Laser Vision Correction
Your laser eye surgery questions, answered. At Vision Eye Institute, we understand that the decision whether or not to have laser vision correction isn t easy. You ll have many questions What are the success rates? How much does it cost? Is it painful? and Do I qualify? are just some typical examples. (You can find the answers to these questions and many more in the FAQ section of this brochure). Usually, people who come to us are those who are sick of wearing their glasses or contact lenses. They might find them inconvenient, or dislike the way they look in glasses, or discover that the ongoing cost of replacing glasses is an issue, particularly with styles changing so dramatically from year to year. We have a vision correction procedure for almost any age Many people who wear glasses or contact lenses believe they aren t suitable for laser eye surgery for a number of reasons because their prescription is too strong or they suffer from astigmatism and, sometimes, they imagine they are too old. In fact, there s a procedure for most people, no matter what their condition or age. So, what are your options? Anne: LASIK Page 2 Page 3
Vision Eye Institute Transforming Lives. That s our Vision Which eye condition do you have? Short-sightedness Also called myopia, this is the most common vision problem (it can also be hereditary). If you re short-sighted, you can see items that are close up, but can t see anything in the distance properly. It s caused when light entering the eye focuses in front of the retina rather than directly onto it. Page 4 Long-sightedness Also called hyperopia, long-sightedness generally means that you can see objects in the distance, but have difficulty focusing on things that are close up. Not to be confused with presbyopia (the age-related condition that everyone over the age of 45 will eventually suffer from), long-sightedness is caused by an imperfection in the eye, usually when an eyeball is too short or a cornea is too flat. This causes an image to focus at a point behind the retina. Page 5
Astigmatism This is the inability to focus clearly at any distance, because the shape of the cornea (the front surface of the eye) is more curved in one direction. (An ideal shaped cornea is spherical, like a soccer ball, whereas astigmatism occurs when the cornea is shaped in either direction like a rugby ball). Most people have some minor form of astigmatism. However, when it actually affects your vision, you may require glasses or contact lenses. Astigmatism can occur either on its own, or together with shortsightedness or long-sightedness. Presbyopia (aged-related reading vision deterioration) Presbyopia is a condition that everyone, without exception, will experience as they reach their mid 40s to early 50s. It happens because the natural lens of the eye loses flexibility and is no longer able to change shape to focus on near objects. You ll recognise its onset by the fact that you need to hold books, newspapers or menus further away to focus. Eventually, you ll need reading glasses, or some form of vision correction. Page 6 Laser vision correction the options Over the years, millions of laser vision correction procedures have been successfully performed around the world. Laser technology has continued to improve over the decades, allowing surgeons more precision and increasingly predictable outcomes. However, no two sets of eyes are the same. After a thorough assessment, your surgeon will tell you which procedure is right for you, allowing them to obtain the best possible outcome. LASIK By far the most popular laser vision correction procedure in the world, LASIK (laser in situ keratomileusis) uses the very latest in technology currently available. If you re between the ages of 20 and 40, have had a stable prescription for 12 months and you have a history of healthy eyes, LASIK is most likely the right procedure for you. (However, if you have thin or irregular corneas or a very high Page 7
prescription, it s likely that you ll need either ASLA or an implantable contact lens.) The procedure LASIK is a two-step procedure. The first step involves creating a thin flap in the cornea (the front surface of your eye). For this step, most Vision Eye Institute surgeons use the latest proven technology, IntraLase. This laser provides the surgeon with the ability to achieve micron-level accuracy to create the flap, without cutting or using a blade. The actual laser takes around 20 seconds per eye. The surgeon will then fold the flap back, allowing access to the underlying surface of the eye. The second step involves another laser, the excimer laser. Its job is to painlessly laser away the required level of tissue under the flap. This reshapes the eye to provide the desired visual result. 12 to 48 hours, with the flap continuing to strengthen over the following weeks or months. The result Visual recovery can be extremely rapid (with some people noticing a significant difference even as they leave the laser theatre). Typically, people can see clearly with minimal side effects (and little or no discomfort) within one or two days. Most can drive and return to work within a day or two of surgery. Peta: LASIK The surgeon then places the corneal flap in its original place. That s it! No stitches are required it s only a matter of minutes before the flap adheres to your underlying corneal area. The edges heal in Page 8 Page 9
ASLA If your cornea is thin, irregular or weak (sometimes caused by long-term wearing of contact lenses), ASLA may be the procedure your surgeon recommends. Rather than creating a flap, ASLA (advanced surface laser ablation) uses the same technology directly on the surface of the cornea. Sometimes called PRK, ASL, Nu-LASIK, LASEK or Epi-LASIK, the ASLA procedure typically produces a result similar to LASIK. However, because the surgery is performed directly on the cornea, the recovery time is longer. There can be discomfort for several Page 10 Viv: ASLA days after surgery, and it takes more time for the vision to stablise (so you may need to take additional time off work). Once the procedure has finished, your surgeon will place a special soft contact lens on your eye, to protect it for the first few days of healing. You ll need to use antibiotic and anti-inflammatory drops for at least a week. Blended vision/monovision If you re over 40 and haven t previously had a need to use glasses or contact lenses for vision correction, you re now experiencing the inevitable condition called presbyopia (age-related vision deterioration). There are several procedures that your surgeon will consider. Blended vision (or laser blended vision) results in monovision that is, the use of one eye for distance and the other for near vision. Monovision can be achieved using laser technology or a refractive lens exchange (see below). Clever use of optics can increase the depth of focus in both eyes to optimise the balance between the eyes and enhance the range of clear vision focusing. Page 11
