29 Jan All you need to know about laser eye surgery
This guide covers the following:
- What exactly is laser eye surgery and how can it fix my eyes?
- How does the laser technology work?
- What are the risks of getting eye laser surgery?
- How much does the surgery cost?
- How to choose a clinic and an eye surgeon?
Laser eye surgery, or laser vision correction is a great option for people who don’t like wearing glasses, or those who don’t want the inconvenience or ongoing costs associated with wearing contact lenses. In the simplest terms, laser surgery is a type of surgery that uses a laser, rather than a scalpel.
While that can sound a little scary, the benefits of using a laser for procedures like laser eye surgery is that lasers can focus very accurately on tiny areas and so is much more precise when working with a small area like the eye.
Laser eye surgery can be used to fix many common eye issues, such as short-sightedness (myopia), long-sightedness (hyperopia), age-related loss of focus (presbyopia) and multiple points of focus (astigmatism).
The way it works, is that an ophthalmologist (a specialised eye surgeon) will use the highly-precise laser to reshape your eye, in order to restore it to the correct shape. This may involve flattening your eye if you are short-sighted, shaping a sharper curve if you suffer from hyperopia, or smoothing out the curve to correct astigmatism.
There are four main types of laser eye surgery methods;
LASIK is short for ‘Laser in situ keratomileusis’ and is the most common type of laser eye surgery. All-Laser LASIK is a 2-step procedure which uses two different lasers. Firstly, the ophthalmologist will use the femtosecond laser to create a flap in the top layer of the cornea. The excimer laser is then used to precisely correct the patient’s refractive error by reshaping the corneal tissue. This version of LASIK is the newer of the two and so is often preferred by patients.
Traditional LASIK is also a two-step procedure similar to the All-Laser LASIK above, but instead of using a femtosecond laser to create the flap in the top layer of the cornea, a microkeratome (a high-precision, oscillating-blade) is used instead. This method is the older of the two methods, having been used for over 20 years and so has a longer proven history of success.
In both cases of LASIK surgery, the healing process begins immediately. The eye has an amazing ability to heal itself naturally and patients are able to return to most of their daily activities the next day.
Both LASIK methods are effective for correcting short-sightedness and long-sightedness but the two methods can vary quite substantially in price, with the Traditional LASIK being the cheaper of the two. A discussion with your ophthalmologist will help you decide which method is best for you.
SmartSurfACE™ (Transepithelial PRK)
One of the newer approaches to laser eye surgery – SmartSurfACE™ – is a non-invasive surface laser eye treatment method that uses Excimer laser system and pulse technology to create a smoother corneal surface. The pulse technology used can help to create a better result for the patient, in a recent study, two groups of people were studied, with one group undergoing Transepithelial PRK with SmartSurfACE™ pulse technology and one undergoing Transepithelial PRK without SmartSurfACE™ pulse technology, ‘visual acuity was 20/25 or better in 80% of patients in the SmartSurfACE™ group compared with just 55% of those treated without the new pulse technology.’
This method of laser surgery also promotes faster healing as there is no cut made to the eye like in LASIK surgery and there is a reduced risk of suffering from dry eyes after the surgery. People that suffer from dry eyes normally may have this type of surgery recommended to them. SmartSurfACE™ is suitable for all candidates for laser eye surgery, as it works on all eye conditions such as long or short-sighted or astigmatism.
The price sits in between the two LASIK options, but be sure to talk to your ophthalmologist to decide if this method is best to suit your needs.
Lens Implant surgery (cataract surgery)
This kind of eye surgery is also known as cataract surgery and is most commonly used to treat the eyes of people ages 45 and older. A cataract is a clouding of the normally clear lens of your eye, which can sometimes happen as people age. It develops over time and can affect the way in which light enters the eye lens to the back of the eye (retina), and so can affect people’s vision and their ability to see clearly. If left untreated, it can cause blindness.
Cataracts are often initially treated with a stronger glasses prescription, but if the cataract develops further, then Lens Implant Surgery is a great option. Once Lens Implant Surgery is performed, you will gain clear vision within days of the surgery being performed and there is no chance of developing another cataract, so you can enjoy clear vision for life!
The costs for Lens Implant Surgery are often covered by your health insurance, so talk to your insurance provider to see if you are covered and speak with your ophthalmologist to see if this kind of surgery is right for you.
Different forms of laser eye surgery have been performed for over 30 years and the procedure is very well established, so you can be sure that you are choosing a safe and proven vision correction technique.
As with any surgery, there can be risks involved, so be sure to have a lengthy discussion with your ophthalmologist to see if any of the below can affect your success rate of laser eye surgery:
- Laser eye surgery carries extra risks if performed on patients with very thin or irregularly shaped corneas. This can be easily assessed as part of your initial consultation.
- Certain eye diseases like glaucoma can increase the chance of undesirable post-surgery symptoms, so be sure to mention any family history of glaucoma to your ophthalmologist so a thorough screening and evaluation can be done.
- Certain conditions like diabetes, autoimmune diseases such as lupus or rheumatoid arthritis, immunodeficiency states like HIV and medications like steroids can impair the healing process and sometimes make laser vision correction procedures a less-than-ideal choice. Make sure to discuss any preexisting conditions and medication with your
As with many surgeries, there are side effects that affect some, but not all patients. Make sure to discuss these during your consultation to find out what you can do to treat these as part of your after-care.
