At Dr. Alpa Atul Poorabia’s practice, we understand that you may have many questions before making decisions about your eye health. Our FAQ section is designed to provide clear, simple answers to the most common queries about eye treatments, safety, recovery, and outcomes.
Whether you’re considering LASIK, Cataract Surgery, Keratoconus management, or treatment for Dry Eye Disease, these FAQs will guide you with trusted information — so you can feel confident and well-prepared.
Dr Alpa: LASIK is not the correct name. All surgical options given to the patient who does not want to wear glasses or contact lens, are called Refractive Surgeries.
Refractive surgeries are permanent surgical options to become glass-free or independent of glass, and are pure cosmetic surgeries, there are no added advantages as such.
There are two types of Refractive surgeries:
Dr Alpa: For a normal eye, the Clear Cornea (Shape-Normal, Flat or Steep), the Clear Lens (Changes if there is Cataract), and, length of the eye ball (Normal, shorter, or longer eyeball), matters, if they want to see clearly without any aid. Cornea and Lens has power.
If there is a mismatch or problem in any one of them, then vision will not be clear. So, to make vision clear, Patient is prescribed Glasses, depending on the Refractive Error. Like, Hyperopia is treated with plus/convex glasses, Myopia is treated with minus/concave glasses, and Astigmatism is corrected by, either plus or minus glasses at axis.
To make someone independent of glass, either cornea shape is changed by applying laser, or lens is positioned in front of natural lens, or rarely natural lens is removed and, in that place, Intra-ocular Lens is implanted, as we can not change the length of eyeball, which is God gifted like your height.
Dr Alpa: There are basically three Laser Refractive procedures.
In Laser Refractive procedure (Corneal), ultrathin layers from the cornea are removed and cornea is reshaped. Cornea has power and reshaping will change the power of the cornea. The power of the Cornea is changed in such a way, that, now cornea will be able to focus rays on the retina without any help of glass or contact lens. To remove ultrathin layers from the cornea, three different techniques are used.
Dr Alpa: If you are interested to become glass free, you need to undergo suitability test, which is called Corneal Topography/Corneal Scan.
There are many Corneal Topography scans are available from different Company. Like – Orbscan II or 3 or Occulyser or Pentacam or Sirius+ or Galilei Corneal Scan or Anteras Scan and many more.
If you are wearing contact lens, then, before going for the suitability teat, you need to stop them to remove warpage effects on the cornea. Generally, for soft contact lens at least a week, and at least 2 weeks prior in case of Semisoft Contact lenses, and for a month for hard contact lens. Otherwise, you can visit any day.
Dr Alpa: The Topography/Scan is a mapping of the Cornea. In Topography test, we look for good enough corneal thickness (At least 500µ), power of cornea which decides shape of cornea, and some other irregularities over the cornea/eye. Also, Aberrations from the eyes are measured.
Based on the parameters on your Corneal scan and Refractive error/glass number you have, your doctor will answer couple of questions and will guide you, like –
When the suitable surgical options are given and discussed with the patient, it is understood that they are relatively safe in your eyes.
Dr Alpa: Every technique/surgery has value. They have their own advantages and disadvantages. Every technique has side effects and possible complications.
After evaluating you in detail with suitability test (Topography), you will be guided about the possible suitable surgery options, by your Refractive Surgeon.
Some patients are suitable for all options and some will have limited options (Surgery) to select.
When you are informed that you are suitable for surgery either all procedures or limited options, it means that, in a way, these procedures are safe in your eyes.
As I informed before, all procedures have their own advantages and disadvantages, and complications.
Depending on your finance and comfort you can decide, which technique you would like to go from given options.
Dr Alpa: In this procedure, first layer of cornea, called Corneal Epithelium is removed and then ultrathin layers from remaining corneal stroma, are removed by the Excimer Laser to reshape the cornea. And the patient becomes glass-free.
Corneal epithelium is removed either
After surgery, Bandage Contact Lens is applied and is removed on 3-5th post-operative day.
After removal of Bandage Contact Lens, the quality of vision starts recovering. Total healing time can be 3-4 months, though maximum recovery happens during first 4 weeks’ time.
Although recovery is slow in PRK/Surface ablation procedure, in future, on clinical examination, it is impossible to find out that you have undergone surgery, as there is no cut. Very safe procedures for Army people or those who plays contact sports.
