Dr. Sunita Lulla Gur

I am Dr Sunita Lulla Gur, senior consultant eye specialist in Sarita Vihar. Today, I will speak about the topic LASIK.

What do you mean by LASIK?

Lasik is a surgery which stands for Laser-Assisted in Situ Keratomileusis.

Why this surgery is done?

This surgery is done basically to correct the vision and eye power like- near sightedness, far sightedness, astigmatism. LOt many times we do get questions from many people like "I am eligible for LASIK or not?". So just for the short brief I will take you to the journey of LASIK. 

As it is one of a cosmetic surgery, I would say but there are other advantages that why one can go for LASIK is;

• It corrects the power
• It gives good vision
• It improves the contarst

These are the advantages which is why one can go ahead with the LASIK surgery.

Sometimes people think that at what age a person can have LASIK surgery?

So the criteria for the LASIK surgery is that;

• The age should be more than 18 years.
• Your power should be stablized for atleast 1 year
• Your cornea should be fit to under take the LASIK surgery.
• Another criteria is that the females who are pregnant should not undeergo LASIK at that time.

These are the main 4 selections for the LASIK. Again depending on the number, LASIK can be done from 0.5 to -10 also. Nowadays there are many technologies coming and lot of advances have been done . We are now doing in high powers also. Again we have to select the candidate properly for successfull outcome of LASIK.

The success rate of LASIK is usually 93-95%. Initially the success rate was less and the reasons for improving its success rate is that the selection criteria has improved. Our protocols have improved over the period of time.

There are different types of LASIK which are been done, those are,

• C-LASIK  - We make a superficially thin flap and the reshaping of the cornea is done as per the number and a person can see a good image after that. When the re shaping is done then the rays which comes focus properly on the retina. So it does the work how we do in practical correction. Here the microkeratome blade where the flap is removed and after that the reshaping of the cornea is done by the laser.
• I-LASIK - It is bladeless LASIK surgery where the flap which is being removed is done by the laser itself and no blade is used. The advantage of this is that it can be done in thin cornea also. So, if the person is having thin cornea as per the criteria which we set, then I-LASIK can be done in these type of cases.
• Contoura vision LASIK - This is an advanced surgery which has come in which the computerized topography is done and which is attached to LASIK which can pick up the minor abrasion which are present in the cornea so that it can correct the vision to its fullest. So sometimes we do have patients who are completely satisfied with the change in their vision. It also reduces the chances of dryness which is there after LASIK surgery.

So, when we plan for LASIK, there are certain criteria for the selection as I have explained. But for the successfull result,

• You have to follow the advices that are been given by the doctor.
• You should not put any water in the eyes after LASIK surgery.
• You should not rub your eyes.
• You should use the eye drops as suggested by the doctor.

Follow the protocol atleast for one month.

The precautions are;

• Water should not go inside the eyes.
• Avoid swimming atleast for 3 months.
• Avoid going to gym atleast for 1-3 months.

Otherwise, you can go to the office next day. Initially you may feel discomfort but you can see the improvement in the vision the very next day. Every season is suitable for LASIK sugery and rest it depends on the fitness of a person for the surgery.

If you want to contact for any LASIK appointment, you can do it through Lybrate.

Thank you
 

Causes, prevention, and treatments for Cataract

I am Dr. Sunita Lulla Gur, a senior eye specialist at Accuvision Eye Centre and AcuVision center. It has been long that people wonder, why we see less with ageing. Of which, ageing is itself a problem of many disease, or may be degenerative changes which are taking place in a body, of one, cataract is an important thing that happens. Now let’s see what is cataract. Now when we see the complete structure of the eye, this is the cornea; then you have a natural lens, which is situated over here, and then we have the retina. So whenever the degeneration, normally when we see, the lens, which is more clear, okay? Now, what happens , with ageing, this degeneration of the proteins which are there in the lens, and it leads to opacification.

Now when we look into this, this is opacification of the lens which is happening. Now because of this opacification, what happens is, the natural clarity of the lens is lost, and then we see through this haze which is there. So this reduces, or leads to the diminishing of vision, or blurred vision. So, this condition is called as cataract. Now cataract can be of many types, and depending on the stage, your vision will be affected. Sometimes what happens in early cataracts, you will have little bit blurred vision, but you can cope up with your daily day to day life. There are different types of cataract; age-related, in children also we have seen, which is since birth and which is called as congenital cataract.

