Refractive Surgery

LASIK  Surgery is a laser procedure that works by reshaping the cornea. It can correct Myopia (Short-sightedness), Hyperopia (Long-sightedness) and Astigmatism This procedure reduces or eliminates a person’s dependence on spectacles and contact lenses.

Spectacles impede those who lead an active lifestyle, especially in sports and games. While contact lenses provide good vision to many people, it can cause issues such as dry eyes and eye allergy. When worn over a prolonged period, it can damage the surface of the eyes due to the lack of oxygen. Furthermore, it can lead to infection of the cornea. In light of these constraints, LASIK Surgery is the solution

As a good candidate for LASIK surgery, you should:

Have a stable spectacle power for at least one year
Have a suitable range of myopia and/or astigmatism
Not be pregnant
Not have eye diseases such as keratoconus (weak protruding cornea)

What is LASIK

The term LASIK is used when the method involves creating a cornea flap. Many years ago, a blade instrument called Microkeratome was used to create the cornea flap. The flap created is then folded aside, to enable the Excimer laser to do the job of reshaping the cornea. The cornea flap is then put back to its original position. The term LASIK is used when the method involves creating a cornea flap.

Femtosecond Laser Procedure (LASIK)

The Microkeratome method has slowly been phased out over the years. These days doctors will make use of the blade-free method to create the cornea flap. This is a laser machine which uses an advanced femtosecond laser technology to achieve a more accurate, and safer flap-making procedure.

Because the Femtosecond laser is empowered by computer control precision, it allows the surgeon to customise the depth, width, shape and location in creating a very thin cornea flap in order to customise to the needs of the individual patient.

The Femtosecond laser creates air bubbles in the stroma of the cornea. Air bubbles create space and the flap is not lifted until the LASIK surgeon uses a special surgical instrument to lift the cornea flap. This means that the cornea is still intact after the Femtosecond laser and the patient can blink normally and walk around normally without fear that the flap will dislodge.

The excimer laser is then applied on the cornea after the cornea flap is lifted. It is this step that the shape of the cornea is changed (reduction or elimination of the spectacle degree).

PRK / Epi-LASIK / LASEK / Trans PRK

Apart from the above methods in which a cornea flap is made, Epi-LASIK is a method that does not make any cornea flap. A specialised equipment is used to separate a thin layer of cells known as epithelium on the front surface of the cornea. The laser is then applied.

Another way to perform the surgery without the need for a cornea flap is to perform PRK (Photo Refractive Keratectomy), this method involves scraping off the epithelium. A variation of this method involves applying some alcohol over the cornea for a short period of time to make it easier for the cells to be removed, this method is known as LASEK.

No-flap/No-touch Epi-LASIK or Trans PRK

An even more advanced variation of PRK or Epi-LASIK is No-touch Epi-LASIK or Trans PRK. This method utilizes the advanced Amaris laser to remove the epithelium. This means that there is no need to use any equipment to scrape the skin cells away, the laser does the entire procedure. This reduces surgery time and increases precision. There have been quite a few terms for this particular method of surgery, some call it Bladeless Epi-LASIK or Trans PRK or Trans Epi-LASIK. The simple way to think of it is No Touch and No Flap, the laser prepares the cornea and also reshapes the cornea.

Not everyone is suitable for this technique. It is important for you to go through an assessment of your eyes and our doctor will determine which method best suits your eyes.

SmartSight laser eye surgery (flapless laser vision correction)

SmartSight is a flapless keyhole refractive laser correction surgery that uses the KLex (Keratorefractive Lenticule Extraction) method. It is similar to the ReLEx SMILE procedure.

Clinical results

‍A multitude of international clinical studies have documented the excellent treatment quality with AMARIS technology. Visual acuity of 100 percent or better was achieved in nearly all cases. A high percentage of treated patients could see better than before with glasses or contact lenses. The study results also show improved contrast vision.

LASIK XTRA (LASIK + Cornea Cross-linking)

After the flap is created by the femtosecond laser or the cornea is prepared by the Trans PRK method, the excimer laser is applied to reshape the cornea after of which some patients (example those with thin corneas and high degrees) will benefit from a cornea strengthening procedure called LASIK Xtra (adding on Cross-linking to LASIK).

LASIK Xtra™

A system to strengthen the cornea by ultraviolet light induced cross-linking with riboflavin.
Based on established principles which have been in use with older machines for almost 10 years, but much faster and more efficient in treatment compared to older machines.
Stabilises conditions like keratoconus and corneal ectasia.
Very important to add this on during LASIK in patients with high spectacle powers, pre-existing thin corneas and slightly uneven shape corneas as it helps to strengthen the cornea.

Side Effects Of LASIK Surgery

As in all surgical procedures, there are some side effects that may occur after LASIK surgery. Although this surgery is very accurate; perfect vision cannot be guaranteed. Most of the problems after surgery are temporary and do not affect vision. Some of the side effects:

Dry eyes

‍Dry eyes after laser vision correction is common. This is easily treated with eye drops. This condition does not usually affect vision and will subside within 1 to 2 months.

Night Vision Problems

‍This refers to seeing glare and star-bursts when looking at bright objects in dim light, for example, headlights of cars at night. It occurs in those whose pupils dilate well in dim light and in those who need a high correction. Not all patients will have this side effect. For those who observe this effect – it occurs in the early stages after treatment but will gradually diminish over the course of 3 to 4 months. Pupil size in dim light is measured before the surgery and you will be advised if you are at risk of observing this effect after surgery.

Infection

‍Infections due to this surgery is very rare, compared to infections caused by contact lens wear. Antibiotics are given during and after surgery to prevent such occurrence.

Under and Over-corrections

‍Different eyes absorb the laser energy slightly differently. Hence there may be a slight deviation from perfect vision in about 1% of people. For example, a person with 800 degrees of short-sightedness may be left with 50 degrees in a case of under-correction. If it does occur a top-up laser can be performed at 3 months after the first laser treatment if the cornea is suitable for this.

Pre-Lasik Suitability Assessment

Find out whether you are a suitable candidate for laser surgery with a pre-lasik assessment today. Call us to enquire or book an appointment. We look forward to meeting with you and clarify any queries you may have.