Dr Alpa: In LASIK (Laser in-situ Keratomileusis) procedure, Cornea is partially split/divided, either by Microkeratome (Blade) or by Femtosecond Laser (Blade free or Femto LASIK) with hinge at one place. After that the upper part/flap is lifted, at a hinge, like a page of a book. On lower exposed corneal stroma, Excimer Laser is applied, which will reshape the cornea by removing ultrathin layer. After that flap is repositioned back over corneal stroma without any suture, pad, or patch. And patient can start seeing within 24 hours of surgery, without any glass or contact lens. First day patient need to take rest by keeping the eyes closed. Total recovery is around 6 weeks.
Now a days, Femto Lasik is regularly performed surgery. Blade Lasik is rarely performed as there are better and safe surgical options available.
Advantage of LASIK surgery, is fast recovery. Disadvantages include, flap related complication, not only during and after surgery but also can be present in long run.
Dr Alpa: As there are many lenticule based surgeries available today, like SMILE/SMILEpro FROM Zeiss, SILK from J & J, CLEAR from Zeimer, SMARTSIGHT from Schwind/ATOS. These lenticule based surgeries are now given new name, KLEx- Kerato Refractive Lenticule Extraction.
KLEx is small incision, flap less, one laser, one stop surgery, where only Femtosecond laser is used. In this surgery, Refractive corneal lenticule which is ultrathin layer from corneal stroma is separated, along with small access incision to remove it, by Femtosecond laser. Size of lenticule is calculated depending on the Refractive error patient has. After completion of laser pass, the refractive lenticule’s anterior and posterior plane is separated, through small access incision. Finally, whole separated Refractive lenticule is removed through same small access incision. By this, the cornea will be reshaped to focus rays on the retina without any glass or contact lens.
In this procedure, patient will start seeing within 24 hours of surgery, without any glasses or contact lenses, though first day rest is required. Total recovery is around 6 weeks.
Advantage of Lenticule surgery is faster recovery. Also, a good option for those who plays contact sports. Disadvantage is, expensive procedure, as comparatively, it is newer technique.
Dr Alpa: Lens based solutions means Phakic lens (PIOL)/Permanent contact Lens (PCL) implantation. In this surgery, artificial lens, which has power, is positioned in between Iris and natural Lens. After surgery, the patient can see without glasses or contact lenses. Though patient can start seeing within 24 hours, reading comfort may take few days to come. By one week, most of the patients are very comfortable with the surgery. Total recovery time is 4-6 weeks.
There are different lenses available. Spherical (For Spherical power) and Toric Phakic lens (For Astigmatism/Cylinder correction). Brand includes, Staar (ICL, T-ICL), IOCare (IPCL, T-IPCL), Biotech (Eyecryl- Spherical and Toric)
Advantages include; good quality vision compared to Laser Refractive Surgeries. As it is intraocular surgery, I prefer to do both eyes on different days. Whereas Laser Refractive surgeries are performed in both eyes together.
Dr Alpa: “Wavelight Plus InnovEyes” is another program developed by Alcon. It suses AI driven ray-tracing technology to deliver truly personalized treatment down to the individual optical sytem oof each eye.
The system uses the InnovEyes (SightMap) device to integrate three diagnostic tools- Wavefront Aberrometry, Corneal topography and Biometry- into one, allowing a fully comprehensive 3D mapping of your eye, “EyeVatar/Digital twin”, created for surgical planning. AI thensimulates virtual surgery on the EyeVatar, refining the plan using Ray-tracing to optimize how light travels through the eye. Final treatment is then done via EX500 Excimer Laser System.
Advantages includes- it is fully personalized, AI-driven precision, and that’s why predictive adaptable outcome.
Dr Alpa: Contoura Vision is a Topography-Guided LASIK/PRK Treatment designed to provide surgeons the ability to perform more personalized and custom laser procedures for patients, based on their unique corneal topography. It is available on “Wavelight” platform from EX500 Excimer Laser sytem from Alcon.
In addition to correcting your specs power, Contoura Vision also corrects your corneal irregularities while working on Visual axis, thereby providing much sharper visual outcomes (Almost in 40% Patients).
Corneal Irregularities Removal- Contoura Vision with the help of Topolyser, can map the corneal irregularities using 22,000 unique data points and then correct these irregularities, creating an optically perfect surface of the cornea giving you sharpness in the vision.
Visual Axis Treatment- Two kinds of axis exist in our eye.
