What is LASIK?
LASIK is short for "Laser-assisted in-situ keratomileusis". It is a procedure used to correct myopia, hypermaetropia and astigmatism.
What should my expectations about the LASIK procedure be?
The main aim of LASIK is to reduce a person's dependence on spectacles or contact lenses. If the patient's only expectation is to achieve perfect vision, he may be disappointed.
At Jerry Tan Eye Surgery, 100% of Dr Tan's patients have achieved 6/12 vision and of which 88% have 6/6 vision or better to date. These results are for patients having powers ranging from 1.00 dioptres to 7.00 dioptres (100 to 700 degrees) of myopia.
However, it should be re-emphasized that not everyone can achieve a perfect result. Occasionally patients may still require glasses for night driving or very clear distance vision. Many do achieve 6/6 vision, and many achieve better than normal vision.
For those who wish to achieve "better than perfect" results e.g. 6/4.5 or 6/3 vision, it is better not to have this surgery, as they will not be happy with even an excellent 6/6 result.
Everyone uses their 2 eyes simultaneously. Seeing with 2 eyes is better than seeing with one. A patient with perfect vision in each eye will be able to achieve 6/4.5 vision with the simultaneous use of both eyes.
In rare patients suffering from pathological / progressive myopia - where the myopia constantly increases over time - they can only have their myopia 'reset' but not cured by LASIK. This means that LASIK treatment can only reduce their myopia but cannot prevent it from increasing again.
Who can perform LASIK surgery?
All ophthalmologists can perform LASIK surgery.
Ophthalmologists who perform LASIK should be surgeons who perform several procedures each week, as LASIK is highly dependent on skill and experience. Fine attention to detail is essential for good results.
An eye surgeon who is a specialist in cornea and external eye disease has an advantage over the general ophthalmologist since he is familiar with special techniques of corneal surgery. Complex techniques of corneal surgery may be necessary in difficult cases of LASIK surgery.
Eye surgeons who want to perform LASIK should be properly trained. Courses for proper training in LASIK surgery are available worldwide. Ask your surgeon if he has attended these courses.
How do I select the right surgeon?
You will want an experienced eye surgeon doing the surgery. The doctor should have special training in the procedure, plenty of experience and a high success rate.
Once you have identified a possible surgeon ask the following questions:
- How long have you been doing this kind of surgery? (Someone with years not months of experience).
- How many surgeries have you performed? (Someone who does several surgeries every week).
- What percentage of patients achieve 6/6 or 20/20 vision without corrective lenses? (The reported international average is about 80%).
- What percentage of your clients return for additional surgery? (The international average is 5% to 15%).
- What are the risks and possible complications? (If your doctor guarantees the surgery will eliminate your need for glasses, or that the risks are non existent, look for another surgeon. Unfortunately, there are no guarantees).
What happens during a LASIK procedure?
LASIK basically involves 2 major processes:
- Creation of the LASIK "flap" using a microkeratome (a device with a very fast oscillating blade) or using the IntraLase® Femtosecond Laser and
- Removal of eye tissue from the surface of the cornea bed with an Excimer laser to correct a patient's refractive error.
How long will the procedure take?
LASIK surgery will take about 8 to 10 minutes. The critical periods are when the cornea is cut (or lasered) to create the "flap" and when the eye tissue is removed by the laser to correct the refractive error. The time taken for the LASIK flap to be made is less than 10 seconds using a microkeratome. Using the new Femtosecond laser to create the LASIK flap takes 30 to 60 seconds for All Laser LASIK.
The remaining time is spent cleaning and preparing the eye, as well as allowing the "flap" to adhere back to the eye.
How accurate is the procedure?
The LASIK procedure is extremely accurate. However, there are some major factors that affect the accuracy. These include:
- The strength of the myopia, hypermaetropia or astigmatism. The higher the myopia, hypermaetropia or astigmatism, the more difficult it is to obtain the desired result. The lower the amount of correction to be made, the more accurate the result will be.
- The age of the patient. The older the patient, the stronger the effect of treatment. This would mean that there would be a higher chance of slight over-correction in patients over the age of 50.
What kinds of lasers are used in LASIK surgery?
Excimer lasers are used in LASIK surgery. The Excimer laser is known for its precision, as well as its ability to remove corneal tissue without causing scarring or burning of the cornea.
Its inability to burn the cornea reduces inflammation and promotes superficial healing. This allows the cornea to remain in the shape intended.
One of the latest developments in LASIK is the Femtosecond laser. This laser is used to create the LASIK flap in place of a mechanical microkeratome. The Femtosecond laser has a better safety record and our current iFS laser only takes 10 seconds to make a LASIK flap.
