Refractive Surgery in India

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What is Refractive Surgery?

Clear vision is achieved when light passes through the pupil, lens, and cornea, focusing directly on the retina. Refractive errors such as astigmatism, farsightedness, and nearsightedness can occur when the cornea has a flat, steep, or round shape that is related to the eye length. In such cases, light rays may focus behind or in front of the retina. Vision correction surgery, also known as refractive surgery, is performed to address these errors by modifying how the eye focuses light and changing the shape of the cornea.

Types of Refractive Surgery

Intraocular : In this procedure, a synthetic lens is implanted into the patient's eye. This can be achieved by either removing the natural crystalline lens or by performing the procedure without removing it.

Keratorefractive : In the course of this refractive surgery, alterations are made to the physical structure of the cornea.

Who should consider Refractive Surgery?

  • Candidates who have an appropriate refractive error.
  • Candidates who want to decrease their dependence on contact lenses or glasses.
  • Candidates who understand that it is still required to wear corrective lenses or contacts after the surgery so as to achieve better vision.
  • Candidates who are free from eye diseases.

Refractive Surgery Procedures

Refractive Lens Replacement : This surgical procedure is designed for individuals aged 50 and above who have experienced distortions in the eye lens. Those dealing with significant nearsightedness and farsightedness often choose this surgery. It involves the replacement of the natural lens with an artificial lens of appropriate power, akin to cataract surgery. This method is suitable for individuals in the cataract group or those in the early stages of cataract development. In situations of high refractive errors, this approach becomes the sole viable option.

Photorefractive Keratotomy (PRK) : Astigmatism, farsightedness, and nearsightedness refractive errors find correction through the application of an excimer laser in this surgical procedure. It is tailored for addressing low to moderate degrees of these refractive issues. The method involves ablating certain tough tissue and detaching the thin corneal epithelial layer. The final refractive outcome may take 2-3 months to fully manifest. Initially, there might be some discomfort in the eye for a few days until the corneal surface layer regrows over the treated area. The use of topical treatment during surgery, along with the Mitomycin-C drug, can prevent haziness in the eye.

Phakic Intraocular Lens Implantation : In this method, an intraocular lens is strategically placed either behind or in front of the iris. Working in tandem with the natural eye lens, this additional lens ensures a more accurate bending of light rays. This approach proves highly advantageous for addressing high degrees of myopia, particularly benefiting younger patients by enabling them to focus near their natural lens.

Laser In-Situ Keratomileusis (LASIK) : In this method, a microkeratome is employed to provide support to the tissue and create an outer flap of the corneal epithelium. Using an excimer laser, a precise ablation is then performed on the underlying structure. LASIK is a comprehensive procedure that effectively addresses all refractive errors. The outcomes post-LASIK are generally positive, and the recovery is swift. One significant advantage of LASIK is the absence of discomfort or pain after the procedure, making it a widely favored and popularly performed refractive technique.

Laser In-Situ Epithelial Keratomileusis (LASEK) : In this method, the outermost layer of the cornea, known as the epithelium, is treated using a dilute alcohol solution. The alcohol serves to harden the epithelium, making it easier to dissect and enhancing its manageability. The cornea's reshaping is achieved by substituting the epithelial layer with an excimer layer. A newer variation of this procedure, EpiLASIK, involves using a mechanical instrument to push aside the superficial layer of the cornea, eliminating the need for alcohol treatment in such cases.

Refractive Cataract Surgery

Refractive cataract surgery represents the integration of contemporary refractive surgery techniques with conventional cataract surgery. The primary objective of this surgery is to eliminate the dependence on corrective eyeglasses, providing individuals with cataracts the opportunity to achieve normal vision.

A noteworthy advancement in refractive cataract surgery involves the utilization of intraocular lenses (IOLs). In cases where a cataract is present in only one eye, an individual has the option to undergo IOL implantation in both eyes. Refractive lens exchange (RLE) is the specific procedure employed to replace a natural lens that has not yet developed a cataract.

Benefits of merging RLE in one eye and Cataract in the other Eye

  • Presbyopia is addressed by incorporating a clear lens to diminish the need for reading glasses.
  • Enhanced refractive outcomes are achieved for binocular vision overall.
  • Anticipating the need for future cataract surgery by maintaining a natural clear lens in the eye.
  • Rectifying refractive errors in the eye using the natural clear lens.

Types of Intraocular Lens (IOLs)

There are two types of IOLs that are used in refractive cataract surgery :

  • Presbyopia Correcting IOLs
  • Toric IOLs

Cost of Refractive Surgery

India has gained recognition for its specialized eye treatments, boasting well-trained eye surgeons who comprehend the needs of patients. The cost-effective nature of eye surgery in India draws patients from around the globe.

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