Pupillary Axis- A line passing through the line of sight in the eye
Visual Axis- A line passing through the line of sight in the eye
The difference in this axis is 5 degrees
Contoura Vision Treatment is directed towards Visual Axis, providing much sharper visual outcomes compared to other Laser Refractive surgeries, where treatment is generally done on pupillary axis
Epicontoura/Streamlight Laser- It is a TRANSPRK procedure where first layer is removed with Excimer Laser and then power correction done by Excimer laser.
Dr Alpa: It is a touchless, flapless, bladeless, stressless, smoother TransPRK, a type of Surface ablation surgery. SmartSurf combines the benefits of touch-free TransPRK surface treatment with innovative SmartPulse Technology. People also call it Robotic surgery.
SmartSurf in combination with Corneal wavefront (Aberrations or irregularities), allows maximum correspondence between the corneal topography and the ablation profile.
The healing process is faster and vision recovers sooner than, with other surface treatment.
As it is non-invasive, there is less stress on the cornea, and the potential for more biomechanical preservation and stability. Suitable for all, ideal for active and athletic people who do contact, water or air sports.
The innovative SmartSurf procedure is the gentle, safe, stress-free, non-invasive answer to LASIK and SMILE/Lenticule Extraction.
This innovative method is available with “SCHWIND AMARIS” platform.
Dr Alpa: The Refractive surgery makes you glass free till you develop age induced changes in the eyes, like, Reading glass (Presbyopia) at the age of 40 years and Cataract in future etc.
So yes, Refractive Surgery is a permanent option to become glass free or independent of glass in majority of the patients.
There are few people, where power progresses even after 21 years of age, because of unexplained reason.
Dr Alpa: Generally, No. But for that, surgery should be done ideally, means without any compromises. Though Refractive surgeries can be done after 18 years of age, my personal recommendation is to wait till 21 years of age. Also, last 2 years there should not be any change in refraction/power, means it should be stable for at least last 2 years.
Sometimes, there are reasons, in some patients’ small power comes back (Regression), e.g., for girls during first pregnancy, generally higher refractive error/power corrections especially above 8 DS, compromised correction at first place-inadequate thickness etc.
You can discuss your condition with your Refractive Surgeon.
Absolutely No.
Dr Alpa: Not directly, because of Laser surgery.
For Myopia, regular detailed eye examination at least once a year is very important and it is recommended to continue after surgery also, to avoid any serious complications associated with Myopia/Retina.
Any Retina degenerations/problems should be promptly corrected to avoid serious vision threatening retina complications, in future.
That is why, before surgery, thorough evaluation of your eyes and Topography by expert surgeon is very important.
Dr Alpa: When corneal thickness is not good enough to undergo Laser Refractive Surgery, it means that, Laser Refractive Surgery is not safe in your eyes, but your eyes are normal.
In this situation, if suitable (means good enough anterior chamber depth) then, permanent contact lens/Phakic lens implantation, is the option to get rid of glasses.
Sometimes in borderline cases, where power is small, then Surface Ablation also can be advised. You can discuss this with your Refractive Surgeon.
Dr Alpa: ICL is a Phakic lens available from STAAR, company form Switzerland. It is known as Phakic Lens Implantation surgery, as this lens is implanted in the eye without disturbing lens or any other structure inside the eye.
It is recommended to those people who does not want to wear glasses or contact lens, and not have good enough corneal thickness, either thin cornea or very high power.
For ICL surgery, you should have good enough anterior chamber depths.
Advantages include, good quality vision during day and night, chances of regression significantly reduce. Side effect includes, experiencing glare surrounding the light in initial days/week, which settles down with time. Also, I do not perform both eyes together like, Laser Refractive surgeries.
Dr Alpa: The unavoidable side effect of all Laser Refractive surgeries, is Dry Eyes, which takes couple of weeks to sometime months to settle down. For it, Lubricating Eye Drops are recommended for initial few months.
Sometimes, night time glare and colored haloes around the light can also be there initially after surgery.
Dr Alpa: From 1st post-operative day, face wash and head bath are allowed, but for 2-3 weeks, patient should be careful about water, soap, shampoo, going inside the eyes. One, to avoid getting infection in the eye, Two, it will make your eyes more dry and you will have more discomfort.
Dr Alpa: In Lenticule and LASIK surgery, next day onwards, and in Surface Ablation after 1 week, patient feels comfortable to read or work on computer.
