- Predictable and permanent correction of refractive errors.
- Dramatic improvement in vision without glasses compared to pre iLasik vision without glasses.
- The goal is to reduce or eliminate dependence on glasses and contact lenses.
- A quick procedure with rapid recovery.
- It does not involve any injections or sutures.
- Quick return to usable vision.
- No hiccups of broken or lost glasses.
- No blurred vision due to fogging of glasses during rainy season or coming out of AC environment.
- No hassles in swimming.
- Unhampered participation in active sports.
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| Vision correction techniques |
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| The principle of correcting refractive errors is to modify the refractive power : to decrease the refractive power in a nearsighted person; and to increase it in a farsighted person. The different modalities available include the following : |
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- Spectacles are the most widely used and are universally considered the safest devices. However, for various reasons, many people will find that spectacles are not necessarily the best answer to their vision problems. For example, they are not suitable for people whose focusing problems differ greatly between one eye and another. They are not allowed in certain professions, and are not practical for sports.
- Contact Lens is another popular choice. They provide convenience and are reasonably safe. However, they are not risk free. Users of contact lenses are more prone to infections in the eye than the general population, even with proper care of the lenses. Therefore, one must always consult an ophthalmologist when planning to use contact lenses and strictly follow the cleaning guidelines. Some people cannot use the contact lenses at all, because they are allergic to the lenses, or the disinfecting solutions. Certain environments are prohibitive to the use of contact lenses, such as very dusty or smoky surroundings, and so are a number of activities, such as swimming.
- Refractive Surgery has been developed as a means to correct vision problems for people who cannot (or do not want to) wear spectacles or contact lenses for the various reasons stated above.
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| Refractive Surgery has been continuously developed for decades, from Radial Keratotomy (RK) to PHOTOREGRACTIVE Keratectomy (PRK) which uses a type of laser called the excimer laser to directly reshape the cornea on the surface. Today the Excimer Laser is being used in combination with an instrument called the Microkeratome, in a procedure called iLasik. |
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| iLasik 'Laser In-situ Keratomileusis' |
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| iLasik is a procedure to correct nearsightedness farsightedness and astigmatism. It utilizes the microkeratome to create a corneal "flap" of about one-third of the total corneal thickness. The excimer laser is then used to reshape the exposed middle layer of the cornea. The flap is finally put back to assume a new shape created by the excimer laser. |
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| The history of iLasik |
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| In 1983, Dr. Trokel was the first to recognize the potential of the Excimer Laser and use it in a procedure called Photo Refractive Keratectomy (PRK). Excimer Laser directly sculpted the moderately safe and effective in the treatment of low refractive errors. However, it was grossly unpredictable in higher numbers. |
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| The utilization of the excimer laser in combination with the Keratomileusis was proposed by Dr. Pallikaris at about the same tim in 1990. The resulting procedure, called Laser-in-situ Keratomileusis or Lasik, combines the accuracy of the excimer laser with the paucity of tissue reaction of keratomeleusis, resulting in one of the most accurate and safe vision correction procedures in history. It is also one of the least disruptive, enabling most patients to return to work within few days. |
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| Developments and Advances in the Eximer Laser Technology. |
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| The technology of the excimer laser has been continuously developed in many system, stability and predictability have improved with each new generation of laser. |
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| First Generations Excimer Laser |
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| Broad beam lasers were first generation machines. They projected beam in concentric circles of different sizes on to the cornea. They are prone to inhomogenity of energy across the treatment area, and the problems grow more significant as the laser attempts to treat higher numbers. It led to night vision problems especially in higher corrections in patients with large night pupil diameters. The results had also been hampered with corneal haze and halos. |
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| Second Generation Excimer Laser |
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| Broad beam lasers gave way to second generation slit scanning lasers. A narrow slit like beam of laser is scanned in the direction perpendicular to the axis of the slit, hence a "Slit-scanning" laser. This method can, to a certain extent, improve the problem in inhomogeneity. Nevertheless, its flexibility in treating other vision problems is still inadequate. It has its limits in difficult situations. |
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| Third Generation Excimer Laser |
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| Third generation excimer lasers use a computer controlled scanning mirrors to scan a small spot (2mm) of laser energy over the treatment area, hence "small-sport scanning" or "Flying-sport" lasers. These lasers produce smooth surfaces, because any unevenness within the spot cancels itself out as it is spread across a large area. The spot can be scanned to cover an area as large as 12mm in diameter. Thus night vision problems are rare with these lasers. The scanning mirrors are controlled by software, thus enables third generation lasers to create any treatment profile to correct any refractive error. |
