What is refractive surgery?
In recent years, there have been tremendous surgical advancements. If you have a refractive error, such as near-sightedness, far-sightedness or astigmatism, refractive surgery can correct these visual impairments and reducing spectacles or contact lenses dependence. Refractive surgery is an option to consider, especially if you have an active lifestyle and don't want to be restrained by glasses.
One type of refractive surgery works by reshaping the cornea, allowing the light that enters the eye to accurately focus on the retina. The cornea is the clear, round anterior portion of the eye. The retina is located at the back of your eye and is responsible for sight. LASIK (Laser-Assisted in situ Keratomileusis) is the most common type of refractive surgery. LASIK is effective and safe, with a high rate of patient satisfaction.
How does LASIK work?
Small incisions are made on the eye to create a thin, hinged corneal flap. The flap is pulled back and a specialised laser is used to ablate the underlying corneal tissues. This moulds the corneal shape to re-focus the light that enters the eye. The corneal flap is then repositioned back in place.
After the surgery, you must avoid applying pressure to the eye. There may be symptoms of ocular discomfort or a burning sensation for several hours after the procedure. If necessary, over the counter painkillers can help relieve these symptoms.
What are the benefits of refractive eye surgery?
LASIK is a painless procedure that doesn't involve any sutures. It is a fast technique with a high success rate. Each eye generally takes 10-15minutes to complete. No overnight stay in hospital is required following the surgery. Fast corneal recovery and so patients generally notice a remarkable improvement in vision within several hours after the procedure.
What are the limitations of refractive eye surgery?
Most health insurance policies will not cover LASIK, all expenses are out of your own pocket. The cost varies, but on average you should allow for several thousand dollars per eye.
LASIK may not be an option if you:
- Are underage (<18 years old)
- Have unstable refractive error - if your prescription has changed within the past 12 months
- Have a chronic autoimmune disease
- Currently take steroids or immunosuppressants
- Have an illness or are taking any medication that can impair healing
- Have uncontrolled diabetes
- Have severe dry eyes
- Have had a herpes simplex or herpes zoster (Shingles) eye infection
- Have severe ocular infection, for example uveitis or iritis
- Have a decompensated cornea
- Have extremely large pupils or an abnormally thin cornea
Note: You may encounter a temporary change in prescription if you are currently pregnant and breastfeeding
Potential risk and post-surgery complications include:
- Dry eyes
- Blurry vision
- Experiencing glare and halos, particularly at night - if the treatment size is small than the patient's pupil size, they are very likely to experience halos after the surgery
- Scarring from the surgical incisions
- Incorrect repositioning of the corneal flap
- Overcorrection of the refractive error
Although LASIK is the most common surgical intervention for myopia correction, the technique is still relatively new and the long term efficacy is debatable. It is important for patients to be aware of the potential risk and complications that exist. Most complications will arise within the first 3 months after surgery. Approximately 15% of patients will need a second procedure or "enhancement". Patients may temporarily experience mild discomfort after the surgery.
Intraocular Contact Lenses (ICL)
These are very thin foldable lenses that are inserted into the eye. They sit behind the iris and in front of the crystalline lens and are able to correct myopia, hyperopia and astigmatism. ICLs are usually the preferred option in patients with severe myopia or hyperopia (over 7 dioptres) as they are considered to have a lower risk profile and greater sucess rate than laser surgery. They are also the preferred refractive surgery option in patients with thin or distorted corneas.
Talk to us to see if you are suitable for refractive eye surgery.