But in any surgery, there is always recovery time. It depends on how fast body start adjusting to the surgery. Generally, comfort slowly comes within couple of days.
Dr Alpa: For LASIK and KLEx/Lenticule procedures, from 2nd day onwards and for Surface Ablation, from next day of contact lens removal, you are allowed to do everything normally, provided you feel comfortable doing it.
Your eyes will be in recovery mode, please give some time to feel and able to do daily chores comfortably, though there is no restrictions on daily activities.
Dr Alpa: For LASIK and Lenticule/KLEx procedures, majority of patients may be able to drive within few days and for Surface Ablation, next day of contact lens removal.
But night driving should be started when you feel comfortable in night light.
I would also recommend that you discuss this with your operating Doctor on first post-operative day.
Dr Alpa: Absolutely no, provided you are suitable for the Laser/Lens Refractive surgery today.
There is one serious risk of Laser Refractive surgery, it is LRS induced Ectasia (Keratoconus).
To avoid this, evaluation/reading of Topography and guidance after that regarding surgery is very important by expert/highly experienced Refractive/LASIK Surgeon.
Dr Alpa: Most important ones are next day and 7th day. After that 1,2,3,6,12 months and then yearly follow up. In case of PRK/Surface ablation procedure, bandage Contact Lens is placed after surgery which will be removed between 3rd – 5th day.
Generally, majority of patients are very comfortable after one month of surgery. So, for some reason, if you cannot visit your Doctor, then also, do not ignore minor issues, get in touch with your Doctor, at earliest.
Do not forget yearly once, detailed Retina Examination of your eyes.
Dr Alpa: They can undergo the Laser Refractive Surgery, for the job purpose, within the applied rules and regulations of that particular job. Most important is suitability of Refractive surgery.
Though there is no 100% guarantee after any surgery, so many of you get this surgery done and get recruited also under the applied rules and regulations. As Refractive Surgeries are pure cosmetic procedures to get rid of glasses, majority of time, “zero” power is achieved in each eye.
Dr Alpa: Laser Refractive Surgeries are not detectable on naked eye. But by investigations it can be detected by Expert Refractive Ophthalmologist/Eye surgeon.
PRK does not have any cut over the cornea but Lasik and Lenticule surgery have cut within the cornea, that cut will always be visible and can be seen by an Eye Specialist on Slit-lamp examination.
Same way, Phakic Lens cannot be seen by naked eye, but Eye specialist can see it in Slit-lamp examination.
There are still ways to detect, whether you have undergone Refractive surgery or not.
Dr Alpa: If you are not suitable for Laser Refractive Surgery, then nothing can be done to change it.
But, remember it is not an abnormal or diseased or problematic eyes, but the Refractive Surgery is not safe in your eyes, as it can lead to some serious sight threatening complication.
Dr Alpa: Absolutely No.
Refractive Surgeries, whether Laser Refractive Surgeries or Phakic lens, are pure cosmetic surgeries for those people who does not want to wear glasses or contact lens.
There are absolutely no added advantages.
Dr Alpa: Refractive Surgeries are cosmetic options for those who does not want to wear glasses or contact lenses.
It can help you with,
Dr Alpa: According to me, all surgical procedures available today with different name have their own pros and cons. I just look at the refractive error, parameters over topography, patients own requirement and budget, finally I decide this is the best procedure for those patients. And remember, every individual is different. Each machine or technologies, I have worked and available today, have given me very predictable and satisfactory results and to all my patients.
Available Laser Refractive surgeries today:
In Surface ablation and LASIK surgeries, different program is available like, Wavelight Plus InnovEyes, Contoura, Smartsurf or Smartpulse, Xyptix HD, WFO, Aspheric ect.
In my humble opinion, experience of Refractive surgeon matters in favorable or excellent outcome of surgery- How He/She evaluates your eyes, guidance for the surgery and finally planning and execution of surgery plan. I have worked on different machines from different companies like, Alcon, Schwind, B & L, Zeiss, J & J (AMO), Zeimer etc. And All platforms have provided very satisfactory outcome for me.
I would still prefer Surgeon experience and skill over Machine, in today’s AI driven world.
I hope all these questionnaires will help you to make a choice about the surgery.
If there are still any doubts regarding surgeries to get rid of glasses, I will be indeed happy to help you, please feel free to reach me.