Lasik Eye Surgery

Our eyes need to be able to refract light in order for us to see and focus on things correctly. This is achieved in part by the cornea which bends and focuses light into the retina. The shape of the cornea is not always correct and as a result the image on the retina is distorted and blurred. This is called, a refractive error. This is why many people are dissatisfied with their vision and need to wear glasses and contact lenses. Refractive errors fall under 3 major branches.

• Myopia (near/short sited), the further the distance the more difficult an object is to see
• Hyperopia (fair/long sited), the closer the distance, the more difficult an object is to see
• Astigmatism, images of objects are distorted due to irregularities in the cornea or eye lens

Eye problems made up of a combination of any of the above is not uncommon.

LASIK surgery (Laser-Assisted In Situ Keratomileusis)

LASIK surgery is considered a type of refractive surgery, whereby the shape of the cornea is altered to improve focus. A laser is used to change the shape of the cornea by removing tissue.

Is LASIK Suitable For Me?

While you are considering LASIK surgery, there are a few questions you need to ask yourself.

Should I take the risk?

• Are you willing to take the risk that the surgery may not improve your vision, or even make it worse?
• There will always be a percentage of people who are at a greater risk of complications and as it stands, statistical data is unavailable
• The results from surgery and the healing process vary greatly from person to person

Am I 18 years old?

• If your answer is no, then you must wait until you are 18 before you can undergo LASIK surgery.
• Including the information provided here, there will be much for you to consider as you approach 18 years of age and whether LASIK surgery is an option for you.

Career impact

• Certain positions do not allow the use of refractive surgery. Check your current company
• Your surgery could affect future career prospects

Cost

• Refractive surgery is expensive
• Can you afford it? Payment plans and subsidies may be available

Have you changed your glasses or contact lenses in the last 12 months?

• This could indicate what is called refractive instability,
• Being younger then 25, hormonal, pregnant, breast feeding or taking certain medications can increase your chances of having refractive instability.

Do any medicines or diseases affect my ability to heal?

• Some medicines and diseases could affect your ability to heal and therefore make LASIK surgery, or any form of refractive surgery inappropriate.
• You should be in overall good health with the ability to heal quickly.

Are you involved in contact sports?

Boxing, football, rugby and karate examples of contact sports where damage to the face is not unlikely, increase the chance of eye damage.

LASIK Surgery Risks

Though LASIK surgery is more often successful, as with most medical surgeries there are potential risks involved. How these risks affect you and what they mean to you vary from anyone else and the decision should be yours alone. Avoid being overly encouraged or discouraged by doctors, friends, family members or other LASIK patients.

Being familiar with the pros and cons and carefully weighing them up in your own mind is the best approach.

• Unrealistic Expectations and hopes should be avoided. The more severe the refractive errors, the less likely 20/20 vision is achievable.
• You may still need your glasses/contact lenses because only some people will have 20/20 vision after surgery. Even if you are close to achieving 20/20 vision, the need for a weak prescription may still be necessary. Further surgery may not be an option.
• Vision Loss has occurred with some patients to the extent that glasses or contact lenses cannot improve vision
• Other visual problems arise including glare, halos, double vision and impaired nighttime vision. A risk factor in developing this condition is larger pupils, which can be established and discussed with your doctor
• Severe dry eye syndrome is a side effect of surgery experience by some patients. The eyes ability to create tears is reduced resulting in uncomfortable, dry eyes. Furthermore, the quality of vision is likely to be reduced and this can be permanent requiring treatment.
• Vision improvements may diminish for farsighted patients as they get older.
• No long term data or statistics are available; this makes it difficult for people to make decisions and to establish risks. Being a relatively new technology of the late 90’s is the reason for little long term data.

Before, During and After Surgery

What to expect before, during and after surgery can be outlined but because of the great variations in patients and their experience, full comprehensive and detailed discussions need to take place with your doctor.

Before Surgery

When considering LASIK surgery, you will go through an initial evaluation with an ophthalmologist to establish your suitability for surgery.

