1. Can I drive immediately after having LASIK surgery ?
2. Can I wear contact lenses after LASIK surgery ?
3. Does the LASIK procedure hurt ?
4. How long after giving birth can I undergo LASIK surgery ?
5. How long will I be out of work after having LASIK ?
6. What is Wavefront LASIK ?
7. When can I go scuba diving after LASIK ?
8. Why is an HIV Test required before undergoing LASIK ?
9. Will it be harmful to the eyes if I fly on a plane after the surgery ?

1- Can I drive immediately after having LASIK surgery ?
Answer Patients may experience some discomfort and/or blurred vision for a few hours after surgery. After surgery, the eye is covered with a plastic eyeshield, which is held in place by adhesive tape. Although the eye-shield is perforated and the patient can see through the holes, peripheral vision is very limited and driving should be avoided. Once the eyeshields are removed the next day, the patient can resume driving as normal.

2- Can I wear contact lenses after LASIK surgery ?
Answer Even in the normal unoperated population, not everyone can successfully wear contact lenses. There are several factors that determine whether one can wear contact lenses, e.g. corneal curvature, tear function, etc. After LASIK the main attribute that changes is the shape of the cornea, so it is conceivable that if someone needed to go back to wearing contact lenses, he or she might have to be fitted with a new pair of lenses, and that the fitting might required more effort than usual. It is also possible that even after considerable efforts, he or she may not be able to successfully wear contact lenses. In our experience, post operative patients required to wear contact lenses (mostly “fashion” contact lenses) have been able to use them successfully.

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3- Does the LASIK procedure hurt ?
Answer Patients will be given a local anesthetic ( eye drops ) to numb the eye. They should experience no pain during the procedure. They may experience a slight pressure during the 10 –15 seconds when the surgeon applies the vacuum ring and the microkeratome – the instrument used to create the flap. The laser causes no pain at all but makes a audible noise. The patient will also notice the smell of the tissue that has been evaporated from the eye’s surface (a sometimes frightening burning smell although the laser itself causes virtually no heat to the surrounding tissue). There are a number of symptoms that may occur immediately and on the first night after LASIK surgery. Patients may feel some irritation, similar to having dust in the eyes. Some people experience either tearing or dryness. Most symptoms will have improved by 80% on the morning after the surgery. It is important to get a full night’s rest on that first night.

4- How long after giving birth can I undergo LASIK surgery ?
Answer During your pregnancy or breast-feeding period, your eye measurements are subject to fluctuations due to hormonal changes. Hence, you may not be a suitable candidate for LASIK during these periods. It is recommended that you should wait at least 3 months after delivery or wait until after your second menstruation period or cessation of lactation before undergoing LASIK.

5- How long will I be out of work after having LASIK ?
Answer It depends on your occupation. Certain jobs that require intense clarity of vision (accounting, dentistry, and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery, especially during prolonged near work.

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6- What is Wavefront LASIK ?
Answer Wavefront LASIK measures the eye’s light-bending characteristics that not only include defects like near-or-farsightedness, and astigmatism, but also finer, higher level of errors (collectively known as “optical aberrations”). This information is then used to drive an excimer laser to create a near-ideal optical system of a human eye. It is applied as a part of the next-generation LASIK. The first part, the measurement of optical aberrations, is carried out with an Aberrometer, a “wavefront sensor” that measures global(front to back) deviations at various positions in a given eye. This information is combined with elevation /curvature/thickness data from the cornea in that eye, obtained with the Orbscan 2Z topography system, to create the laser pattern that would fit that particular eye and result in the best refractive (light-bending) characteristics with the least remaining aberrations possible. The laser pattern is fed into an excimer laser that can create this customized pattern on the cornea. This whole system is called Wavefront LASIK. Standard(3rd-generation) treatment would be equivalent to grinding your prescription glasses into the cornea, which is quite adequate for some people. Wavefront LASIK, however, aims to create a nearer-to-perfect optical system. This should yield an even better quality of vision, especially in low-light situations.

7- When can I go scuba diving after LASIK ?
Answer After 2 weeks, swimming and scuba diving are permitted. Opening your eyes underwater in a swimming pool is never recommended for anyone (LASIK or not), because the chlorine is a strong chemical irritant.

8- Why is an HIV Test required before undergoing LASIK ?
Answer It must first be stated that there have never been any reports of transmission of the HIV virus through LASIK surgery. Our HIV testing policy is in accordance with practical standards required for surgery. In an elective procedure such as LASIK, it is all the more important to have appropriate information about the patient’s general immune status. For an HIV positive patient, we would work with a trained internist to determine the patient’s immune deficits (CD-4 count, viral load, etc.) and then decide candidacy for LASIK. HIV positive patients will also perform LASIK one eye at a time. Whether HIV positive or negative, we adhere to ‘universal precaution’ protocol and standard aseptic and sterilizing protocol in handling all instruments. We sterilize all equipment and incinerate all single-use items after each patient. We take great pride in our superb safety record and were the first in Asia to be recognized by ISO 9001:2000 for our excellent safety standards. We continue to meet and exceed these necessary standards.