Traumatic cataract, it means, whenever there is injury to the eye, then it can lead to traumatic cataract. Or sometimes, drugs; there are some kind of drugs which can cause cataract, like if you are on, long term on steroids, or other drugs, then it can lead to cataract formation. So keeping that in mind, you should always have your regular eye check up, once you are at the age of 40 or 50 years old. In Indian scenario, as we are a tropical country, too much of sunlight and UV radiation, the chances of cataract formation in Indian scenario is much higher than the counterpart in American scenario which we have seen. Now coming to, when should I get the cataract surgery one? Now when we say that you have cataract, one should not panic, because it is a normal ageing process which is happening; and surgery is the only treatment option available, as there are no drops or drugs or oral medication available to prevent it. Yes the role of anti-oxidants and good healthy diet is definitely there, to prevent early onset of cataract, okay? Now coming to the treatment or the preventive part.

Now how can you prevent cataract? As I already said, it is an ageing process, nothing can be done, but still, get a regular eye check up, have a healthy diet, including greens, reds, and yellow vegetables in your diet. Take some, well, you can include some almonds, and walnuts in your diet. These are all antioxidants which can delay the degenerative process. Now another thing is, as I said, there are no drops etc, so there is no need to put any drops for that. Sometimes people do take over-the-counter drops, many say that these are the drops which will be able to reduce the cataract, but then nothing happens. Now when can one get the surgery done? Now we have seen that surgically, it is one of the safest procedures to get done.

Nowadays with technology, so many good machines are available, the evaluation protocols have improved, what are seeing. So nowadays we do laser surgery, microincision surgery which is the key-hole surgery, through a, very small incision, that is made; and then cataract is emulsified and removed. Now, because we make a very micro hole surgery or a very small hole surgery, the wound healing is very fast. Now the techniques which are available to remove cataract is, one is laser, where we make a very small laser cut over here, where no blade is used, and a small phaco emulsification, for objects like the tip of this pen, if you see, it is entered, and whole of this cataract which is there, is emulsified. The cataract which is there is emulsified, and intraocular lens is implanted, and then the wound healing occurs, and the next day, or within 2 to 3 days, you are back to your normal work.

You have to take some precautions, which we will explain to you later. So this process is called as laser technique. Then we have another technique which is microincision, which is a very small key hole that is done, around 1.8-2 mm, through which the probe goes inside, it emulsifies the cataract, the cleaning is done and then the lens is implanted. The 3rd technique is phacoemulsification, where again, the incision size is slightly more than the microincision hole, but still it can be moved, through a small incision and the wound healing is faster. So, well, what was happening in the initial days, we were making incisions of this size, to this size, but now the incisions are hardly around 1.5 to 3.5 mm, which helps in healing process. It does not induce any number, and again the intraocular lens which is implanted, it is implanted as according to your eye power, so that most of the time, it will help you to get rid of glasses for distance, but for reading, you will require some glasses, for reading.

There are different types of intraocular lenses to be implanted, depending on the need of the patient, the profession of the patient; after discussion with the doctor, one can decide, what kind of lenses one can go for. Now, after care treatment of cataract if we look, it is not very hard. Only, well, some precautions you have to take, like no water should go inside the eyes, no rubbing of eyes. These are the two main precautions to be done. Otherwise you can carry forward your daily routine as you were doing before. Regarding what can be done, after, as in, preventive, if we say, there are many patients who come an ask me, “Doctor, how can I prevent cataract?” , so I say to them, that as I cannot prevent cataract in my eyes, how can I suggest? But still, as I already said, good eating habits.

Smoking is again, one of the causes of cataract early. So do not smoke, or if you are smoking, quit smoking or reduce it. Third, again, if you are on UV exposure lights too much, like working in sunlight, always wear protective glasses, so that the UV radiation does not fall directly in your eyes, and then the amount of cataract can be reduced. If you all do not take any steroids on your own, always consult a doctor before you start steroids. So these are the precautionary things which can prevent cataract, from happening. And once you develop, you should be seen by an ophthalmologist. Get your eyes checked and then decide with your doctor that when you should get your surgery done.

Thank you. For further details, if you want to know, you can, contact me. I am Dr Sunita at Accuvision Eye Centre and you can book your appointments to Lybrate.com or call to Lybrate and also, you can visit the website. Thank You.