LASER VISION CORRECTION
Laser vision correction
Here at Atlas Eye Specialist Centre, we adopt the US FDA-approved ZEISS technology to provide all 3 types of laser vision correction (ReLEx® SMILE/LASIK/PRK) to correct myopia, hyperopia and astigmatism. We recognise that not everyone’s eyes are the same and we aim to find a treatment most suited to your lifestyle and visual needs.
The type of treatment you go for is dependent on the shape of your eyes, corneal thickness, the amount of myopia and/or astigmatism you have may, your occupation and lifestyle needs.
Useful information
ReLEx® SMILE
SMall Incision Lenticule Extraction (ReLEx® SMILE) is a minimally invasive procedure which combines the qualities of both PRK and LASIK – flapless and fast recovery. A flapless procedure where the corneal structure is left largely intact, SMILE is ideal for individuals who have active lifestyles/occupations with a risk of trauma to the head or eyes and/or for those predisposed to chronic dry eye. The single-step procedure takes 24 seconds and patients need not change their position unlike LASIK that requires 2 different lasers:
- A femtosecond laser creates a disc-shaped piece of corneal tissue (lenticule) just beneath the surface of the cornea.
- The same laser then creates a small incision of 4mm in the cornea, from which the lenticule is removed, resulting in a reshaped cornea that corrects the vision.
Wavefront bladeless LASIK
Laser-Assisted In Situ Keratomileusis (LASIK) is a flap surgery. A thin 22mm flap is created with a rapid femtosecond laser. The flap is then gently folded back to expose the corneal surface for an excimer laser to reshape the cornea for vision correction. Visual recovery is quick and it is rare for patients to experience flap-related effects. LASIK is the more widely performed laser vision correction procedure since its introduction in the early 1990s. LASIK improves upon PRK in the areas of discomfort and recovery time, but may come with a higher possibility of dry eye. Here is the procedure:
- A femtosecond laser creates a 22mm flap which can be folded back temporarily.
- An excimer laser guided by Wavefront technology (maps your eye in 3 dimensions giving a reading for the laser to customise the treatment) sculpts the corneal tissue over a few seconds to correct the refractive errors.
- The corneal flap is repositioned and will stay in place until it is fully healed.
Advanced surface ablation
(Wavefront PRK)
PhotoRefractive Keratectomy (PRK) is a ‘no-flap no incision’ procedure based on surface ablation. The visual correction is made directly on the cornea surface after the thin outer layer of the cornea (epithelium) is removed. Visual recovery following PRK treatment generally takes longer and can be accompanied by some discomfort. PRK offers distinct advantages for patients with lower prescription and slightly thinner corneas. Other procedures that fall under the category of advanced surface ablation include epi-LASIK, LASEK and TransPRK. Wavefront PRK comprises 3 main steps:
- The epithelium on the surface of the cornea is dissolved by a diluted alcohol solution and then removed by an instrument.
- An excimer laser guided by Wavefront technology (maps your eye in 3 dimensions giving a reading for the laser to customise the treatment) sculpts the corneal tissue over a few seconds to correct the refractive errors.
- A protective contact lens is placed over the eye until the epithelium grows back within a few days.
Collagen cross-linking (CXL) (Xtra)
Incorporating collagen cross-linking (CXL) into laser vision correction procedures activates the cornea’s collagen fibres to cross-link and thereby strengthening the cornea. For patients with slightly thinner corneas and higher prescription of astigmatism, CXL may extend the longevity of the laser procedure and aims to minimise the need for enhancement, lessening the risk of long-term changes to your vision. The following procedure is applied after the removal of the lenticule (in ReLEx® SMILE) or reshaping of the cornea (in LASIK and PRK):
- Riboflavin eye drops are dropped onto the cornea.
- The eye drops are allowed to soak for 1 minute after which the cornea is rinsed clean and its flap (if any) is restored.
- Ultraviolet light is then directed on the eye for 1 minute binding the chemicals between the collagen molecules.
Is Laser Vision Correction For Me?
If your eye prescription has been stable for the past 12 months, and if you have good general health and are free of any eye disease, you are likely suitable for any one of the 3 types of Laser Vision Correction (ReLEx® SMILE, LASIK, PRK).
Most people are suitable for ReLEx® SMILE or LASIK, but if you have thinner corneas or low prescription, PRK may be recommended.
If you have both thin corneas and a moderate to high refractive error, an Implantable Contact Lens procedure can be performed. If you have a high level of hyperopia or presbyobia, Refractive Lens Exchange or ‘Clear Lens Extraction’ may be a better option. Another procedure for presbyopia that you can consider is monovision laser vision correction.
Please note that pregnant and breastfeeding mothers are not suitable for laser vision correction because the hormonal changes they are undergoing may cause changes to their prescription. Breastfeeding mothers will need to cease nursing for at least 3 months before considering laser vision correction.
What If I Have Presbyopia?
If you have presbyopia, Monovision may be the solution to allow for both near and far vision so that you are able to read books and do computer work, as well as drive your car and watch movies. Utilising one of several Laser Vision Correction techniques, your dominant eye is set for distance focus while the other eye is set for near focus.
Although it is not a perfect solution for presbyopia, most patients who choose Monovision find it satisfactory. Minor trade-offs for the procedure include some difficulty with high performance sports, night driving and intricate close work. The alternative will be going for Full Correction to allow both eyes to see far clearly and to wear reading glasses for near.
