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LASER VISION CORRECTION SURGERY

Laser vision correction surgery may decrease your dependence on glasses and contact lenses. Laser surgery is safe, quick and can be performed with only minor discomfort.

At Marsden Eye Laser Clinic we use one of the worlds most technologically advanced excimer laser machines, The Schwind Amaris. The excimer laser is used to permanently reshape the curvature of the cornea to improve the way the eye focuses light rays onto the retina, the same way your glasses or contact lenses do.

There are two different laser vision correction procedures: LASIK and PRK

LASIK

WHAT IS LASIK?

LASIK is short for “Laser in situ keratomileusis”. It is a simple surgical procedure used to treat myopia (shortsightedness), hypermetropia (longsightedness), astigmatism and presbyopia (age-related long sightedness). It has become the most popular form of laser vision correction surgery.

LASIK procedure involves the creation of a flap to the cornea (the front part of the eye). The flap is then lifted and the excimer laser is applied to the deeper layers of the cornea to reshape and to alter the optical power of the eye. The corneal flap is then repositioned to its original position. LASIK is safe, quick and virtually pain free.

HOW IS LASIK PERFORMED?

  • Creating the flap
  • Laser correction
  • Closing the flap
  • image056.jpg

    Part I: Creating the flap

    It involves creating a "flap" of the cornea with a specialised instrument called the microkeratome
  • image057.jpg

    Part II: Laser correction

    Excimer laser beam is used to reshape the cornea
  • image058

    Part III: Closing the flap
    The “flap” is then replaced to its original location, bonding securely, without the need for stitches

    The eye heals within the first 24 hours and patients can generally resume work the day after surgery.

ON THE DAY OF THE PROCEDURE

Do not wear any form of make-up, powder or perfume on the day of your procedure.

You can not drive yourself home on the day of your surgery. Please arrange for someone to take you home.

Plan to be at the surgery centre for 1- 1.5 hours. The actual procedure takes 20 minutes for both eyes.

  • Local anaesthetic eye-drops will be placed in your eye to ensure your eye is comfortable during LASIK.
  • A sedative tablet is often given prior to surgery.
  • You will be placed under the Excimer Laser and your head will be positioned directly under the laser.
  • A sterile dressing will be placed over your face exposing only the eye to be treated.
  • A speculum will be placed between your eyelids to open your eye and prevent blinking.
  • A clear, adhesive plastic film will be placed over your eye to hold down your eyelashes. A suction ring and the microkeratome will be positioned on your eye.
  • The Doctor will ask you to fix your focus on a blinking light.
  • As soon as the Doctor is satisfied with your eye's fixation he will begin creating the flap. You will hear a low "whirring" sound and observe a shadow momentarily blocking your view of the fixation light and feel a firm pressure on your eye. Relax and keep your eye fixed.
  • Once the flap is created, the Doctor will lift the flap and begin reshaping your cornea. You will hear a rapid "clicking" sound and see a bluish white light rapidly flashing. At some moments you may not see the fixation light but you should keep your eye as still as possible. However, if you do accidently move your eye, the laser will stop and restart once you have regained fixation.
  • When the cornea reshaping is done, the Doctor will irrigate your eye, replace the flap and gently press down the edges of the flap with a sponge.

AFTER YOUR SURGERY

Immediately after surgery, you will perceive an improvement in the vision. Your vision will be blurred as though looking through frosted glass, usually lasting 6-12 hours. You may experience tearing and a mild foreign-body sensation. Painkillers can be taken to reduce any minor pain.

We recommend you go home and rest or go to sleep after your procedure.

The next morning your vision will be dramatically improved.

For the first two weeks after your procedure, please don’t rub your eyes, don’t go swimming, don’t wear eye make up and please avoid dusty environments, contact sports or long overseas air travel.

Work: You can generally return to work 2 days after the LASIK procedure.

Driving: You can generally drive the next day following your LASIK procedure. At your 1 day post operative check we will inform you when it is safe for you to drive.

Follow up appointments

  • 1st visit: 1 day after surgery
  • 2nd visit: 2 weeks after surgery
  • 3rd visit: 2 months after surgery

PRK

WHAT IS PRK?

