Laser Vision Correction

There are several laser and surgical options for the correction of short sight, long sight and astigmatism. Although no single vision correction procedure will be suitable for all eyes.

Unlike some centres which may offer only excimer laser treatment or only non-laser surgical options, our ophthalmic surgeons can offer a wide range of both laser and surgical treatments. This means that we can consider treating all degrees of short and long sight with or without astigmatism.

Before deciding upon which may be the best treatment option for your eyes it is important for you to have a thorough eye examination. Our experienced ophthalmic surgeons can then discuss with you the procedures that may be suitable for the correction of your sight.

You may consider our Treatment Guide for your possible treatment options.

Treatment Guide

Low to moderate myopia (-1.0 to -4.5 dioptres)	LASIK LASEK
High myopia (-4.75 to -10.0 dioptres)	LASIK Refractive Lens Exchange (occasionally) Phakic Implant (occasionally)
Extreme myopia (over -10.0 dioptres)	LASIK (up to -15 dioptres) Refractive Lens Exchange Phakic Implant
Low hypermetropia (+1.0 to +3.0 dioptres)	LASIK LASEK
Moderate hypermetropia (+3.25 to +6.0 dioptres)	LASIK Refractive Lens Exchange
Extreme hypermetropia (over +6.25 dioptres)	Refractive Lens Exchange
Astigmatism	LASIK LASEK Astigmatic Keratotomy

If an individual has signs suggestive of early cataract development then it may be more appropriate to perform a lens extraction and intraocular implant regardless of the refractive error. For details see Refractive Lens Exchange.

Laser Surgery

Excimer laser surgery involves the use of a laser to reshape the cornea (the clear portion of the eye in front of the pupil).

The excimer laser is a precise device utilising a laser beam to recontour the cornea with a high degree of accuracy. It can remove corneal tissue in a controlled manner not possible with conventional ocular microsurgery.

The accuracy of the laser can be seen in this picture of a human hair cut with an Excimer laser

The two main refractive procedures using excimer laser are LASEK and LASIK

LASEK (or Epi-Flap)

Laser ASsisted Epithelial Keratomileusis is a variant of PRK.

Instead of rubbing off the surface epithelial cells prior to lasering the corneal surface, the epithelial cells are lifted as an intact layer.

After the laser treatment is complete the epithelial cell layer is replaced and protected with a contact lens for up to five days. This usually helps to reduce postoperative discomfort and quicken visual recovery.

The actual laser procedure is short, painless and only requires topical anaesthetic (eye drops). The patient's refraction is programmed into the laser computer which calculates how much of the corneal surface to remove to correct the refractive error (this is usually less than 10-20% of the corneal thickness and the physical strength of the eye is essentially unchanged).

LASIK

Whilst surface ablation (LASEK) is highly accurate in correcting low refractive errors, the results can be less predictable with higher degrees of refractive error, in these patients LASIK is the preferred procedure.

LASIK also accurately corrects low refractive errors.

The technique falls into two distinct steps, the creation of a corneal flap and the subsequent lasering of the corneal bed.

Instead of lasering the surface layers, a superficial, thin, hinged flap of corneal tissue is cut. This flap is then lifted and the laser is applied to the deeper corneal stromal bed before the flap is repositioned. The eye has a naturally occurring suction capacity which holds the flap secure when the procedure is completed, therefore no sutures are necessary.

As with LASEK this is a painless procedure.

LASEK or LASIK?

LASIK can provide several advantages over LASEK:

Less postoperative discomfort - as the cornea is only slightly disturbed it is rare for the LASIK patient to experience discomfort. Minimal irritation is expected initially. With LASEK it takes about five days for the surface epithelial layer to regenerate and some pain or discomfort is likely in this time.
Faster visual recovery - as the epithelium is only minimally disturbed during LASIK the recovery is usually very fast with the majority of patients having a good level of unaided vision by the next day. Useful vision in LASEK occurs only when the epithelium has regrown and vision may take a little longer to become clear.
Lower incidence of corneal haze and scarring with LASIK - corneal haze is a significant side effect of LASEK, particularly with higher refractive errors. Haze can cause or exacerbate symptoms such as glare and haloes, and contribute to myopic regression. LASIK allows surgeons to approach higher errors with greater confidence in relation to the end refractive result.
Faster stability - less fluctuation through the healing process (ie. regression) and decreased corneal haze or scarring offers a faster and more stable correction with LASIK.

For mild to moderate degrees of myopia (up to -5.0 dioptres) LASIK provides similar clinical results to LASEK but visual rehabilitation is improved.

For severe degrees of myopia (over -5.0 dioptres) improved clinical results and a lower incidence of complications such as haze and steroid usage make LASIK the procedure of choice.

Benefits

There are many benefits associated with vision correction. The benefit one receives depends mainly on the person and their visual requirements.

Some of the potential benefits include:

Less dependence on glasses or contact lenses.
Freedom from limitations associated with glasses or contact lenses.
Occupational reasons - some jobs (eg. police) require the employee to reach a certain standard of vision without glasses or contact lenses. It is important to check with the relevant authorities to make sure if refractive surgery is accepted as an alternative.
Enjoyment of sports such as swimming, football, tennis and skiing without the burden of optical correction.
No worry about glasses or contact lenses being broken or lost.

Complications

All forms of surgery carry some degree of risk and complications are possible. On the whole refractive surgery enjoys a high safety record, it is however an elective procedure and there are certain potential complications and risks you should be aware of before considering treatment.

Our patient information brochure outlines the potential complications and risks in greater detail. The complications will be discussed in-depth at your assessment consultation.

All forms of Surgery have associated risks and complications.