Refractive treatments is gaining popularity
in India both among the public as well as among ophthalmologists.
Till a few years ago only a few centers performed high volume radial
keratotomy. Today, the highest international quality of eye care
for cornea, cataract, squint and glaucoma is available in various
centers all over India. When it comes to reliability, India has
the best ophthalmic surgeons with clinico-academic expertise honed
to perfection in the best possible institutions. Visual aid Center
in Delhi, Manipal Hospital in Bangalore are some of the more popular
eye care hospitals.
The No Stitch Cataract Surgery with the most modern way of removing
cataract through the use of Phacoemulsification procedure can be
performed in India for as little as US$ 480 for both the eyes, whereas
the same surgery costs $ 45,000 in the USA.
Mediescapes India could arrange the
following low cost medical procedures for you.
Eye Procedures routinely done in India
- Cataract + Glaucoma
- Corneal Transplantation Surgery
- LASIK (both eyes) Eye Surgery
- Ocular Surface Reconstruction
- Phototherapeutic Keratectomy (PTK)
- Phaco + IOL (one Eye)
- Glaucoma
- Squint (general anesthesia based) Surgery (2 / 3 muscles)
- Retinal detachment
- Vitrectomy
- Vitrectomy + Retinal detachment
- Ptossis
- ICL/ ICL TORIC
- C3R Treatment for Keratoconus
- Phaecoemulsification Cataract Surgery for foldable IOL '+' /
non-foldable IOL '+'
- Phaecoemulsification Cataract Surgery forTecnis Monofocal foldable
IOL / Monofocal foldable IOL for lenses marked '+'
- Cataract with Trabeculectomy
- Vitreo retinal Surgery / Retinal Detachment
- Keratoplsty
- Entropion / Ectropion
- Dacryocystorhinostomy
- evisceration
- Ennucleation
- Chalazion drainage
- Cryosurgery
P.S.: If the procedure you require is not listed here or if
you require further information's then please send medical records
with doctors diagnosis reports to
mktg@mediescapes.com and we assure you that we will quickly get
back to you.
Lasik Eye Surgery:
The success of laser vision correction or LASIK depends on a
multitude of factors, primary being the expertise of the doctor
along with a good laser technology in an International standard
set up of hygiene and care with stringent eligibility criteria.
Dr. Anand Shroff, Chief Surgeon, Perfect
Wave LASIK Centre at Mumbai, has several years of
experience in LASIK and is among the country's longest-standing
users of the benchmark 'flying-spot' laser technology. He
also is the first to use the WaveLight Allegretto 200 Hz excimer
laser in India before the most recent Allegretto Wave Eye-Q 400 Hz
was launched at our Eye Hospital.
Wavefront LASIK or custom LASIK is the most advanced LASIK
method today. It can be performed using various lasers.
The speed of the laser and its applications are very important in
delivering results. Today, we use the worlds fastest laser
the 400 HZ whereas most other lasers are close to 50-100
Hz and some to 200-250 Hz.
Wavefront technology has been around since 1998. It is
specifically for those patients who would end up unhappy if a
standard LASIK procedure is done on them. These patients are
detected during their LASIK screening and evaluation,
by certain specific indications which would arise on the
topography and aberrometry tests
We believe in the best, having always stood for distinction in eye
care. After working on different lasers and being offered other
lasers like Mel 80, Zyoptix, VISIX etc. some, still entering the
market, we went ahead with the Wavelight wavefront 400 Hz laser
because of its superior technology. Most lasers are retrofitted
for wavefront or to simply put upgraded whilst this laser has been
developed for wavefront from scratch. The detailed research in the
laser system took into account the needs of the surgeon, patient
as well as looked after the many drawbacks of the other laser
systems.
To put it simply, the 'wavefront' is the way the
natural light pathway goes in the eye thru the entire optics. This
is supposed to be a smooth path in an ideal eye. As the light
travels thru the other optical system inside the eye, like the
lens, vitreous jelly etc. it undergoes further degradation. This
is acceptable to a certain extent and that is why the eye surgeons
have reached a 6/6 criteria as normal sight. However, when these
errors or 'higher order aberrations' as they are known, exist to
an extent in which they need to be treated then wavefront
treatments are a must for such patients.
Earlier lasers without wavefront technology can only correct the
spectacle number, which arises from the curvature irregularities
of the cornea. Our laser can treat the entire optical system
errors. Further, when we treat these optical errors by doing
wavefront, some patients actually gain lines of sight, better than
6/6.
EVALUATION OF A CANDIDATE FOR LASIK
EYE SURGERY
We evaluate pupil size, dryness of eyes, corneal thickness,
topographies etc in our LASIK evaluation. The thickness of the
cornea is a very important aspect of screening. We do this with a
digital pachymetry test, which would determine if your eye is
suitable for LASIK.
