At our laser eye center, we check each and every LASIK candidate for dry eyes. Depending on its degree, various treatment options are advised. Dry Eyes are tested by a quantitative test, Schirmer’s Test and Tear Break Up Time [BUT] is also done when necessary.

This helps us screen patients who should first wait till their dry eye treatment is complete, before undergoing LASIK.

What are LASIK effects on Pregnancy?

If you are pregnant, or expecting to become pregnant, you should not undertake the LASIK procedure until after the pregnancy. The reason for concern in pregnancy is the possibility that your refraction may be different due to hormonal changes. Also there is the rare possibility that your response to the surgery might not be usual. This holds true even when you are nursing. There is no known harm to the fetus by the excimer laser but your results might be affected. If you have the surgery and then get pregnant a few months later, it should have no significant effects.

What are LASIK effects on Presbyopia?

Even if you undergo LASIK when young and achieve perfect vision, you may still develop a condition called ‘presbyopia’ usually beginning between the ages of 40 and 50. Presbyopia is the inability of the eye to focus on close objects because the lens loses elasticity with age. Bifocals and reading glasses are used to see close objects.

LASIK surgery can reduce or eliminate the need for bifocals or reading glasses using a procedure called Monovision. Monovision corrects one eye for near vision and the other for distance. The brain can concentrate on the near eye for close objects and the distance eye when looking far away.

Monovision and LASIK

One way to deal with presbyopia is by producing monovision. Normally, both your eyes work together equally when you look at an object, to produce what's called binocular vision. However, you probably have a dominant eye that your brain tends to favour (most right-handed people are right-eye dominant, for example). Contact lens fitters often take advantage of this "one-eye dominance" to produce monovision with the contacts: they fit one eye for distance vision (typically the dominant eye) and one for near vision.

Some LASIK surgeons will produce monovision in their presbyopic patients by purposely leaving the non-dominant eye slightly nearsighted so that these patients can see up close without glasses (out of one eye). Many are wary of the technique because not everyone can become accustomed to the absence of binocular vision.

We recommend you to try monovision with contact lenses or trial lenses in our office or with your optometrist first to be sure if you can adapt to this.

The other surgical procedure called CK or Conductive Keratoplasty is also available. However its effect is temporary and diminishes with time, hence repeated procedures are required.

If a patient has cataract, can LASIK surgery be performed?

Remember that the goal of LASIK is to reduce or eliminate a patient's dependency on glasses and contacts. Cataract surgery can also accomplish this goal with an implantable contact lens (which has a specific power that has been selected prior to the time of surgery) so LASIK surgery would therefore not be necessary. If LASIK surgery is performed on an eye that has a cataract, the cataract would still have to be removed and the patient would be subjected to a second operation.

What about patients who have early cataracts and want LASIK surgery?

This depends on the degree of cataract. Once people reach their 50's and 60's, doctors can often see some slight changes in the appearance of a person's natural lens. Once there is any colour change - even if it has no effect on vision - it can be considered a cataract. For patients with early cataracts, it can sometimes take 10, 20 or even 30 years for the cataract to progress to a point where it is impacting vision enough to consider cataract surgery.

There are many people in their 50's 60's and 70's who lead active lifestyles and who have decided to have laser refractive surgery despite their having a very early cataract (defined as a visible change in the lens without loss of best-corrected vision). In general - patients in this group have very satisfactory results. On the other hand, if a patient has a cataract that is actually impacting the vision, resulting in visual symptoms or reduction in best-corrected vision, then clearly LASIK is not a proper choice for the patient. Patients in this situation should be advised to wait for cataract surgery

Our LASIK doctor will be discussing this in great details with you before reaching an informed decision.

With a conventional implant, the patient uses bifocals or reading glasses following cataract surgery to see close objects. With the new Tecnis Multifocal implant the patient will not require, in most cases, bifocals or reading glasses following cataract surgery.

The latest generation of Tecnis group of lenses from Advanced Medical Optics, USA help a patient see things more clearly in low or dim light conditions and the possibility of seeing well for near and distance, without glasses.

Our ability to distinguish light from dark areas and objects from their background is Contrast Sensitivity. Natural aging results in gradual loss of this visual ability. With loss of Contrast Sensitivity, objects or images end up merging with the background and cannot be seen as distinct eg. driving safely at night.

Does the new generation of Tecnis implants improve contrast sensitivity after cataract surgery?

Yes, today the Tecnis implants available in the market resemble the "young" natural lens of the eye thus leading to sharper, clear vision even in low light conditions.