Is everyone suitable for laser eye surgery?

Laser eye surgery, also known as laser vision correction, is a popular refractive surgery procedure amongst people who are short-sighted, long-sighted and/or astigmatic. Some of the more popular and common types of laser eye surgeries include ReLEx SMILE, LASIK and PRK, which involve the use of a laser to permanently reshape the cornea (most front part of the eye), allowing people with refractive errors (short-sightedness, long-sightedness, astigmatism) to see well without glasses and contact lenses.

To ascertain suitability for laser eye surgery, one will need to through a 3-hour pre-laser evaluation. Most people are suitable for laser eye surgery though a small handful may be deemed unsuitable due to various conditions which include:

  • Below the age of 21
  • Unstable prescription in the last 12 months
  • Thin and irregularly shaped corneas – Increases the risk of corneal ectasia (a condition whereby the cornea is unable to retain its shape, resulting in poor vision) post-surgery
  • Big pupils – May increase the incidence of seeing glares and haloes at night
  • Severe dry eye – Laser eye surgery may not be recommended for people with persistent or chronic dry eye as it is a common temporary side effect which usually subsides for most people 1 to 3 months post-surgery
  • Refractive errors that are not within the laser treatment range
  • Pregnant or breastfeeding women – Hormonal changes occur during pregnancy and breastfeeding, which results in fluctuating vision. Laser eye surgery to be considered 3 months after breastfeeding has ceased completely
  • Pre-existing eye conditions (eg cataract and glaucoma)
  • On certain type of long-term medication (eg acne treatment)
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There are 3 main types of laser eyes surgeries available today:

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Photorefractive Keratectomy (PRK) is a flapless laser eye procedure. The most front part of the eye (epithelium) is removed prior to surgery. After which, the laser is applied directly on the cornea to reshape it. A bandage contact lens will be placed over the eye after PRK to help with healing and to provide comfort for the first 3 days. Comparatively, the recovery for PRK is slower and there is a higher level of discomfort (first 3 days) which includes tearing and difficulty opening the eye. It is recommended for people with thinner corneas as it is the most tissue saving treatment. PRK is considered the most gentle treatment as it does not create a corneal flap nor incision.

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Laser-assisted In Situ Keratomileusis (LASIK) is a flap laser eye surgery which promises low level of discomfort and a fast recovery. A 22mm corneal flap is created with a femtosecond laser. Thereafter, a second laser known as an excimer laser is used to reshape the cornea. Most people recover about 75% of their vision the next day. Despite its speed of recovery and low levels of discomfort, LASIK is usually not highly recommended for those with dry eye concern or those who are highly engaged in contact sports as there is a higher risk of flap dislodgement.

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Small Incision Lenticule Extraction (ReLEx SMILE) is another flapless laser eye surgery (akin to PRK). A laser is used to create a piece of corneal tissue (lenticule). The same laser then creates a small incision of 4mm, from which the lenticule is removed to reshape the cornea. SMILE seeks to combine the qualities of both PRK (flapless) and LASIK (fast recovery and low levels of discomfort). Akin to LASIK, most people can recover about 75% of their vision the next day. As a flapless surgery, SMILE is usually recommended for those with active lifestyles or highly engaged in contact sports.

At Atlas Eye Specialist Centre, we understand that everyone’s eyes are different. By providing an entire suite of refractive surgery options including laser eye surgery, implantable contact lens and refractive lens exchange, we seek to find you a customised treatment that meets your budget, professional and lifestyle needs.

If there have been instances in your life where you felt living without glasses and contact lenses will improve your quality of life, please contact us at +65 67379119 or for a pre-laser evaluation as we lead you in this journey that millions of others had taken.