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| Fourth Generation Excimer Laser |
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| The latest State of the Art, fourth generation excimer lasers have made improvements in spot size, tracking ability, speed of treatment and stability of laser beam. Fourth Generation Lasers create a "perfect" optical system that can yield better that 6/6 vision and at the same time reduce, or eliminate, the risk of low-light vision problems like glare and haloes at night. |
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| GEI has opted for the fourth generation Allegretto Wave Laser |
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| Its less than 1mm spot size has mathematically been proven to give best results. Spot size grater them 1mm has its limitation in correcting difficult numbers. The fourth generation machine at Grewal Eye Institute is only machine where the beam is bathed in nitrogen atmosphere to maintain homogeneity and stability. This prevents loss of energy as the rays travel from laser head to the eye. This is the only machine with 200hz tracker. It means the laser beam locks itself to center of cornea and assures delivery of laser energy accurately centered around center of cornea. It is the fastest machine at 200hz. It means that it fires 200 laser pulses per second making it the fastest machine available today. With slower machines, the time taken for laser is long, and the surface of cornea dries up therefore making the results unpredictable. It is the only machine that has been built from scratch based on Wave-front technology. It is not upgrade of oldermachines as done by other manufacturer. Till date this machine has given best result in USA, FDA trials. |
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| Eligibility for iLASIK |
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Yes, if -
Your are 18 years or older
Your number has been stable for last 12 months
You have a healthy cornea and eye
You have complete and detailed understanding of the advantages and disadvantages of the surgery & have realistic expectation of the outcomes
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| Advantages of iLasik |
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- Predictable and permanent correction of refractive errors.
- Dramatic improvement in vision without glasses compared to pre iLasik vision without glasses.
- Predictable and permanent correction of refractive errors.
- The goal is to reduce or eliminate dependence on glasses and contact lenses.
- A quick procedure with rapid recovery.
- It does not involve any injections of sutures
- Quick return to usable vision
- No hiccups of broken or lost glasses
- No blurred vision due to fogging of glasses during rainy season or coming out of AC environment.
- No hassles in swimming
- Unhampered participation in active sports.
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| How to prepare for an eye examination prior iLASIK |
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| A detailed comprehensive ophthalmological examination is carried out before performing iLASIK. Vision uncorrected, with glasses and trial spectacles is assessed to accurately decide the refractive correction required. |
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| We routinely do cycloplegic refraction in every patient. This is done after putting some eye drops. Schirmer test is done to assess the degree of dry eyes. We perform keratometry and corneal topography to rule out keratoconous. Keratoconous is an absolute contraindication for iLASIK. For contact lens wearers we may peform repeated corneal topographic examinations to make sure that the eye has achieved natural condition before ilasik. Pachymetry is done to record the thickness of the cornea. Please do not forget to brink your old glasses with you. If the findings of examination are not consistent you may be called for examination again. |
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| We routinely do cycloplegic refraction in every patient. This is done after putting some eye drops. Schirmer test is done to assess the degree of dry eyes. We perform keratometry and corneal topography to rule out keratoconous. Keratoconous is an absolute contraindication for iLASIK. For contact lens wearers we may peform repeated corneal topographic examinations to make sure that the eye has achieved natural condition before ilasik. Pachymetry is done to record the thickness of the cornea. Please do not forget to brink your old glasses with you. If the findings of examination are not consistent you may be called for examination again. |
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| Abstain from wearing contact lenses before the examination. At least three days before the examination for soft contact lens and at least seven days in case of GP lenses. During this period, the person receiving treatment can wear spectacles. |
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| Process of iLASIK |
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| The iLASIK procedure will be performed on an outpatient basis in the comfortable environment of GEI. You will be given a medication to help you relax before the procedure. Your eyes will be numbed prior to the procedure with a numbing drops. You will be awake during the procedure. |
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| During the procedure itself you will be lying back comfortably on a motorized bed. Eyes are draped with a sterile transparent sheet. The eye is kept open with a self retaining speculum. A small suction device is used to keep your eye still during the procedure. |
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| A microsurgical instrument called a microkeratome is then used to make a thin flap in the cornea. This corneal flap remains attached at one side. You may feel a sense of pressure in your eye during this step. |
