Laser Eye Surgery
Laser Eye Surgery
Laser eye surgery is the use of an excimer laser to reshape the cornea with extreme precision to focus the light sharply on to the retina. Depending on the level of the prescription, it can be used to treat myopia, hyperopia and astigmatism. Technological advancements in laser eye surgery have been rapid and modern laser delivery systems are generating the best outcomes over the last 20 years.
LASIK is the commonest type of laser eye surgery performed in the world. Its success is due to the excellent visual outcomes and rapid recovery with minimal discomfort after surgery.
LASIK first involves the creation of a very thin flap in the front of the cornea. This is performed with a femtosecond laser for maximal accuracy. The flap is carefully lifted and an excimer laser is then used to reshape the underlying cornea to treat the refractive error. The flap is then gently repositioned and a bandage contact is placed over the eye to protect the flap.
Not all patients are suitable for LASIK surgery. If you have conditions such as rheumatoid arthritis, diabetes or keratoconus, have thin corneas, are involved in contact sports such as rugby or boxing, or in the military or police, a surface laser treatment (PRK) may be the better option.
PRK is the treatment of choice for the police, military and the air force. Visual outcomes are excellent and it is the procedure of choice for certain patients.
PRK is a surface laser eye surgery technique where the excimer laser is applied directly onto the surface of the eye without initially creating a flap (as in LASIK). A bandage contact lens is placed on the eye afterwards. Its main advantage is that it disrupts less of the cornea as no flap is created. As such, it is the ideal procedure for patients who have thin corneas where tissue preservation is important. It is also preferred for patients who enjoy full contact sports or who are in the military or police as there is no risk of flap dislocation in the event of trauma.
Visual recovery is slower than after LASIK eye surgery, but once the eye is healed the visual outcomes are the same between procedures.
Most are able to return to office-based work the day after LASIK surgery. A week is needed for recovery from PRK surgery.
For the first week, it is important that no water gets into the operated eye and care must be taken with face and hair washing. Eye make-up should not be worn during that time either. Do not drive until vision meets driving standards, which will be confirmed at the first follow-up appointment. Activities such as swimming or contact sports must be avoided for one month.
Preparation for a Refractive Surgery Consultation
The consultation is a multi-stage consultation process requiring a series of eye checks and scans, and your eyes will be dilated towards the end of the eye examination for a retinal check. Typically it takes 1-2 hours to complete.
It is important that you:
- Do not wear your contact lenses prior to the consultation (1 week for soft contact lenses and 2 weeks for hard contact lenses). This is to ensure that the scans we take reflect the shape of your cornea without interference from your contact lenses;
- Bring a record of your glasses or contact lenses prescriptions over the last two years. Your optometrist can be contacted for this information if you do not have it. Variations of greater than 0.5D typically mean that the eye is not yet stable and a recommendation to postpone surgery for 12 months to ensure stability may be suggested.