Photorefractive keratectomy (PRK) is a laser assisted surgical procedure using the excimer laser to correct refractive error. PRK involves the removal of a thin layer of epithelial tissue from the cornea, followed by the excimer laser permanently changing the optical power of the eye. Once the laser is applied the removed epithelial cells need to regenerate. A bandage contact lens placed on the eye for four days aids in the cells regenerating and healing.

PRK has the same visual outcome as LASIK, however the recovery process is slower and there will be a period of discomfort during the first 4 days after surgery.

HOW IS PRK PERFORMED?

  • PRK1.jpg

    Part I: Instrument used to prepare the corneal surface for laser.

  • prk2.jpg

    Part II: Excimer laser is used to reshape the cornea.

  • prk3.jpg

    Part III: Bandage contact lens is placed over your eye to allow healing.

ON THE DAY OF THE PROCEDURE

Do not wear any form of make-up, powder or perfume on the day of your procedure.

You can not drive yourself home on the day of your surgery, please arrange for someone to take you home.

Plan to be at the surgery centre for 1 - 1.5 hours, the actually procedure takes 20 minutes for both eyes.

  • Local anaesthetic eye-drops will be placed in your eye to ensure you experience no pain during PRK.
  • A sedative tablet is often given prior to surgery.
  • You will be placed under the Excimer Laser and your head will be positioned directly under the laser.
  • A sterile dressing will be placed over your face exposing only the eye to be treated.
  • A speculum will be placed between your eyelids to open your eye and prevent blinking and a clear, adhesive plastic film will be placed over your eye to hold down your eyelashes.
  • Doctor will ask you to fix your focus on a blinking light, while he prepares the corneal surface.
  • Once the doctor has done this the laser will begin reshaping your cornea. You will hear a rapid "clicking" sound and see a bluish white light rapidly flashing. You will also smell the scent of burning hair or similar. At some moments you may not see the fixation light but you should keep your eye as still as possible. However, if you do move your eye accidentally, the laser will stop and restart once you have regained fixation.
  • When the cornea reshaping is done, Doctor will put some more drops in, then cover the treated surface with a contact lens.

AFTER YOUR SURGERY

  • Your vision will be blurry and fluctuating for the first four to five days.
  • You will be in quite a bit of discomfort for up to 4 days, with some improvement as each day passes.
  • You SHOULD NOT remove the contact lens yourself. This will be done at your 4 day post operative visit. Follow the instructions you are given and instil all drops on top of contact lenses.
  • Pain killers will be essential and these are provided to you. Feel free to use your own form of pain management if you choose.
  • You will be light sensitive and feel much better with your eyes closed – do this as much as you can especially for the first 24-48 hours.
  • Cold compress on your eyelids and resting in a dimly lit room are also quite helpful.
  • Taping bandages over your eyes is not essential but sometimes the pressure of this can help to suppress the discomfort.
  • You will notice your vision gradually improving over the first week and especially after having your contact lenses removed on the fourth day after surgery.

For the first two weeks after your procedure, please don’t rub your eyes, don’t go swimming, don’t wear eye make up and please avoid dusty environments, contact sports or long overseas air travel.

Work: You can generally return to work 5 days after the PRK procedure.

Driving: You can normally drive 5 days following your PRK procedure, at your 4 day post operative check we will inform you when it is safe for you to drive.

Follow up appointments

  • Day 1 – vision check and review of pain management
  • Day 4 – removal of contact lenses
  • 2 weeks post op – review with doctor
  • 2 months post op – review and discharge

Frequently Asked Questions for LASIK

How does Lasik Work?

The LASIK method (also called Flap and Zap) is a major leap forward in refractive surgery. LASIK combines conventional surgery with laser surgery. The procedure began in 1989 and has since evolved into a safe and effective method to correct several eye conditions. To perform LASIK, the surgeon uses a special micro-keratome or intralase technique to create a flap on the front surface of the eye (cornea) that is then lifted back and preserved.

The Excimer laser rapidly reshapes the curve of the exposed corneal tissue, and then the flap is returned to cover the reshaped / remoulded tissue.

This flap acts as an 'own body band-aid' which re-adheres fully within a few minutes, without stitches. The eye is protected, the risk of infection is minimised and the natural healing process is accelerated by minimal intervention

What are the benefits of Lasik?

