Refractive surgery encompasses a very wide range of procedures which primarily aim to reduce the spectacle dependence of patients. Safety profile of these surgeries is excellent and they have given extremely reproducible results over the years. As with any other surgery, the outcomes depend upon patient selection and selection of the right procedure. “One size does not fit all” and that’s why we recommend any surgical procedure after thorough evaluation of our patients. 

With that being said let us explain what is the meaning of “reduced spectacle dependence”. Our vision has two primary constituents namely quality of vision (Contrast sensitivity) and quality of vision (Visual acuity). What any optometrist measures when they ask a person to read the Snellen’s chart (chart with many alphabets written on it) is the quantitative assessment. So 6/6 vision is 100 percent of that of a normal population. Now this 100 percent is calculated by taking an average of vision of thousands and thousands of normal patients of which, many will be better that 6/6 (6/5 or 6/4) and many will be worse (6/9 or 6/12). The normal individuals having lesser than 6/6 vision practically have no problems in their day to day life because their optical requirement is not same as that of a pilot or a surgeon. So similar analogy applies to results after any laser vision correction surgery. All patients undergoing spectacle correction surgery may not achieve 6/6 vision but almost 90% (see reference below) patients hold a vision of 6/12 or better after 10 years of lasik surgery. And as we have seen that 6/12 in either eye separately translates almost to 6/9 with both eyes, which is very well within the range of spectacle free result after 5 years of surgery. Some of the patients may need spectacle if they wish to read very fine prints from far off, like small prints in television etc but most people will not have any difficulty.

Lasik long term results

The Regression

Regression means appearance of glass prescription (more than 1 D Spherical or 1.5D cylindrical) which requires correction either by spectacles or repeat surgery. More often than not true regression (the one which happens due to altered corneal remodeling) is very rare. The major problem in LASIK Industry is misinformation. Unfortunately many ophthalmologists are doing refractive surgeries without proper knowledge or training. What we commonly see in cases of regression is

1. A surgery performed before the glass prescription was stable.

2. Incomplete/poor ablation profiles used.

3. Lasik machine not well maintained.

4. Eccentric ablation leading to residual astigmatism.

5. Patients on hormone replacement therapies.

Keeping in mind the above said points a laser vision correction surgery performed by an experienced surgeon with a well maintained modern Excimer machine gives nothing less than Exceptional results.

Laser surgery is not a “one time gig”. Patients are expected to visit at defined interval to check for dry eyes and healing response. Topical steroids (commonly used after surgery) may need to tapered according to the patient condition. General condition and overall health is an important aspect of tissue healing.