What we need from you [the patient] is
1. No contact lens wear for 5 days to a week
[soft CL] before coming to our centre for evaluation. This is
because the lenses sit straight on top of the cornea and flatten
it. We need accurate measurements and we want to perform this
procedure just once.
2. The procedure of evaluation takes an hour and
a half in our office since we dilate the pupils.
3. After the evaluation, if the patient is found
suitable enough for the Lasik procedure then the LASIK procedure
takes just about 20 mins in all and normally both eyes are done in
one sitting. The laser treatment itself is very short. Our laser
treats one dioptre in 2.5 secs, so the actual treatment even for
numbers like minus 12 takes just 30 secs. This is the 400 Hz
difference you get.
4. We send you home immediately after that
explaining the after care of eye drops, see you next morning once
and at least 3 days later.
We give detailed report with which follow ups can be done in your
city. These follow up examinations need not be done before the 3rd
month, and that too with an optometrist, not necessarily an eye
surgeon. So there you have the flexibility as we have done our
professional work and after care instructions are given to the
patient.
As far as your refractive error is concerned, the results are very
predictable and stable provided we find your eye fit to undergo
the procedure.
Hence, if this visit is specifically for LASIK, then we request
certain tests which would determine your fitness such as the
pachymetry [test for corneal thickness] if you have numbers higher
than -3.00 D. Another test is the topography, which gives maps of
the eye and screens out abnormal cornea. This is only done so that
the trip is successful.
It is most important that you choose the centre by seeing a
combination of factors. The expertise of the doctor, the
international standards that they use and hygiene of the centre
and also important the laser machine. Many doctors today budget
the LASIK and discount LASIK prices esp. in India. This is only
possible if one can cut costs, but that would be at the cost of
compromising quality, re using blades, working with older cheaper
technology etc. Many use the Nidek and Mel 70 lasers which give
problems in night vision and glares in over 50% of their patients.
These lasers do not have wavefront technology either. In the USA
the FDA has even proven that most complications arise in discount
LASIK centers world wide, let us face it and be honest in what is
in offer!
There is a lot more of this laser, which helps the patient and the
doctor. We can now treat higher numbers with more accuracy, re-
treat earlier laser unhappy patients to get better night vision
etc. and include patients who would have been poor candidates for
earlier technology. This is why our success rates have been good
from the beginning, as we have been thorough in our patient
evaluation and stringent in our eligibility criteria. We have
simple health care philosophy, complete education to a would be
patient with details on doctors, centers as well as latest in
technologies that is why sometimes our detailed mails are called
upon as too verbose ! But we like to be informative that is where
we pride being the only medical trip packaging company in India
which specializes in core competence knowledge bases and sharing
of complete medical procedures with a would be patient and for us
mere monetary satisfaction is secondary, a patient's safety as
well as health and handling of a patient is the primary focus.
The difference between wavefront
or custom and non wavefront LASIK in a simple
way explained;
The way I explain to my patients here is whenever you see an
ophthalmologist for an eye examination and he is doing the
refraction, he depends on your answers whether the letters on the
chart shown to you is clear or not. The refraction that you are
comfortable with is what is your best-corrected vision, which
again is subjective, because you do not know if you can see
clearer than that or not. Secondly, this refraction jumps in 0.25
digits. i.e.. if your numbers read 3.25 this visit, the next visit
it may read 3.50 or 2.75. The refraction, which you read the line
of 6/6 well, is what is fed into the laser. A laser will treat
anybody's 3.25 the same way as it would treat yours in standard
treatments!
With wavefront technology, we go beyond
clinical refraction with our wavefront analysis. The numbers that
we get are in 0.01 accuracy. ie, with this machine your numbers
would read 3.27 or 3.28 [examples]. We take 5 maps of each eye and
hence have very accurate readings. Furthermore, the readings are
customized with each eye.
With this, it eliminates internal optical errors and one can have
the opportunity of seeing better than they have with glasses or
contacts.
Another advantage is dynamic refraction.
Simply put, in the night when the pupil expands, due to certain
changes, there are some people who have a change in refraction in
the night. ie. their numbers read differently for the day and for
night. Standard LASIK treatments cannot address this issue. Hence
amongst all lasers be it even other wavefront lasers, the
Wavelight Alegretto Eye Q 400 Hz laser helps us tremendously as
we have near zero night vision problems as it follows the
dynamic refraction principle. This is not present in most
lasers.
There is the Bausch and Lomb laser 'Zyoptix' which you may have
come across, which is also doing wavefront treatments but as a
basic laser from the 217-technolass [its non wavefront laser], it
has not changed much. the Wavelight laser on the other hand was
built from scratch to suit wavefront treatments.
The Wavelight company [our laser company] was the first laser to
have done the worldwide wavefront LASIK treatment which others
have modified or upgraded in their already existing lasers.
