When contact lenses were developed, children and adults cursed with the 'four eyes' nickname breathed a collective sigh of relief. Yet contact lenses brought with them a new host of problems ranging from the inability to remove the lenses (usually after first being fit) to blindness from infections.

For those tired with having to 'upgrade' their corrective eye wear every year, or lose a contact lens ever so often, a more permanent solution is available - laser surgery.

The only outlet of its kind in the southern Caribbean, Laservision at Grand Bazaar is the brainchild of eye refractive surgeons Dr Anirudh Mahabir and Dr Deo Singh. They were the first to use the technology, followed by surgeons in Jamaica. With the use of the latest technology in the field, they can eliminate the need for contact lenses and glasses by changing the refraction of the eye.

Dr Mahabir explained: "The procedure changes the shape of the cornea. With near sightedness we can make the cornea less curved if it is less curved. For those with far sightedness, whose corneas are too flat, we make them more curved. For those with astigmatism (if the corneal surface is different from the ideal ball-shape curvature) we make it equal on both counts so that you get good vision without glasses."

During the procedure, the patient is prepared by washing the eye, putting local anaesthetic drops in the eye and then taken into the laser room. The eyelid is held open during the operation. All this time the patient is awake and feels no pain. The patient lies below the laser and asked to look at a particular flashing light and the laser is turned on. This laser is fixed with an eye tracker. If the patient was to move the eye a little, the laser would move together with the eye. If the eye moves out of range, the laser would stop. The whole process literally takes less than ten minutes per eye.

Mahabir said: "The two basic types of surgery we do are Lasik where a very thin flap is made in the cornea, lifted, the corneal bed is reshaped and the flap is brought down. The obvious advantage to that is that the flap acts like a plaster. The only places that need to heal are the edges. That happens within an hour or two."

"We can predict by the computer software how much tissue needs to be removed," Dr Deo Singh pointed out. "We can predict what the residual corneal thickness is going to be. If it is going to be marginal, then we opt for the Lasek. That treats on the surface. Lasik treats beneath. The residual thickness we look at is the deeper thickness and not that of the flap."

The cost, energy and data involved in both methods are the same. On the day of the surgery, Dr Singh said that a patient needed to adhere to a few guidelines.

"The face, eyes and hair must be kept clean. Women are advised not to wear any eye make-up to avoid contamination. The rest of the preparation is done here. Following the procedure it is advisable not to drive yourself. The vision tends to be a bit blurred with a marked difference being noted overnight."

Following the surgery, a pair of goggles is given to the patient which should be worn during sleep. No matter how tempting, the eye should not be rubbed. No make-up should be worn for three weeks. No swimming or physical activity (like contact sports) for two months.

The VISX Star S4 Excimer Laser System is the machine used to perform the procedure. With the previous design, a measurement of two meridians was noted then input into the machine. The VISX model almost takes a map of the eye which can be transferred via diskette. The latter, because it provides hundreds of measurements, is more accurate.

Dr Mahabir said: "We can boast that with this machine, we can give you better than 20/20 vision. Not all the time but there is that possibility."

"There are some situations in which it is a recommended option. People have conditions for which they need corneal transplant surgery. The refractive outcome of a corneal transplant is not predictable. In that situation, after the transplant is healed, you may supplement the correction by the use of the refractive laser. It is also done for people who have cataract surgery."

Dr Mahabir added that for sports players and members of the protective services--including the army - such a procedure was more convenient than aesthetic.

This is cache, read story here