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Is there any specific preoperative preparation for tests required for this procedure?

Updated: Mar 18


Your doctor might have recommended you undergo Lasik surgery to rectify your vision. Most doctors favor this surgical procedure as it offers amazing results. Doctors recommend Preoperative LASIK evaluation to determine your eligibility for LASIK surgery. The evaluation conducted is a comprehensive ocular exam performed today. You should choose the best clinic to undergo this surgical remedy.


What type of history will be required by your doctor?


Past Ocular History / Past Medical history

Thorough ocular and medical history is vital to identify diseases that otherwise might affect surgical outcomes. Wound healing can be affected by systemic diseases like autoimmune diseases. It includes diabetes, collagen history of cheloids, and collagen vascular diseases. After surgery, ocular conditions like peripheral keratitis or ocular herpes might reactivate. Patients with a strabismus surgical history might experience recurrence after having LASIK surgery.


High-risk conditions


Some patients might suffer from high-risk conditions. The specialists will evaluate their present health condition and inform them about the risks faced. If such patients are advised by their doctor during the surgical process, it becomes necessary to gather more information. Only then should you go ahead with the surgery to be on the safe side.


Present illness history and chief complaint


If you want to enjoy the benefits of LASIK surgery, you need to ask yourself a few questions. Why should you undergo this surgery? What goals you can achieve through this surgery? Proper answers to such questions can help your ophthalmologist determine the surgery type (monovision, distance vision, etc.) and your expectations from the surgery.

Meeting patient expectations


Successful LASIK surgery is when you are happy with the results obtained after the surgery. It should go beyond your expectations. For instance, if you wear contact lenses, the surgery should help you to have a better view without using them. However, having unrealistic expectations will only prove to be a poor candidate for refractive surgery. In such a case, you will be disappointed with the surgical outcome.


Medications

You may be taking some medications to treat other medical conditions. If so, you should inform your doctor before availing of contoura vision Lasik surgery. It also includes over-the-counter drugs as they might affect surgical outcomes. Even migraine drugs like ImitrexTM might alter cornea wound healing. Also, AccutaneTM used to cure severe acne, could cause ocular surface drying.


Social History


Healing could alter if you use cigarettes and alcohol after surgery. Lifestyle questions like work, hobbies, etc. provide a better understanding of the vision type vital to you. The doctor will pose questions, like if you engage in high-risk activities like contact sports since it could cause flap complications. If you have a high-risk social history, you should share it with your doctor before the surgery.


Past surgical history and family history


You may have had eye surgeries earlier, like childhood strabismus. These are vital things that your doctor should know before recommending LASIK surgery. You may perhaps consider this as some trivial information and hence fail to inform the doctor. Some families might share hereditary diseases that might present risk factors. If you suspect keratoconus, it requires thorough screening.


What physical examination is necessary before the surgery?


Visual acuity and Refraction

The doctor will take both Corrected and Uncorrected visual acuities. Initially, thorough manifest refraction, evaluating cycloplegic refraction is done. Both refractions help identify if you have latent hyperopia. It also guards you against over-misusing myopic patients.


Complete eye evaluation


It includes a posterior dilated and tonometry exam. The exam’s anterior part is given more focus. A lid exam helps identify meibomian gland dysfunction signs. In the case of lid disease, the doctor may prescribe pre-treatment. Attention is next given to the cornea and conjunctiva, investigating dry eyes, and punctuate keratitis. Vital dyes help stain, including lissamine green and fluorescein. It is to quantify the dry eye amount.


Other types of exams conducted


Corneal abnormalities/irregularities are basement anterior membrane dystrophy. Vascularization or corneal scaring signifies old infections where herpetic infection may occur. Iris exam and anterior chamber inspection help determine iris atrophy, old iris signs or other inflammatory diseases. The posterior cornea inspection helps identify endothelial dysfunction like guttae. To find cataract formation signs, the crystalline lens is thoroughly examined.


Dry eye testing


Those already having ocular dryness may experience post-operative dryness risks. Prompt treatment is strongly recommended. Tear break-up time helps measure tear film quality. If abnormal, lid hygiene along with other treatments help cure blepharitis. Tear film quantity is determined by Schirmer testing. An abnormal patient is suggested to have lifitegrast and/or cyclosporine treatments, nutrient supplements (flax or fish oil), punctal plugs, and tear substitutes.


Pupil testing


Pupil size evaluated in the dark enables you to make well-informed consent. Special devices like infrared pupilometers measures accurately your pupil size. Large pupil sizes might cause a risk for halos and glare after undergoing LASIK surgery. However, doctors still debate the relationship between post-operative complaints and pupil size.


Topography, Topography, and Corneal Biomechanics


Computerized videokeratography or corneal topography plays a vital role in refractive surgery. It involves imaging of the anterior or front corneal surface. Corneal tomography is used for cornea back and front surface diagnostic characterization with thickness mapping. Technologies used are rotational Scheimpflug imaging, horizontal slit scanning, anterior optical coherence, and arc scanning using high-frequency ultrasound. Screening protocols’ specificity and sensitivity are improved considerably for all refractive surgery candidates.


Contrast sensitivity testing


Some doctors carry out these tests to understand functional vision beyond the high contrast chart referred to as the Snellen chart. Two tests suggested these days include the Mars-Letter Contrast Sensitivity exam and the Hamilton-Veale Contrast Sensitivity exam. The test type is determined on a case-by-case basis.

Undergoing pre-operative preparation tests


Those who seek vision correction surgery should undergo pre-operative preparation tests as suggested by their doctor. Modern technological advancements have enabled LASIK prediction, making it a comfortable outpatient procedure. But doctors recommend prepping your eyes to ensure positive results and eliminate risks, if any. The qualified LASIK surgeon will provide detailed, clear pre-operative instructions that you should follow sincerely.


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