How LASIK eye surgery works

Having performed over 22,000 LASIK surgery procedures, Dr Ron Binetter is one of the most experienced LASIK surgeons in Australia.

LASIK surgery is the most commonly used technique for vision correction around the world. With LASIK most patients will see an improvement in their natural eyesight immediately after surgery with a full recovery and correction by 3 months. In fact, by the next day, the vast majority of all patients have functional vision without glasses and can see well enough to drive a car and return to work.

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LASIK procedures

Traditional LASIK

Procedure: Traditional LASIK is a two-step procedure where a microkeratome (a high-precision, oscillating-blade) is used to create the flap in the top layer of the cornea. Once the corneal flap has been lifted, the excimer laser is then used to precisely reshape the patient’s corneal tissue. This LASIK method has been used for over 20 years and is suitable for people who are nearsighted, farsighted, or have astigmatism.

Technology: Traditional microkeratome blade and Excimer laser.

Cost: Traditional Lasik surgery costs $1,500/eye at the Binetter Eye Centre*

More on Traditional LASIK

All Laser LASIK or Blade-free LASIK

Procedure: All-Laser LASIK is a two-step procedure which uses two different lasers. Firstly, the eye surgeon will use the femtosecond laser to create a flap in the top layer of the cornea. Once the corneal flap has been lifted, the excimer laser is then used to precisely reshape the patient’s corneal tissue. Like with Traditional LASIK, this type of laser eye surgery is perfect for people who are nearsighted, farsighted, or have astigmatism.

Technology: Femtosecond laser and Excimer laser.

Cost: All Laser LASIK surgery costs $3200/eye at the Binetter Eye Centre*

More on All-Laser LASIK

LASIK Surgery for Myopia

(Short-Sightedness)

Myopia up to -10 D can now be treated with the Excimer laser. Results will vary according to the severity of the refractive error and the amount of laser treatment that will be required.

Most individuals have myopia less than -3D. Results indicate that up to 99% of this group can achieve 20/20 vision following LASIK surgery. And in those with myopia between -3D to -6D up to 96% can achieve 20/20. Additional treatment can be undertaken when necessary, to gain further improvement in vision. Less than 1.5% undergo such treatment.

Individuals with extreme levels of myopia greater than -10D can be treated with intraocular lens implants or a combination of refractive surgical procedures including lens implants, and LASIK.

LASIK Surgery for Hyperopia

(Long-Sightedness)

Hyperopia treatment requires a steepening of the curvature of the cornea to increase the magnification power of the eye.

Results for low and moderate hyperopia are similar to those with myopia with up to 94% achieving 20/20 vision.

Hyperopia greater than +3.0D requires a larger amount of laser treatment. Alternative treatments may be offered such as Intraocular Lens Implants or Refractive Lens Exchange which may provide superior visual results to LASIK surgery. Both reading vision and distance vision is improved by Hyperopic LASIK. However, older individuals may still find a need for reading spectacles. This requirement varies from one individual to another.

myopia b&w diagram
Normal Eye B&W Diagram
Hyperopia B&W diagram

Regression after LASIK surgery is uncommon and usually less than 1% of initial treatments will regress.
Complications associated with LASIK refractive surgery are uncommon. The risk of infection is estimated to be one in 10,000.

LASIK Surgery for Astigmatism

Astigmatism is a common eye condition typically caused by the front surface of the eye having an asymmetrical shape. Depending on its severity LASIK can permanently correct it. Some symptoms of astigmatism include blurry vision regardless of how close or far away something is, double vision, squinting and eye strain and headaches.

A LASIK procedure will reshape the cornea so the front surface of the eye is more symmetrical, thereby eliminating vision problems caused by astigmatism.

Common questions about LASIK surgery

What to expect during surgery?

Almost every patient wants to know what LASIK surgery is like. What will I see? Will it hurt? The only thing you that you will see during the procedure is a bright light and all you will feel is pressure on the eye itself. During recovery, you will likely experience eye discomfort and dryness, but, once again, actual pain is rare.

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Lasik is painless. The eye is numb for the procedure, but you may feel some pressure when the flap is being created. The procedure is quick, taking perhaps 10 minutes for each eye. And typically right after the procedure, you can look up and see the clock on the wall and tell the time. That’s exciting for most people.

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There are really three steps. The first is the complete and thorough evaluation of the eye before we do anything. The second is using very experienced staff and very highly technical equipment to perform the treatment. Thirdly, there’s monitoring of the eye after treatment to be sure that everything goes exactly as we anticipate it should.

Is Lasik a risky procedure?

Laser eye surgery has an incredible safety and efficacy record, perhaps safer than wearing contact lenses and most risks and complications are mild and can be successfully managed.

The chances of having a complication following Lasik surgery is about 1-2% and is usually minor, such as having dry eyes and needing to use lubricating drops. The risk of a potentially serious risk such as getting an infection are approx 1:10,000 and most severe complications such as significant loss of vision are of course possible but highly uncommon.

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The most common side effects of Lasik are three things. First, I may make your vision good, but not quite perfect. Now that’s still good but it can be a disappointment. In that case, we usually recommend what we call a re-treatment, which means another laser procedure about three to six months later, to just refine the vision and make it right.

The second possible side effect of Lasik is relatively common, is you may notice glare around lights at night. That means if you look at a headlight or streetlight, you will see a little glow of light around it. That can be an annoyance while you’re driving but for most people, it’s really a non-issue.

The third most common side effect of Lasik is you may notice that your eyes feel drier after the surgery. That typically goes away in about six months or less but not always. If it persists, it can be treated with eye drops and some other treatments.

For most people after Lasik, it is so much more comfortable than their contact lenses that a little bit of dryness is not a bother.

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The first step of the Lasik procedure, and this is critical, is making the correct diagnosis and analysis of the eye to see whether Lasik is suitable for you in the first place. There are very sophisticated tests that we do to see how strong the eye is to tolerate Lasik and to assess if Lasik is a good option for you. We have the latest technology. We have, if you will, the Rolls-Royce of Lasik units which all together creates the most accurate and the safest Lasik procedure. So you can be in and out of the laser room in under 15 minutes for each eye.

What happens in the long term following LASIK surgery?

It is possible that results could last a lifetime. Once refraction has stabilised, (usually by 3 months after LASIK surgery), the reshaped cornea is permanently modified – your refractive error corrected.

However, as you age it is important to realise that natural degeneration and other diseases may affect your vision which is a perfectly natural process. Should these arise we have safe and effective procedures for both cataracts and presbyopia (loss of reading vision).

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The wonderful thing about the Lasik procedure is the minimal downtime and the almost immediate results. When I see someone the day after Lasik, it’s almost always the same sentiment, the same impression they have and then there comes that morning when they wake up after the Lasik treatment. Their brain still thinks that they have trouble seeing. They open their eyes and they can see. And for a moment a second or two their brain is saying, “Wait a minute how come I can see? What happened to me?” And then suddenly they wake up enough and they say to themselves, ” Oh, yeah, I had Lasik yesterday.”

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Glasses are in fashion, to wear glasses is not a problem – to be dependent on glasses, that’s a problem. To be able to wake up and go, if you’re an active person that’s freedom. You’re going to have to make this decision on whether or not this procedure is for you – do I want this 20 min procedure to improve my vision for the rest of my life?

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