Individuals consider the option of refractive surgery and LASIK for a variety of very personal reasons. While LASIK does not promise perfect vision, it does hold the promise of reducing one's dependence on contact lenses or glasses, which will allow many people to more freely pursue their hobbies, sports activities or career options.

Sports Enthusiasts - from weekend warrior to professional athlete, many wish to be reducing their need for contacts or glasses for safety or performance reasons.

Mothers of Young Children - many women express concern about the safety of their children if they should lose their glasses or contact lenses -- while playing in the surf or trying to escape a burning building, for example. LASIK may even reduce the anxiety produced by simple tasks, like finding one's way through the house at night.

Frequent Travellers - for those who spend a considerable amount of time on the road, being less dependent on glasses or contacts promises numerous advantages, from safety (ability to read evacuation signs) to convenience (less to pack).

Am I suitable for Lasik?

Not everyone who wears corrective lenses would be suitable. To determine suitability you will need a thorough eye examination. At the Marsden Eye Laser Clinic we invite you to take advantage of our complimentary consultation where we will perform all relevant tests and discuss all the risks and benefits of the procedure. If at this stage you fulfil the criteria required, you will have the options of meeting with Dr Fitzsimons or Dr Lewis where a full general eye check up including the examination of the back of the eye (retina) to make sure that there are no contraindications. The consultation with the surgeons will costs $245 with some Medicare rebate if you have a referral from your GP or Optometrist.

Why are there so many price differences between centres?

The differences in prices are dependant on the technology and resources used. All major centres inSydneywould have the latest technology and are continually upgraded and serviced every 6 weeks. What differs is the amount of inclusive fee that the centre offers and whether there is any add on costs e.g. enhancements or high overhead costs such as advertising/marketing that the practice incur.

How long does the procedure take?

You may be required to spend about 1.5 hours at our day surgery although the laser procedure itself may only take 10minutes to perform. A relaxant tablet will be given prior to the procedure. Pre-operative administration and preparation takes about 20 minutes. After your Lasik procedure, you will be offered tea or coffee and rest for about 10-15 minutes. Your eyes will be checked under the microscope by the surgeon prior to discharge from day surgery.

Am I awake during the procedure?

The procedure is done under local anaesthetic in the form of an eye drop. With you being awake for the procedure is more controlled because your focus on the laser beam helps to centre and align your vision with the laser for better tracking and treatment outcome.

Is the surgery painful?

The eyes are completely numbed with local anaesthetic eye drops and will not experience any pain. However, you will still feel pressure sensation and touch especially the tension caused by the lid holder that keeps the eye open and prevent you from blinking. During the laser treatment (takes about 1-2 minutes) you will hear the laser impulses and the smell of the plume but there will be no pain.

When will I see again?

Visual recovery is very quick, most people can see close to their best vision within 24 hours after surgery. Straight after surgery you will experience blurry vision (like somebody has smeared Vaseline on your glasses) but you should be able to see through the blur.

How much time will I need off work?

Recovery time is approximately 24 hours. Usually we recommend you take the day of your procedure and the following day off work and resume to normal by the 3rd day.

What are the side effects/risks of the procedure?

During the first consultation we will go through the full list of complications/risks and the benefits of surgery. If you have been selected as a suitable candidate for LASIK, the chances of success are usually 99% without any complications. Full detail of specific risks and side effects are better discussed at your consultation where results of tests will allow the doctor to fully inform you of such if any will apply to your treatment outcomes.

Is the treatment permanent?

All reports suggest this treatment is permanent since it's beginning 30+ years ago. We cannot however, predict whether your eye would have naturally become more short/long sighted with time. The surgery will not halt the natural progression of the eye. We do assume that if you are over 21 years of age and have had a stable prescription for 12 months, that your eyes will not change and the treatment will therefore be permanent.

Are there any restrictions after surgery?

You can resume normal activities however, we do ask you to take care for the first 2 weeks and refrain from swimming, contact sports or rubbing the eyes.

What's the next step?

The decision to have LASIK is an important decision and we at the Marsden Eye Laser Clinic believe it should be a fully informed one. For a full assessment and discussion about the procedure please contact our clinic on Phone: (02) 9635 6964 Mobile: 0417 635 400 or email us on [javascript protected email address]