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| You will be asked to look at a light in order to centre your eye for laser treatment. A special type of laser (excimer) is then used to reshape the cornea underneath the cornea flap. Your will hear some noise from the laser instrument as it performs, this procedure. The laser process usually takes less than one minute. The flap is then laid back and allowed to set in place for approximately five minutes. The adhesions become very strong in three to five minutes without the use of any sutures. The eye is then covered with a plastic eye shield which is held in place with adhesive tapes. The eye shield is perforated so that you can see through the hole. The entire iLASIK procedure usually takes less than then minutes per eye. |
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| Any time during the procedure you fell uncomfortable please communicate to the surgeaon. Although Laser machine does take care of the movement of eye, it is advisable not to move your head or squeeze your eyes. |
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| Your will stay with us for few hours before going home. The doctor will examine you before you go and explain the post operative instructions and make an appointment for the next day. |
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| On the day after procedure, take a lot of rest. Try to keep the eyes closed as much as possible. Leave the eyeshields covering the eyes until the postoperative visit at Grewal Eye Institute on the next day. |
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| Use the prescribed antibiotic eyedrops and artificial tears as directed until the next visit You may experience some light sensitivity and foreign body sensations or feeling that something is in your eye for some weeks after the procedure. Wearing sunglasses will help make your eye feel more comfortable during the healing. |
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| Most people are able to notice substantial improvement in their vision within several days to several weeks after the procedure. |
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| After iLASIK? |
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| Initially, your eye may be slightly overcorrected and may require up to six months before your vision stabilizes. |
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- During the first week after iLASIK, try to keep all external fluids such as tap water or sweat from coming in contact with the eyes. Absolutely no rubbing. (about one week later).
- Put on an eyeshield over each eye before going to sleep or taking a nap, to prevent from inadvertent rubbing for 1 week.
- No eye makeup for 2 weeks. No swimming for 2 weeks. Avoid dusty environment.
- Return to Grewal Eye Institute at the appointment date and time for a postoperative evaluation. After the day one visit, your follow-up visits will typically be at one week,
- 3 months, 6 months and one year following the procedure. Additional visits may be scheduled if the doctor feels it is medically necessary.
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| Side effects and complications of iLASIK
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| Complications occur in iLasik as in other surgical procedures. There is no accurate estimate of the incidence of complications bcause of the difficulty in defining what constitutes a complication compared to a minor annoying side effect. However serious adverse complications leading to significant permanent visual loss such as infection or keractesia occur rarely following iLasik procedures. In contrast, annoying side effects such as dry eyes, night time start burst, reduced contrast sensitivity occur relatively frequently. Usually patient considers the symptoms minor nuisances but in rare situations they may be severe enough to cause optical handicap. |
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| Foreign body sensations or a feeling that something is in the eye may be experienced. Over a period of a few weeks these foreign body sensations usually diminish. |
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| The most common complication is the induction of dry eyes. Multiple factors have been implicated in this problem, including aqueous tears deficiency, poor tear coverage of teha ltered corneal surface, neurotropic epitheliopathy and existing pre disposition to dry eye syndrome. This side effect calls for frequent use of artificial tears. |
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| Under and voer corrections are very uncommon. Re-touch up to fine-tune the vision can be carried out in appropriate cases, if agreed upon by the patient and the surgeon. Rarely one may return to spectacles or contact lenses again. |
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| Glare, especially from bright lights at night, may be experienced, particularly in the early months after the procedure. |
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| Halos, or hazy rings surrounding bright lights may be experienced, particularly at night after the procedure for sometime. |
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| iLASIK has no effect on the natural progression of refractive errors. |
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| Perforation of the corneal flap is extremely rare complication that may necessitate a corneal transplant. |
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| Although all precaution are slowly adhered to an eye infection may result just as with any type of surgery. |
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| Ocular pain may occur immediately or in the long term postoperative period. |
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| From low to moderate myopia the results from the studies from the literature has shown that ilasik is effective and predictable in terms of obtaining very good to excellent corrected visual acuity and that it is safe in terms of minimal loss of visual acuity. |
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