Some side effects of laser eye surgery can include:
- Dry eyes – this happens temporarily in roughly 69% to 85% of patients but can be very easily treated with lubricating eye drops. As laser eye surgery disturbs the eye’s tear film it can be common to experience this for a few weeks or months after surgery, but only in rare cases does this persist past that point. LASIK is anecdotally more likely to cause this side-effect, so people who suffer from dry eye may be recommended SmartSurfACE™ treatment instead.
- Over or under-correction – this can be common due to over treatment or under treatment. You may need a second ‘enhancement’ procedure to ensure optimal vision.
- Sensitive eyes – particularly to bright lights or glare.
- Blurred vision – ‘halos’ or rings of fuzzy light may result from the treatment.
- ‘Regression’– In a small number of cases due to ageing or changes that can occur in the lens inside the eye, the previous refractive error (short-sightedness or long-sightedness) can return. This isn’t technically regression, but often a progression of the existing refractive error. The onset of presbyopia (when the eye lens loses its ability to focus on objects nearby) which often starts at around age 40 in most people, can often attribute to this phenomenon. An enhancement procedure may be necessary to keep the patient out of glasses. This is rare though, happening in less than 5% of all cases.
- Infection – this is extremely rare, but treatment with antibiotics may be necessary. The chances of having a complication following Lasik surgery is about 1-2% and often include the lesser and more easily treatable symptoms such as experiencing chronic dry eyes. Of course, if symptoms persist, always refer back to your ophthalmologist.
Any risk factors to laser surgery or potential side-effects from your surgery should be discussed as part of your initial consolation and as part of your follow-up appointments. If you have any concerns about any of these symptoms or risk-factors, make sure you discuss them with your ophthalmologist or your GP.
The price for laser surgery can vary from clinic to clinic so make sure you shop around to compare prices. Keep in mind also that cheapest may not always be best – make sure you do your research on the provider and seek testimonials and reviews where possible. The prices for different types of laser surgery can also differ as mentioned, but it is best to speak to your ophthalmologist to make sure you are getting the most appropriate treatment for you.
Unfortunately, as laser eye surgery is an elective surgery, you may not be able to claim anything if you have standard health insurance cover. If you have top hospital and extras cover, you may be able to claim part of your surgery or initial consultations costs. Talk to your health care provider about what you are covered for, and if it is worth changing your policy so that your surgery can be covered. You can also check out comparison sites for health cover like iSelect, Choosi or Compare the Market to see if there may be a better suited policy for you.
As cataract surgery is covered by Medicare, if you need to undertake Lens Implant Surgery and choose to go through a public hospital, then you should have little or none out-of-pocket costs. This can be discussed with your GP or Medicare for more information. If you choose to go private for this procedure, then you may have to pay additional costs, but many private health insurance policies will cover these. Be sure to speak with your insurer to see what your policy covers.
There are lots of factors you should take into consideration when choosing your laser eye surgery clinic.
Getting recommendations from people who have undergone the surgery is a great place to start, as well as searching for online reviews and testimonials.
Where the surgery is located is also something to keep in mind, as you will needing to get there for pre- and post-surgery appointments so you don’t want to choose somewhere that is located far away and will make it inconvenient to make these appointments.
It’s always a great idea, as we have already said, to shop around. Not only to compare prices, but to get a second opinion on what treatment is best for you and to find an ophthalmologist who you trust and feel completely comfortable with.
Once you have shortlisted a couple of places, make sure you know the following:
- What their experience in each type of surgery is – not only how many people they have treated, but also what their success rate is. Find out if and how they track the success of their surgeries.
- What their costs include – is it a comprehensive cost that includes all consultations, as well as after-care and post-surgery checkups? You don’t want to be hit with unforeseen costs after your surgery!
- What exactly is involved in the surgery, make sure that the surgeon completely explains the procedure to you, as well as anything you need to do pre-surgery as well as any aftercare that will be required. Make sure they can answer any questions or concerns you have about the procedure.
Once you have taken the above into consideration, it should be easy to narrow down your search. If you are still unsure, ask your potential ophthalmologist if there are any clients that you can contact for feedback about the procedure and their experience. This may not always be possible, but will really help to calm any nerves or dispel any uncertainties you may be feeling!
Once you have chosen your perfect surgeon and clinic, you are well on your way to clear vision.
The Binetter Eye Centre, we are proud of our history of successful surgeries and our many satisfied clients. If you are considering eye surgery, contact us on (02) 9460 1177 or book an initial consultation.
This article is not a substitute for a consultation with your surgeon. Before choosing to proceed with laser eye surgery your surgeon will have a detailed discussion with you about the right procedure and about the potential complications.
Better Health.gov (Victoria) – Eyes – laser eye surgery
Glaucoma.Org – Can I Have Laser Vision Correction?
CERA.org.au – Cataract
AOO.org – Creating LASIK Flaps: Femtosecond Laser vs. Mechanical Microkeratome
Ophthalmology Times.com – Pulse technology boosts all-laser PRK for one-step, no-touch ablation
A unique mix of expertise, experience and international reputation, Dr Ron Binetter is the figure behind the Binetter Eye Centre. With more than two decades of hands-on experience in eye surgery, Dr Binetter is a specialist in cataract, lens implantation and laser eye surgery. Learn more about Dr Ron Binetter’s background and qualifications.