1. HOW LONG HAS THE SURGERY BEEN PERFORMED?
Eye Laser Surgery was introduced to South Australia by Dr Peter Ingham in 1992 but it was initially developed in the mid 1980's as an alternative to Radial Keratotomy. Initially it was performed on the surface of the eye as PRK, which is still performed today. LASIK evolved to overcome some of the disadvantages of PRK, most notably the time of recovery, and involves the combination of PRK and the fashioning of a corneal access flap. This corneal flap involves techniques very similar to those employed in the 1950's. LASIK, therefore, is the combination of two procedures, each with a long history. With a history of over 20 years much confidence can be gained from its related procedures.
2. IS THE PROCEDURE SAFE?
In medical terms, LASIK and PRK are very safe procedures with adverse outcomes from complications of a serious nature occurring in under 1:1000 eyes. This is not to say that complications and side effects cannot occur. Before proceeding with this procedure the risks specific to your circumstances must be assessed and fully explained to you so that you can make an informed decision.
3. WILL I REQUIRE TIME OFF FROM WORK?
Generally the surgery will be performed late in the week so that you can return to work after the weekend. How well you can function depends on the degree of your refractive error, the recovery rate of your eye and the type of visual tasks you perform. In general, people with smaller corrections who do not engage in heavy near or screen based tasks can expect to function very well the first week. Others may have a longer recovery. If possible, you should consider taking up to a week off work with a further 3 – 5 days for PRK and perform less near tasks initially.
4. DOES THE PROCEDURE HURT?
During Eye Laser Surgery of any form the eye is anaesthetised with drops. As such, you should not experience any pain during the procedure. It is normal, however, to feel some mild stretching of the eyelid from the speculum during the procedure. During LASIK there is a 10-15 second period of pressure from the suction ring used. These sensations should not be bothersome to the point of being painful. Following the procedure there will be a foreign body feeling in the eyes which in the case of LASIK is for a period of 2-6 hours and is generally mild. PRK on the other hand is initially more uncomfortable and takes 3-4 days for the corneal epithelium to heal. In both cases pain relief is provided for the initial post-operative period. The degree of pain or discomfort experienced can vary depending on individual pain threshold.
5. HOW LONG DOES THE PROCEDURE LAST?
After the initial recovery period that lasts for 6 months you can expect to have a permanent effect from the surgery. Rarely there may be some regression of the effect requiring remedial treatment and at times your refractive error may still be progressing at the time of the surgery. Also, should the eye develop other conditions such as a cataract or if you should become diabetic then there may be changes in the refractive error of the eye. If there is evidence of either regression, under or over correction or progression of your refractive error to the point where it is bothersome, then an enhancement procedure can be performed. Remember that as with the original surgery this surgery also carries a small risk that you must consider.
6. AM I COVERED WITH HEALTH INSURANCE?
There is no Medicare benefit for these procedures, however, rebates may be available from some health insurers and Adelaide Eye & Laser Centre has contracts in place with most major health funds. Please check with your fund to see if any entitlements apply, and if you wish to claim, please advise our staff prior to your admission.
7. WHAT HAPPENS IF I BLINK OR MOVE MY EYE?
Blinking is prevented by the speculum that keeps the eye open and therefore is not a problem. Eye movement on the other hand can significantly influence the outcome so it must in some way be compensated for during the procedure. Some older lasers rely on the patient to fixate on a blinking light but unfortunately this is not always possible, especially during LASIK. To overcome this difficulty, the advanced lasers employ techniques to follow your eye movements during the procedure to compensate for the errors in placement of the pulses that would arise. These tracking systems ensure that the full benefits of the laser are provided improving predictability and rate of recovery thereby reducing the chance for remedial enhancement surgery and/or loss of best potential vision.
8. HOW DOES THE LASER WORK?
The excimer laser used in Eye Laser Surgery procedures is a high energy ultraviolet laser. It works by precisely removing very small amounts of corneal tissue with each pulse with the pattern of laser pulses creating the desired change in refraction. The position and number of the pulses is controlled by the algorithm within the laser's computer. Depending on the correction and the laser used the treatment time may be only a few seconds up to over a minute.
9. WHEN CAN I RETURN TO NORMAL ACTIVITIES?
Apart from the restrictions listed below, normal activities can begin immediately. Driving and using dangerous machinery should be avoided until the next day and then only if you are confident to do so. It is necessary to avoid any contact with the eye for three days and shampoo and make-up around the eyes must be avoided. Eye shields must be worn at night and sunglasses or clear protective glasses at all other times during this period. Swimming and contact sports should be avoided for a week. Rubbing the eye is ill advised at any time but should be restricted for at least a week.
10. CAN THE RESULT BE IMPROVED SHOULD IT BE LESS THAN PERFECT?
Enhancement surgery can be performed once the result of the initial surgery is stable. This is usually after three to six months. Enhancement surgery has a similar risk profile and recovery as the initial surgery but usually starts with a much smaller error. The likelihood of enhancement surgery is determined by the initial refractive error and will be discussed as part of the consent process.
11. WHAT EXPERIENCE DOES THE CENTRE HAVE?
The surgical staff at Adelaide Eye & Laser Centre have been performing Eye Laser Surgery in Adelaide since February 1992, introducing it to South Australia. During this period over 25,000 laser vision procedures have been performed with the vast majority being LASIK. This experience extends beyond the surgical staff to everyone working within the centre to ensure that you receive the best care at all stages of your involvement with us.
12. IS THE PROCEDURE SUITABLE FOR EVERYONE?
No, if you only require reading glasses then almost certainly this procedure will be of limited or no benefit since this results from a lack of flexibility in the natural lens. This is termed presbyopia and whilst leaving one eye short-sighted to give some reading ability is possible, for most this is a less than ideal compromise.
Some people have contraindications either of an ocular nature or a medical nature making them unsuitable for Eye Laser Surgery. Other procedures may provide an alternative surgical option. Remember, those people who are content with their glasses or contact lenses should ensure that the benefits of the procedure are fully considered.
13. WHY SHOULD I HAVE MY PROCEDURE DONE AT ADELAIDE EYE & LASER CENTRE?
There are many benefits that Adelaide Eye & Laser Centre can offer should you decide to proceed with surgery.
• Extensive experience since 1992 with more than 25,000 successful procedures.
• Fully accredited, theatre level facility dedicated to Eye Laser Surgery.
• The most advanced equipment available to maximise predictability and safety.
• Unparalleled levels of customer service during all stages of the procedure.
14. CAN I REALLY THROW AWAY MY GLASSES?
This is the goal of Adelaide Eye & Laser Centre in regards to your distance vision. For the vast majority of cases we can achieve this goal although enhancement surgery may occasionally be required. But remember that this is a surgical procedure of living tissue and therefore is subject to some degree of variable response. Also, it is important to remember that Eye Laser Surgery does not alter the normal ageing processes of the eye such as the loss of flexibility of the lens required for good near vision. It cannot overcome diseases of the eye that reduce the vision potential of the eye such as retinal disease.