There are many other differences between the two lasers. If you
still want to learn more, run through the matter below, although I
must tell you that it is a bit technical and lengthy even though I
have tried my best to simplify it!
The 217 B & L is the earlier gen laser, their newer laser being
the Zyoptix. 217 has a speed of 50 Hz which the Zyoptix has
improved to 100 Hz. We work at a speed of 400 Hz with this
wavelight machine. I have compared their new laser [Zyoptix] with
our machine, as it makes no sense to compare a non wavefront to a
wavefront laser.
Some other glaring differences are that the B & L wavefront laser
[Zyoptix] comes with a microkeratome [that makes a flap on your
cornea] called the Hansatome that makes a very thick flap. A
thinner flap means a stronger cornea after the laser, hence thin
flaps are better when possible. We use the Moria and have the SU
[single use]. Also,the Allegretto Wave tracks your eye and treats
much faster than the B & L [Zyoptix] which basically hasn't
changed much as a laser in 7 years. In short, the Allegretto Laser
which we use has better technology than the B & L [Zyoptix] Z100
in our experience.
1.The Zyoptix takes off much more cornea than the
Wavelight laser which we use.
2. The Zyoptix comes with a Hansatome which makes
a thick flap and uses more of the corneal tissue, leaving behind a
very thin stromal bed
3. During the Zyoptix treatment the laser will
stop many times since it treats in phases with several pauses
during the actual laser firing time. This is not so with the
Wavelight, which treats the numbers off in one go as it has a
plume removal system.
4. The Wavelight comes with an attached Slit-Lamp
which ensures an absolutely clean interface.
5.The Zyoptix machine comes with open optics
which has more exposure to dust etc.
6. The US FDA gives a safety limit of 250 microns
to be left behind after treatment.
Though the information is exhaustive, I find it imperative for you
to understand the technology before choosing your LASIK centre.
Below is a comparison of our laser with others.
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FEATURES OF OUR LASER COMPARING
WITH OTHER LASERS
1. Laser Spot Size
The small laser spot size is mandatory to produce fine complex
treatment patterns. Smaller the size, finer the treatment. Ours is
the smallest in the world so far. viz 0.68 HM
2. Speed
Shortens ablation/ treatment time remarkably. To the benefit of the
surgeon and to the comfort of the patient, Because shortened corneal
exposure time allows faster visual recovery. The rapid rate is vital
to maintain corneal hydration intra-operatively, especially in
wavefront guided procedures with larger optical zones where a
prolonged treatment time could adversely affect the planned
treatment profile. A simple principle in laser refractive surgery is
to keep the eye as physiologically hydrated as possible
intra-operatively for a faster visual recovery. Hence, faster speed
lasers have better visual outcomes. Our is the fastest in the world
so far. viz 400 Hz keeping in mind the safety limit as well.
3. Optical Zone
Ideally the laser should have the widest treatment area that also
removes the least tissue possible, which is what our laser supports.
Most Other lasers in order to treat a wider area, take out more
corneal tissue. This also results in night vision problems. In the
night the pupil expands or dilates to let in more light for
visibility. If a laser treats a zone, which is smaller in diameter
than the diameter of expansion of the pupil, then what you have is
an untreated rim of cornea, which in the night is going to result in
haloes or glares of light. Most lasers treat upto a 5 mm zone to 6
mm only , ours can treat upto 7 mm.
In cases of patients with night glare due to earlier treatments, the
ability of our laser to retreat is highly beneficial.
4. Eye Tracking speed
The eye is kept fixed with the laser during treatment. However there
are fine saccadic eye movements not seen by naked eye. The Wavelight
Allegretto 400 Hz is better than any other excimer laser system as
it tracks the eye at 400 times a second and allows for spot on
treatments. Most other lasers have an eye tracker which if the eye
moves even to some extent during treatment, then the laser stops.
5. Topography Link treatment
Is necessary for a customized laser treatment. Especially in re
treatments when undergone earlier LASIK and patient is unhappy. For
topography-linked retreatments, the Wavelight Allegretto laser has
the best capabilities at present.
The Allegretto is better technology than the B & L Z100 in our
experience.
We are proud to say that within an
ISO 9001:2000 certification hospital (and soon to
receive JCI Accreditation) combined with strict
patient care protocols and with a Wavelight laser that has been
launched world wide only in Jan 2004, being one of only few centers
in the world and the first hospital in India to have the 400 Hz
wavefront technology, we offer a far superior, safe and reliable
technology at affordable comparable prices.
Shroff Eye Hospital, Mumbai
are among the most recognized refractive surgery centre in MUMBAI
and has strived to provide the best of the treatment and always
has looked out to incorporate the latest techniques and technology
in patient care. To be able to provide this, they are equipped with
state of the art instruments.
For Detailed Dossier on
Eye Care Treatment, please write to us at
mktg@mediescapes.com
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