• Contact lenses need to be removed for weeks prior to your evaluation so that your cornea is its natural shape to encourage accurate measurements and planning. These measurements will be taken again several days after the evaluation and before surgery to ensure they have not changed.
  • Soft contact lenses – 2 weeks
  • Toris soft lenses\rigid gas permeable (RGP) lenses – 3 weeks
  • Hard lenses – 4 weeks
• To greatly reduce the chance of infection, the day before surgery you must refrain from applying
  • Cream
  • Lotion
  • Fragrance
  • Makeup
• You will discuss with your doctor
  • Your complete medical and eye history
  • Medications you are taking both prescribed and over the counter
  • Allergies you may have to medications
• You will undergo an eye exam with your doctor discussing
  • Your suitability for refraction surgery
  • Risks and benefits of the surgery
  • Other alternatives
  • What to expect and what you need to do before, during and after your surgery
• You should be able to have discussions with your doctor that allow you to have queries and concerns answered sufficiently so that you are comfortable with all the pros and cons laid out in front of you. This includes written material relating to LASIK procedures. Only then should you sign consent forms
• You should have someone organised to drive you to and from your surgery and for your first one or two follow up appointments as your vision may be blurry and unsuitable for safe driving

During Surgery

Surgery will take approximately 30 minutes

• Chemicals will be dropped into your eye to numb them
• They will be cleaned
• Lid Speculums are applied to the eyes to keep eyelids open

The Procedure

• A flap is cut into the cornea
• A light is directed into the eye for the patient to focus on
• A preprogrammed amount of corneal tissue is vaporized by a laser
• The corneal flap is replaced
• A protective shield is placed over the eye. This should be worn every night after surgery to prevent you from rubbing your eyes and tearing the cornea

After Surgery

DO NOT

• Wear makeup for 2 weeks
  • Preferably no lotions or creams either
• Wear contacts
• Play sports of any kind for 3 days
• Engage in intense contact sports for 4 weeks
• Swim or spa for 8 weeks
• Rub the eyes as this could tear the cornea
  • Eyes may be itchy
  • A reason why the eye shield is so important especially while you sleep

After surgery symptoms may include

• Eye burn, itch and the desire to rub (do NOT rub) – about 3 days
• Irritation and the sense of a foreign particle inside the eye – about 3 days
• Watering eyes – about 3 days
• Dry eyes – about 4 weeks
• Blurry vision – about 1 week
• Light sensitivity – about 1 week
• Effects around lights such as halos, glare – 4 weeks
• Eyes bloodshot in appearance

Post Operative follow up

• Consultation with your doctor must be made 24-48 hours after surgery
  • Your eye shield will be removed
  • Eye will be examined and vision tested
  • Eye drops will be given to prevent infection
• Regular appointments should then be made within the first 6 months

Months After Surgery

• Fluctuations in vision may be experienced in the first few months, possibly up to 6 months
• During this time, lighting effects such as halos and glare may occur
  • The symptoms associated with such lighting effects may not subside
• If you experience visual symptoms that worry you its important you seek attention to avoid the possibility of full vision loss

How much does it cost?

• Eye laser surgery can cost anywhere between $2000 to $3500 for each eye
• Shop around and get all the facts on the services offered
  • Methods may differ
  • Reputation should play a role in your decision
  • Conditions and restrictions may apply which enable cheaper pricing but a less desirable service
  • Does the price include medications, post operative care and evaluations
• Financing options are generally available allowing customers to pay all or part of their surgery in monthly installments
  • These can start from a 3month plan up to 48 months
  • Some practices may have interest free plans for the shorter payment plans
  • Most payment plans will probably be in the form of a loan with interest rates and other associated costs through a financial institution such as GE Money
• Some private health insurance companies may cover all or a portion of LASIK eye surgery
• Medicare does not cover LASIK eye surgery but some concessional deductions could be made in tax returns

LASIK eye surgery locations

Medownick
Epworth Medical Centre
185 Hoddle St (Cnr Bridge Rd)
Richmond Victoria Australia