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9- Will it be harmful to the eyes if I fly on a plane after the surgery ?
Answer Patients are often concerned that changing pressure in an airplane can hurt the eyes after LASIK. This is not a problem. The truth is that the dryness of an airplane cabin is the greater concern. LASIK patients will need to moisturize their eyes frequently with artificial tears to prevent dryness and discomfort (perhaps every 15-30 minutes of air travel). We routinely have patients who fly the day after LASIK surgery.

Eye Focusing Problems
Normal Refraction
The eye is the most significant and precious part of our body. As much as 70-80% of what we perceive and learn is achieved through vision. Being able to see clearly is, therefore, the most important factor that influences our capacity to lead and enjoy a normal life. Clear vision is the result of light being focused by the cornea and the crystalline lens on to the retina.
If the eye's focusing power does not correspond with its length, the retina will not receive a clear, focused image, causing a condition called Refractive Errors or Ametropia. This condition can be categorized into the following forms:

• Myopia or Nearsightedness

• Hyperopia or Farsightedness

• Astigmatism

• Presbyopia

1. Who is at risk?
2. How is a cataract diagnosed?
3. How effective is cataract surgery?
4. What happens after surgery?
5. What is the chance of having normal vision again?

1- Who is at risk?
Older people are generally more at risk of developing cataracts than younger people. Approximately 60% of people ages 60 and older have their vision significantly affected by cataract formation. For people over age 55, cataracts are the leading cause of vision loss. In addition, cataracts can result from a variety of other causes, including injury, heredity, and disease.

2- How is a cataract diagnosed?
Cataracts are usually detected during an examination by a qualified ophthalmologist. Regular appointments are important for early detection of cataracts. Some of the standard eye tests that may be used to diagnose cataracts include:

• Visual acuity test - A chart is used to evaluate how well the patient sees at multiple distances.
• Pupil dilation - Eye drops widen the pupil so that the lens and retina can be better examined.
• Tonometry - Fluid pressure in the eye is gauged in this exam, which also helps detect glaucoma.

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4- What happens after surgery?
Recovery time after cataract surgery is usually about six weeks, but most discomfort should subside after a day or two. Immediately following surgery, the patient may experience some pain and irritation of the eye. Many patients also experience increased light sensitivity and a small amount of fluid discharge. Special pills and eye drops may be prescribed to promote healing and regulate the pressure inside the eye. Pain relievers may also be taken during the first few days if necessary. Follow-up exams allow the physician to monitor patient progress. Sunglasses or eye shields can help protect the eye while it is healing.

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5- What is the chance of having normal vision again?
Most people will still require glasses or contacts after cataract surgery, despite the improvement in vision that the procedure offers. After surgery, there will be a period of recovery time, while the eyes adjust to seeing without the cataract. If only one eye is treated, the eyes must learn to work together again. Many everyday activities can be resumed soon after surgery, although patients may experience blurry vision for a time. Driving may be impractical and unsafe for at first; the physician can advise the patient on the appropriate time to begin driving again. Also, patients who receive intraocular lenses (IOLs) may notice some color distortion at first. This should resolve itself within a few months, as the eyes adjust to the new, clear lenses of the IOLs.

Questions and Answers About Vitrectomy Surgery for Proliferative Diabetic Retinopathy (PDR)

1. How long will I be in the hospital for my vitrectomy surgery?
2. How is the surgery performed?
3. What are the complications of vitrectomy surgery?
4. Are there risks to anesthesia?
5. Will my eye hurt after surgery?
6. What if I do experience a great deal of pain?
7. What instructions must I follow when I go home after surgery?
8. What medicines do I use after the surgery?
9. How long will I need to wear a patch or metal shield?
10. Will I see better right after surgery?
11. Is it possible that I might not see after surgery?

2-How is the surgery performed?
The surgery is performed under general or local anesthesia. Small openings are made in the white part of the eye. Small openings are made in the white part of the eye. Small openings are made in the white part of the eye. Small, thin instruments are placed into the eye through these openings. These vitrectomy instruments include a fiberoptic light used to light the inside of the eye, and a variety of cutters, scissors, and forceps. The surgery is done using a microscope that focuses through the pupil.

3- What are the complications of vitrectomy surgery?
There are risks and complications that can occur with any surgery. The risks and complications that can occur with vitrectomy include: infection, retinal detachment, retinal tear, cataract formation, glaucoma, more vitreous hemorrhage after surgery, and the development of scar tissue. Although these complications can often be managed by further treatment, any one of them may cause the vision to get worse or cause a total loss of vision and perhaps eventual loss of the eye.

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4- Are there risks to anesthesia?
General anesthesia always carries a degree of risk. Minor risks include postoperative nausea, vomiting, and hiccuping. Some patients experience an upset stomach following surgery. If nausea does develop, it can be controlled with medication. Occasionally, patients will experience some confusion and prolonged sleepiness. Older men may have trouble urinating. Very rarely, serious reactions occur that may result in liver failure, cardiac arrest, and even death.
Local anesthesia involves placement of a needle through the lower eyelid, beneath the eye. There is the rare possibility that the needle could penetrate the eye or cause damage to the optic nerve.

