What are the Types of Lasik Surgery?

LASIK eye surgery, also known as laser in-situ keratomileusis, is a cutting-edge technique to correct various vision problems. During the procedure, a laser is used by the surgeon to reshape the cornea, resulting in improved vision. The surgery takes only about 30 minutes to complete and is an effective solution for individuals suffering from nearsightedness, farsightedness, or astigmatism.

To be eligible for getting LASIK surgery done, the patient has to meet the following criteria, 

1. The patient must be above 18 years of age.
2. Overall the patient must be healthy. For example, a patient having an autoimmune disease or diabetes is not a good candidate to get LASIK done.
3. The patient must not have any eye diseases like glaucoma, keratoconus, strabismus, etc.
4. The patient's prescription must be within a certain limit 
5. Since pregnant women experience hormonal fluctuations, it is advised that for pregnant women to be a suitable candidate for LASIK, they must get at least one menstrual period post-delivery or once they have stopped nursing before they undergo LASIK

With all the advancements in medicine and technology, several types of LASIK surgery are now available, each offering unique benefits and features. The types of laser eye surgery cater to different individual needs and provide effective solutions for various vision problems. So, what are the various types of LASIK eye surgery? Let's find out. 

The various types of LASIK surgery include the following,

Traditional LASIK Surgery

Traditional LASIK eye surgery, also known as standard LASIK, is the most common type of LASIK procedure. 

1. The process of traditional LASIK Surgery is as follows
   1. In traditional LASIK surgery, the surgeon uses a microkeratome or femtosecond laser to create a thin, hinged flap in the cornea. 
   2. The flap is lifted, and an excimer laser is utilised to reshape the cornea, thereby correcting refractive errors that lead to conditions such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. (32)
   3. Once the procedure is completed, the flap is placed back in its original site. During the procedure, wavefront technology may also be utilised to generate an accurate cornea image to serve as a guide.
2. Advantages:
   1. Quick procedure with immediate results
   2. Minimal discomfort during the surgery
   3. High success rate
   4. Little to no pain post-surgery
   5. Most people achieve 20/20 vision or better
3. Disadvantages:
   1. Some patients may experience dry eyes or glare and halos around lights
   2. The procedure is not reversible
   3. Flap complications can occur during surgery
   4. The procedure may not be suitable for patients with thin corneas or other eye conditions
4. The recovery time is also relatively short, with most patients able to return to normal activities within a few days to a week after surgery. Additionally, traditional LASIK has a high success rate, with most patients achieving 20/20 vision or better after the procedure.
5. Complications:
   1. Dry eyes, glare, and halos around lights are the most common side effects.
   2. Flap complications, infection, and under-correction or overcorrection of vision are rare but serious complications.
   3. However, traditional LASIK may not be suitable for everyone. Patients with thin corneas, dry eyes, or other eye conditions may be better suited for other types of LASIK surgery. 

Photorefractive Keratectomy

Photorefractive keratectomy or PRK is a type of refractive surgery that uses a laser to reshape the cornea and correct vision problems such as nearsightedness, farsightedness, and astigmatism. 

1. The procedure involves removing the outer layer of the cornea, called the epithelium, and then using a laser to reshape the cornea to improve the way light enters the eye. Once the cornea has been reshaped, a soft contact lens is placed over the eye to promote healing.
2. PRK has a high success rate and can provide patients with clearer vision without the need for corrective lenses.
3. Patients may experience blurred vision, light sensitivity, and discomfort for several days after the procedure. Full visual recovery may take up to six months.
4. PRK has several advantages over other types of laser eye surgery. 
   1. For one, it can be used to correct a broader range of vision problems, including astigmatism. 
   2. Additionally, PRK may be a better option for patients with thin corneas since no flap is created in the cornea during the procedure. 
   3. PRK also has a lower risk of complications associated with the corneal flap, which is a potential complication of LASIK surgery.
5. Like all surgeries, PRK does come with some risks. 
   1. The most common side effect is discomfort and pain during the initial healing period, which can last for several days. 
   2. Patients may also experience blurry vision, glare, and halos around lights, but these side effects usually resolve within a few weeks. 
   3. In rare cases, patients may experience more serious complications, such as infection or corneal haze, permanently affecting vision.

