We spoke to two top doctors known for their expertise as ophthalmologists, Dr. Mahipal Sachdev, Centre for Sight and Dr. Rushad Shroff, Shroff Eye Center who explained in detail why the disease happens, the ways to deal with them and also if LASIK is the best option to treat it.
What percentage of myopia is hereditary?
According to Dr Shroff, “The hereditary component of myopia varies among individuals and populations. Genetics can significantly influence its development, with studies suggesting that if both parents are myopic, the risk for their child to develop myopia increases. However, genetics is complicated, not fully understood and many genes are thought to be involved. The exact percentage of myopia that is hereditary is challenging to quantify precisely. It is estimated that hereditary factors may contribute to about 15-98% of myopia cases, depending on the population and the specific genes involved.”
Can it be avoided or naturally cured?
Dr Shroff says that “Myopia cannot be naturally cured once it has developed, but there are measures that may help slow its progression. Lifestyle changes, like spending more time outdoors and reducing screen time may help in stopping its progression in young adults. Newer treatments like atropine eye drops in younger children orthokeratology lenses are available at our centre and may slow its progression in certain cases- but this doesn’t work in all patients. However if you are under 18 years of age, you will have to wear prescription eyeglasses or contact lenses to correct myopia and provide clear vision. Once you are over 18 years of age and your eye power is stable, options to remove specs like SILK, LASIK and ICL are safe and effective.”
How effective is LASIK surgery?
Dr Shroff says, “Over time, various vision correction techniques have been developed to combat myopia and enhance overall visual acuity. LASIK surgery is widely acknowledged as an effective vision correction procedure, with high success rates. It reshapes the cornea to reduce or eliminate the need for glasses or contact lenses, offering clarity and convenience. However, LASIK is not as safe for sportspersons or those in combat professions. The recently launched SILK (Smooth Incision Lenticule Keratomileusis), a groundbreaking laser vision correction technique is designed to address myopia, whether with or without astigmatism in all patients- even sportspersons or combat professionals. SILK stands out due to its flapless technique, potentially reducing the risk of flap-related complications associated with LASIK. SILK also demonstrates a faster recovery, minimal dryness, and excellent visual outcomes. While LASIK remains a proven option, SILK’s unique features offer advantages in terms of safety and patient comfort.”
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What happens in a LASIK surgery?
The surgery involves the use of anesthetic eye drops for comfort, followed by the creation of a thin corneal flap using a microkeratome or femtosecond laser such as the Elita platform. An excimer laser (such as Wavelight Ex500) then reshapes the cornea to correct the vision error, eliminating or reducing the need for glasses or contact lenses. The corneal flap is repositioned without sutures, and healing occurs naturally. Most patients experience improved vision within a day or two, making LASIK an effective method for vision correction, though eligibility should be determined by an eye care professional.
Who should not be opting for this surgery?
LASIK surgery may not be suitable for everyone, and certain individuals should avoid the procedure. Those with certain eye conditions like keratoconus, cataracts, glaucoma, or severe dry eye may not be ideal candidates. Pregnant or nursing women should wait until their hormonal changes stabilize. Additionally, individuals with autoimmune diseases, a history of herpes eye infections, or thin corneas should avoid LASIK. It’s essential to consult with an experienced eye care professional to assess candidacy and discuss alternative options if LASIK is not recommended.
Most people who do not take up myopia surgery think that it can cost their eyes? Is it true? What can be the worst outcome of this surgery?
According to Dr Mahipal, “Refractive surgeries like LASIK, PRK, SMILE, ICL & SILK are generally safe and effective, but potential complications may include temporary discomfort, dry eyes, glare, or halos, which often resolve over time. In rare cases, issues like over- or under-correction, infection, or visual disturbances may occur.
However, these complications are typically manageable without causing permanent eye damage. It is important to discuss any concerns with your eye surgeon, as they can address and treat any potential complications effectively.”
What precautions should be taken before and after the surgery?
Dr Mahipal adds, “Before refractive surgery, it’s important to follow guidelines provided by your ophthalmologist, which may include avoiding contact lenses, discussing any medical conditions or medications, and refraining from eye makeup or lotions. After surgery, protect your eyes from irritants, follow prescribed eye drop schedules, and adhere to restrictions on strenuous activities or swimming to facilitate proper healing. Attend follow-up appointments as scheduled and communicate any concerns to your eye care provider for optimal recovery and results.”
Can you throw some light on the new techniques employed now for correcting vision?
Dr Mahipals says that, “Advancements in refractive surgery have introduced newer technologies like wavefront-guided and wavefront-optimized procedures, enhancing the precision of vision correction. Femtosecond lasers, used in procedures such as LASIK, enable more precise corneal flap creation. SMILE (Small Incision Lenticule Extraction) is a flapless, minimally invasive procedure utilizing a femtosecond laser. Recently, a new Technology has been launched, for correction of myopia, aptly named SILK (Smooth Incision Lenticular Keratomileusis). SILK is the next-gen in lenticule based surgeries. The laser technology (ELITA) behind SILK is also path-breaking. The laser is super-fast, ultra-precise, and dissipates a very small quantum of energy, causing minimal damage to corneal tissue. Such a fast laser gives smooth cuts on the cornea, thereby giving faster recovery, and patients have very good vision within 24 hours of the procedure. Additionally, topography-guided treatments offer
personalized corneal reshaping based on the eye’s unique surface contours, optimizing visual outcomes. These technologies aim to improve accuracy, safety, and outcomes, providing patients with more customized and efficient refractive procedures.”
A specialised lens, Implantable Collamer Lenses (ICLs) are a type of phakic intraocular lens used to correct vision in individuals with high myopia or other refractive errors. Placed between the iris and the natural lens, these biocompatible lenses offer an alternative to laser surgery, providing high- quality vision correction while allowing the natural lens to remain intact.