5- Will my eye hurt after surgery?
Most patients will not some discomfort around the eye that can be relieved with medication if necessary. Severe pain is very unusual. The eye will remain swollen, red, and somewhat tender and uncomfortable for several weeks. Itchiness or a scratchy, foreign-body sensation when opening or closing the eyes is common. This is caused by small stitches. These stitches will gradually become soft and fall out, or be absorbed.

6- What if I do experience a great deal of pain?
If you experience a great deal of pain, please let your surgeon know promptly. Pain can be an important symptom indicating infection, excessive pressure in the eye, or injury to the front lining of the cornea. You should notify your surgeon promptly if you are experiencing more than mild pain.

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7- What instructions must I follow when I go home after surgery?
We ask that patients not engage in strenuous activity or exercise for about a week after surgery. They may return to work, or to driving, when they feel able to do so; this is usually within a week or two. They are encouraged to take walks and engage in normal activity as soon as possible.
If a patient has had the front lining of the cornea removed during surgery, a snug "pressure" patch is applied to the eye at all times until this lining grows back. It is alright to remove it temporarily when eye medications are given.
If a gas bubble has been placed in the eye to hold the retina in position, the patient may be asked to lie down on one side. Usually, the patient may be asked to lie down on one side. Usually, the patient is required to remain in a face-down position most of the time for several days. This positioning will place the gas bubble in the correct position within the eye so that the retina stays in place. If a gas bubble is in your eye, you should not sleep on your back. Otherwise, the gas bubble rises and rests against the lens of your eye and may cause a cataract. Also, the gas bubble may rise and close off the normal flow of fluid out of the eye, increasing pressure in the eye. If a gas bubble has been used as part of your surgery, you may not travel by airplane until the gas bubble has reabsorbed, and travel to high altitudes should be done in a gradual fashion. It usually takes several weeks for the gas bubble to disappear. Your doctor will advise you as to when you may lie flat on your back, and when you may travel by air.

8- What medicines do I use after the surgery?
Most surgeons will use a type of dilating drop that eases the discomfort of the inflamed eye. An antibiotic drop may be used to help prevent infection. A steroid drop is often used to reduce inflammation and make the eye more comfortable. If your surgeon is concerned about increased pressure in the eye, pressure-lowering eye drops or medications by mouth may be prescribed. Your surgeon will decide when to stop these medications, but most drops are used a few weeks. If you run out of medications, call your physician and ask if more are required.

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9- How long will I need to wear a patch or metal shield?
The patch may be worn for up to one week for the patient's comofort. In most instances, it plays no role in the healing of the eye.
The use of a metal shield may be encouraged for protection. If a patient normally wears glasses, they may be worn over the patch during the day, with the metal shield worn at night. Your doctor will adivse you whether a patch or shield is necessary.

10- Will I see better right after surgery?
The eye and the retina may take many weeks to fully heal.
When the vitrectomy is done for a vitreous hemorrhage, there will always be some blood left. This causes some cloudiness of vision that may take several weeks to clear.
There may be oozing of blood from the retina after surgery, which may result in even more vitreous hemorrhage. This hemorrhage usually clears after several days to weeks. If it doesn't clear, it can sometimes be removed on an outpatient basis by removing the fluid in the eye and replacing it with a gas bubble. The gas bubble will slowly disappear over several weeks and be replaced by clear fluid made by the eye. Infrequently, it may be necessary to reoperate in order to remove this repeat hemorrhage.
If surgery has been performed for a retinal detachment, it will take time for the retina to resume its normal position against the back wall of the eye.
When retinal tears are present, gas may be used to fill the eye at the end of surgery. The gas is used to press the retina flat against the back wall of the eye. There will be no return of vision until the gas bubble disappears.
Often the retina is treated with laser during the surgery. This is done to keep it attached, to seal retinal tears, and to prevent the growth of neovascularization. A special laser instrument is placed inside the vitreous cavity of the eye to do this. This laser surgery can result in inflammation and cloudiness that may take a few weeks to clear.
Improved vision after retinal surgery is not immediate. It may take several months before the vision improves to its best possible level. In most cases, when the diabetes has caused such damage to the retina that vitreous or retinal surgery is necessary, the eye will never again see normally. Sometimes, small amounts of visual improvement occur and, occasionally, a great deal of improvement occurs. Each eye is different and before your surgery, your doctor will discuss with you your chances for better eyesight.

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11- Is it possible that I might not see after surgery?
Despite our increasing knowledge of diabetic retinopathy, and despite the sophisticated surgical equipment and techniques that we bring into the operating room, we may find ourselves unable to improve a patient's vision. The chance for blindness in PDR is very real. When considering surgery, the patient and the doctor together must weigh the risks, including the possibility of total blindness, against the possible benefits of either stabilizing or improving vision. It is important for the patient to know that surgery may fail because of complications, or simply due to the progressive nature of diabetes.