Laser-Assisted Subepithelial Keratectomy (LASEK)

LASEK is a type of laser eye surgery similar to LASIK but with a few differences. 

1. In this procedure, 
   1. The surgeon creates a flap in the cornea using a microkeratome.
   2. The cornea is first exposed to a solution of diluted alcohol (ethanol) to create an epithelial detachment, followed by scraping of the epithelium.
   3. Once the epithelium is scraped off, an epithelial flap is created. 
   4. The laser is then used to reshape the cornea, and the epithelium is replaced. After the surgery, topical steroids, antibiotics, and a soft contact lens are prescribed. The contact lens is removed once complete healing has occurred. 
2. Advantages of LASEK include minimal postoperative pain, quick recovery time, and a reduced risk of dry eye compared to other types of laser eye surgery.
3. Since this procedure allows the surgeon to remove less of the cornea, it makes it a good choice to treat people who have thin corneas. 
4. Disadvantages include a longer healing time compared to LASIK, and the possibility of a transient decrease in visual acuity during the initial healing process.
5. Recovery usually takes about a week, during which the patient will experience discomfort and may have to wear a protective contact lens.
6. Complications can include infection, corneal haze, and under-correction or over-correction of vision. It is important for patients to discuss the risks and benefits of LASEK with their surgeon before deciding whether it is the right procedure for them.

Epithelial Laser-Assisted In-situ Keratomileusis (Epi-LASIK)

Epi-LASIK is another type of LASIK eye surgery which is very similar to the LASEK procedure. 

1. In this laser eye surgery,
   1. The surgeon uses an epi keratome to separate the epithelium (outer layer) of the cornea from the stroma (middle part). 
   2. The cornea is then reshaped using a laser (femtosecond laser)
   3. Once done, the doctor applies a soft contact lens that protects the operated area. 
2. Advantages of eLASIK include a quicker recovery time and less discomfort compared to traditional LASIK.
3. Disadvantages and potential complications include dry eyes, glare or halos, undercorrections or overcorrections, and the possibility of the flap becoming displaced. It may also not be suitable for individuals with thin corneas or other eye conditions.

Intra LASIK

A new technique called Intra LASIK is nothing but a modification of traditional LASIK. This is a type of LASIK surgery that uses a femtosecond laser to create a thin flap in the cornea, rather than a microkeratome blade. This provides more precision and safety during the procedure. 

1. The advantages of IntraLASIK include a lower risk of complications, faster visual recovery, and the ability to treat patients with thinner corneas. 
2. However, it may also be more expensive and take longer to perform than traditional LASIK. 
3. The potential disadvantages include a slightly increased risk of dry eyes, and the need for more follow-up appointments. 
4. Overall, IntraLASIK is a safe and effective option for vision correction surgery.

Small-Incision Lenticule Extraction (SMILE)

Small-Incision Lenticule Extraction (SMILE) is a minimally invasive laser eye surgery used to correct refractive errors. 

1. During the procedure, 
   1. A femtosecond laser is used to create a lenticule, a thin disc-shaped layer of corneal tissue within the stroma. 
   2. This lenticule is then removed through a small incision, which is made to access the cornea. 
   3. SMILE is a flapless surgery, which means that there is no need to create a corneal flap as in LASIK.
2. Advantages of SMILE surgery include a reduced risk of corneal dryness and a quicker recovery time compared to traditional LASIK. SMILE is also less invasive, with a smaller incision size, and may have a lower risk of complications such as corneal ectasia.
3. Disadvantages of SMILE include the limited range of correction it can achieve, as it is currently only approved for the treatment of myopia and astigmatism. It may also have a longer learning curve for surgeons, which may affect the success rate.
4. Recovery from SMILE surgery is generally quicker than traditional LASIK, with most patients experiencing significant visual improvement within a few days. However, patients should avoid strenuous activities and eye rubbing for several weeks after surgery.
5. Complications associated with SMILE surgery may include dry eyes, glare, halos, and night vision problems, although these are generally mild and temporary. In rare cases, more serious complications such as infection or vision loss may occur. 
6. Overall, SMILE is considered a safe and effective alternative to traditional LASIK for the treatment of certain refractive errors.