Are all Excimer lasers equally good?
Excimer lasers play an important part in eye surgery. Not all lasers are the same and presently the older lasers (first and second-generation), which are broad-beamed, are less accurate, exposing patients to more risks. The best lasers at present are the scanning lasers, which gently spread a purified beam of laser energy in small pulses over the cornea, resulting in a smooth ablation surface.
The latest generation of lasers e.g. Wavelight Allegretto Eye-Q Laser can perform standard, wavefront guided, wavefront enhanced, topography guided and aspheric / Q-adjusted LASIK.
Will the ultraviolet light from the Excimer cause cancer?
Studies have shown that the laser does not cause changes in the structure of cells in the cornea. Animal studies have also shown that this short exposure to far ultraviolet light does not cause cancer.
Are there alternative treatments to LASIK? How do they compare to LASIK?
At present LASIK is the best-proven method to correct myopia, hypermaetropia and astigmatism.
There are other forms of treatment available, of which the second most popular method is PRK.
PRK uses the Excimer2 laser to burn through the surface of the eye, leaving a large raw wound. In most cases, patients heal well with good results. The disadvantage of this method is that there is much more pain and this lasts 24 to 48 hours after surgery. It also it will take corneal surface 4 to 5 days to heal, or even 2 to 3 weeks in some rare cases. The risk of infection is much higher and there is higher chance of permanent scar formation, especially for patients who have power of 6.00 diopetres (600 degrees) or more.
Patients who have undergone PRK require up to 6 months for their vision to stabilize, much longer than the time taken in LASIK.
Some procedures recently in the news such as LASEK and epi-LASIK are modifications of the PRK procedure. The epithelial is separated by dilute alcohol (LASEK) or by a plastic blade used in place of a sharp metal one (epi-LASIK). The ablation is done and the epithelial "flap" replaced, unfortunately the "flap" is usually damaged. Most of the cells die, and there is replacement of the "flap" with new cells and superficial healing takes between 4 to 5 days. There is more pain, more chance of haze and scarring as well as slower visual recovery.
What is "PerfectShape™ LASIK"?
Most vision correction programmes are either wavefront or aspheric (Q-Adjusted). At present, treatments are either wavefront guided which do not take the corneal shape into consideration or aspheric which does not take the wavefront into consideration. Advancements in technology have combined Corneal Wavefront Technolgy with Q-Adjustibility, "PerfectShape™ LASIK" - Corneal Wavefront Q-Adjusted LASIK takes the original corneal shape, wavefront and asphericity into consideration. This gives patients superior corneal contours, resulting in good day and night vision.
Most visual aberrations originate from the cornea. Corneal Wavefront Q-Adjusted LASIK will 'regularise' the cornea, and ablate the cornea into a "perfect" shape at the same time. "PerfectShape™ LASIK" aims to improve night vision by customising treatments to each individual's eye.
What if I have poor night vision after LASIK already?
Patients who suffer from night-time glare and halos as a result of previous LASIK surgery may now seek treatment. "PerfectShape™ LASIK" is a powerful tool that can also be used to re-treat patients with post-LASIK night vision problems. Often, such patients have small, decentred optical zones and irregular corneas. The treatment will enlarge and re-centre the optical zone, and 'regularise' the cornea into a "PerfectShape™". The final result is improved night vision and images, which can be seen with better contrast.
How does IntraLase® Method work?
With the IntraLase® Method, tiny pulses of laser light, a quadrillionth of a second each, pass harmlessly through the outer portion of your cornea and form a uniform layer of microscopic bubbles just beneath the surface of your eye.
The exact dimensions of this layer of bubbles are determined by Dr Tan based on what's best for your eye, and are computer controlled for maximum precision - things that are not possible with a hand-held blade. The IntraLase® flap creation process currently takes about 20 to 25 seconds.
When it's time for your LASIK treatment to be performed, Dr Tan will easily separate the tissue where these bubbles occur and then fold it back, thus creating your corneal flap. When LASIK is complete, a flap created using the IntraLase® Method is uniquely able to "lock" back into place. Your eye then begins to rapidly heal.
The IntraLase® Method delivers outstanding visual result: more patients achieve vision that is 20/20 or better when the IntraLase® Method is used. Patients also report better quality of vision overall, particularly in terms of their ability to see well in low light, such as at dusk or at night.
Can I pay for my LASIK/ICL by installment plan?
Yes you can. More details can be obtained with our clinic staff. For contact information, please click here.