Q. Repeat PRK or Photorefractive Keratotomy possible? Hi, welcome this is Dr. Khanna. I’m going to speak to you about a very interesting topic which came up this morning. Somebody who ten years ago had PRK which is photorefractive keratectomy. If you remember, PRK came before Lasik about 20 to 25 years ago. I remember doing my first one in 1997 or so. At that time, we did not have all the advanced lasers that we do now, nor did we have advanced medicines and drops like today, so a lot of the experiences patients had with PRK was very bad. In fact, that’s why we don’t do PRK today and we’ve gone on to Super Lasik, Epi Lasik or Laser Scraper modifications. Today, it’s a much more comfortable journey.
The topic we are coming to is, if you had PRK 10, 15, or 20 years ago and you need a touch up, what’s the best option? The best option would depend on your age. Let’s say you’re in your 40s, the touch up is likely to be less than one or two diopters. In those cases, we would to have to check your cornea with the latest methods of pachymetry and topography mapping to see if, by any chance, Lasik is possible. Ninety percent of the time, PRK might have been done because Lasik was not an option, but there might be 10% of cases that were done because Lasik was unavailable, or the surgeon was not very confident with Lasik at the time.
It’s important to come for a full exam so we can analyze what’s best for you. There are some people who will have corneal weakening or excess refractive numbers, in those cases you would want to see if implantable collamer lens (ICL) might be an option. Let’s say you’re about 55, then before we do a laser touch up, we would first have to discuss other options like presbyopic implants.
Yes, I missed the one age range for 40 to 55, right? That’s interesting because in that group there can be multiple options available and we’ll have to discuss your lifestyle, look at the numbers, and then come up with a better solution. There is no fixed answer for that age group.
As a summary, if you’re less than 40, laser touch up with PRK or rarely with Lasik, might be an option. If you’re above 55, presbyopia implants might be the first option. In 40 to 55, one of these previous two options might work depending on your lifestyle.
If you have any more questions about PRK, Lasik, touch ups or enhancements, feel free to write to us. Thank you and have a wonderful day.
Did you feel that earthquake? Yes, we were rocked by an earthquake with the epicenter being near Channel Islands. We were very lucky, we didn’t have any injuries, and nothing broke down. But, two patients came today with some interesting observations and stories and I wanted to relate them to you.
One patient recently had Lasik with us. He said when the earthquake struck he was one of the special invitees who has the alarm on his phone which goes off a few seconds before an earthquake strikes. He was able to pack his bag and rush out of the building before the earthquake struck. The second patient who came said yesterday he realized why we should have Lasik eye surgery.
He had just taken off his glasses and was rubbing his eyes or something like that when the earthquake struck. When everybody started rushing out, he ran out as well; however, he couldn’t see well because he wasn’t wearing his glasses causing him to hit his head on the door as a result.
He came in today saying, now I need Lasik eye surgery. This is just one of the examples I’ve come across in my twenty-six years helping people see better. One of the small things in life which can change when you have better vision during some big things like a natural calamity like in a storm, Hurricane Katrina, et cetera. Or, an earthquake like yesterday.
When vision becomes one of the most important things in regards to our safety, it’s at that time that we realize how important it is for our emergency responders like firefighters to have good vision when they run into smoke, rubble, and fire to save people.
I’m sure you have other interesting stories where either you’ve already experienced the benefits of having Lasik eye surgery, or you wish you had Lasik eye surgery. We would love to hear from you, so send us your stories.
Lasik Earthquake Safety lesson is over
Thank you. This is Dr. Khanna signing off.
Hi. Welcome. This is doctor Khanna. I want to talk to you about fear of eye surgery. This lesson is divided into three parts. Today’s lesson is on why we are so afraid of eye surgery. In the forth coming lesson, we will discuss how to overcome the fear. Why are we so afraid of eye surgery, we have to delve back into evolution, our upbringing and find some answers there. People are always afraid of the dark. Remember when you were a kid; you thought that there might be a monster in the closet or under the bed. People are afraid to go to the graveyard but today it is so much better. There are streetlights everywhere and we have a phone with flashlight on it.
Imagine Sherlock Holmes going out in the night when there is fog and mist around. There is an inherent fear in us coming from the times we lived in the forest. In the night, predators would come out and that fear has continued. Another thing you might have heard of is insomnia, when people are unable to sleep. It is very interesting why some people find it difficult to fall asleep and the simple answer might surprise you. The answer could be that they are afraid that they may not be able to get up if they go to sleep. They are afraid to lose their consciousness and go into a semi-conscious state. It is inculcated in every culture. Each civilization that is present on earth celebrate the festival of light in the dark days. That is their hope to overcome the darkness.
Another fear the people have is for the white coat. It is funny that people can check their blood pressure at home and it is okay and then they come to the hospital and see the white coat and the blood pressure shoots up. These are all evolutionary mechanisms that are built in for safety to preserve us and they all stack against us. There is one more called the menace reflex; when something comes near the eyes or when we sneeze, they instantly close. That is encoded in our DNA.
Corneas and eyes are every important. In fact, some evolutionary biologists feel that this reflex may have pre-dated the existence of eyes. Small microorganism who do not have eyes have had light shun on them and they immediately move away. All those things combined in the subconscious and conscious mind are all playing to develop fear about eye surgery. Do not feel fearful.
In the next lesson, we are going to come up with methods that are time tested and true to see, how we can overcome the fears regarding eye surgery. Thank you
This is an updated article about what to expect on day of Lasik Eye Surgery. Many people are anxious about the procedure and this informative piece is directed to them. One of our secrets is work on this anxiety even before the day of procedure. How do we do this? We go over all consents and explain the procedure in detail a few days before. Our considerate staff even helps them finance the procedure ahead of time. For the special extra nervous or claustrophobic folks we even lay them under the laser and do a demo.
LASIK surgery is very beneficial and in most cases a painless procedure. The procedure itself is only about 4 to 5 minutes for both eyes. At Khanna Institute we strive to make it as comfortable as possible for each of our patients.
We make all patients feel welcome at our office. There is always someone at the front desk to greet and help the patient. This eases anxiety. We offer Xanax in low dose to further lower apprehension. Last minute questions are answered by our knowledgable techs. Once everything is ready for surgery the patient is taken back and prepared for their LASIK surgery. This includes getting a bonnet to cover their hair and Cleaning the eye with Betadinde solution swab. It is the strongest antiseptic. It kills bugs hiding in the lashes of the eye.
When in surgery suite the patient is lasik flat under the idesign laser system. The patients family or friends can watch all of the laser eye surgery through the window. Advanced automated idesign lasik surgery is performed. Throughout the procedure there is patients fav music in the background. Doctor and surgical and laser techs explain each step so nothing comes as a surprise.
After the LASIK surgery the surgeon checks each eye to make sure the patient is fine. Then the post up instructions are given. The eyes are shielded and dark sunglasses given. Postoperative instructions are given. The patient then is free to go, but will come back the next day for a follow up. Patients are always satisfied with their noticeable improved vision as soon as the next day.
We hope what-to-expect-on-day-of-lasik-eye-surgery helps you to overcome anxiety of your Los Angeles lasik procedure. If you have suggestions for this or future posts please do not hesitate to contact us.