LASIK surgery is a popular procedure to correct vision problems like nearsightedness, farsightedness, and astigmatism. Here are some tips to help you choose the right LASIK surgery:

1. Choose a reputable surgeon: Look for a surgeon who is board-certified and has years of experience performing LASIK surgeries. Check their online reviews, ask for referrals from friends or family, and schedule a consultation to discuss your options.
2. Consider the technology: The type of laser used during LASIK surgery can affect the procedure's outcome. Ask your surgeon which technology they use and research it to determine its safety and effectiveness.
3. Discuss your expectations: Before the surgery, discuss your expectations with your surgeon. They should be able to tell you if LASIK surgery is a good option for you and what kind of results you can expect.
4. Ask about the risks and complications: Every surgery carries some risks and complications, and LASIK surgery is no exception. Your surgeon should be able to explain the risks and how they plan to minimise them.
5. Discuss the cost: LASIK surgery can be expensive, so make sure you understand the cost and what is included in the price. Ask about financing options or insurance coverage, and don't choose a surgeon based solely on price.

Just like every surgery, LASIK surgery also has certain risks and complications associated with it. These risks and complications include the following, 

1. Dry eye: One of the most common risks with LASIK eye surgery is dry eyes due to temporary reduction in tear production. 
2. Glare and halos: In some cases, the patient may experience trouble seeing at night, such as glare, halos, or other visual disturbances.
3. Astigmatism: In certain cases, uneven removal of the tissue during the surgery may cause astigmatism. In such cases, glasses, contact lenses or another surgery may be needed. 
4. Undercorrections: When very little tissue from the eye is removed during the surgery, under-correction may occur. This is more commonly seen in patients having nearsightedness. 
5. Overcorrections: When excessive tissue is removed from the eye during the LASIK procedure, then overcorrection may occur. 
6. Complications with the flap: Flap complications arise in case, where the flap is removed or folded back from the front of the patient’s eye during the LASIK procedure.
7. Regression: Although rare, regression is a complication that arises when the patient’s vision changes back to the old prescription. 
8. Loss of vision: In rare cases, loss of vision may occur after a LASIK surgery.

There are certain post-operative practices that are to be exercised by patients who have undergone LASIK surgery. These post-operative care tips include the following, 

1. Taking adequate rest.
2. Wearing sunglasses.
3. Taking the medications and eye drops as prescribed by the doctor.
4. Wearing a protective shield for the first 4 nights after the surgery.
5. Avoiding rubbing the eyes.
6. Wearing eye makeup is to be avoided.
7. Avoiding hair showers or head baths.
8. Avoid any heavy activity, exercise or driving.

LASIK eye surgery is a popular treatment method for correcting different types of refractive errors. There are different types of LASIK surgeries available today. All these types of LASIK surgeries are effective and safe. After thoroughly examining the patient, the doctor will choose which type of LASIK surgery is best for the candidate. During the examination process, the doctor will also establish whether the patient is a suitable candidate for LASIK or not.

At HexaHealth, we believe in delivering top-notch eye care services to our patients. Our team of highly skilled eye doctors is equipped with the latest technology and expertise to provide the best LASIK treatment. We are dedicated to ensuring that every patient receives personalised care and attention. Our goal is to provide affordable and accessible LASIK procedures to everyone without compromising quality. At HexaHealth, you can trust that you are in good hands and will receive the best care possible.

Suggested Reads

To read more on LASIK surgery, visit the following links:

• Lasik Surgery
• Is Lasik Painful
• Before and After Lasik Eye Surgery
• LASIK Eye Surgery Gone Wrong
• Minimum Age for LASIK Surgery
• LASIK eye surgery recovery time
• Is Lasik Surgery Safe
• Lasik Surgery Side Effects
• Which Insurance Companies Cover LASIK Eye Surgery in India