Implantable Contact Lens Some people have a higher than usual vision anomaly that is, their prescription is outside the acceptable range for laser surgery. In these cases, an Implantable Contact Lens (ICL) can be placed within the eye. This procedure is performed in a day surgery. Refractive lens exchange If you re now suffering from presbyopia and also have some form of myopia, your surgeon might recommend a refractive lens exchange (sometimes called a clear lens exchange or lensectomy). A refractive lens exchange (RLE) is exactly the same surgical procedure as cataract surgery, except the lens being replaced is not cloudy due to the formation of a cataract. (A bonus cataracts can never form once you ve had an RLE). One eye will be operated on at a time and, if the aim of the surgery is to achieve monovision, only one eye may ever be operated on. The continual advances in intraocular lenses (IOLs) means that your surgeon will discuss with you in detail what you want to achieve. There are bifocal and multifocal lenses available which one is right for you depends on your lifestyle. For example, if your near vision is important to you say, you work on a computer or like to read the IOL chosen will differ from the golfer or pilot where distance vision is more important. Whatever you chose, you ll end up with greatly enhanced overall quality of vision. Simon: Refractive Lens Exchange Page 12 Page 13
So, you ve made the decision. Now what happens? Your assessment Byron: LASIK Your first consultation appointment will be a thorough assessment. This will consist of a series of tests to determine your suitability for laser eye surgery and your treatment options. At Vision Eye Institute, we use advanced technology not only for surgery, but for your medical analysis as well. Most people are suitable for laser eye surgery (LASIK or ALSA), and will be counseled against having unrealistic expectations, the possible risks and side effects of the surgery. We want you to be able to make an informed decision. Your surgeon At Vision Eye Institute, our surgeons are world-renowned as pioneers in laser vision correction. Many have achieved firsts, including the first surgeon in Australia to perform laser vision correction, the first Page 14 Page 15
to perform LASIK in NSW and the first in the Asia Pacific region to use Wavefront guided laser technology. Together, they have performed over 100,000 laser vision correction procedures. This depth of experience may be why Vision Eye Institute surgeons are respected around the world. They are regularly asked to participate in global trials and speak at industry conferences worldwide. They have also published hundreds of scientific cornea and laser eye surgery articles in clinical journals and textbooks, as well as training many other doctors to perform laser eye surgery. Perhaps the best endorsement is the fact that many of our staff members have chosen to have their procedures performed by a Vision Eye Institute surgeon. A number of our surgeons have actually had the procedure themselves. FAQs Will it hurt? No pain is felt, although you may notice other sensations, such as the feeling of pressure on the eye. Topical anaesthetic drops are also used, to completely numb the eye. What if something goes wrong? There have been over 16 million procedures of laser vision correction performed since the first in 1987. At Vision Eye Institute, there has never been an incidence of blindness as a result of laser eye surgery, and less than 1% of patients experience serious problems that have the potential to significantly harm vision. Of course, any surgical procedure presents a degree of risk. Your surgeon will fully inform you of these before you agree to surgery. I m really nervous. What will happen during the procedure? Fear and anxiety are normal for everyone. You will be given something to relax you (normally a Valium) before your procedure. Interestingly, most patients say after their procedure that it was so straight-forward, they wondered what they had been worried about. What if I can t keep my eyes open? During the procedure, your eyes will be propped open using a speculum, so you don t need to worry about blinking or closing your eyes at the wrong time. Page 16 Page 17
Am I suitable? Although most people are suitable, you ll need to have an assessment to ensure that you re a candidate for laser eye surgery. Will I be awake during the procedure? Yes, but you ll be given medication to relax you beforehand. Afterwards, most people wonder why they were nervous at all. What will be happening around me? You ll be able to hear the laser operating and see lights, and your surgeon will gently talk you through the procedure. However, you will not feel the laser reshaping your eye. What if I move my eye? The laser s unique eye-tracker system ensures that any movement of your eye is detected and compensated for at the rate of hundreds of times per second. How long will it take? Most people are in and out of the laser theatre within 30 minutes. You ll be in the clinic for around 2 hours in total, which includes preparation and de-briefing time. You ll need to bring someone with you to take you home. You ll then be required to come back for a follow-up appointment the next day. How much will it cost? The cost of your surgery will depend on the procedure you have. As a guide, our laser eye surgery fee ranges from $2,400 to $3,500 per eye. We ll discuss your payment options during your initial consultation. This includes the surgeon s fee, the optometrist s fee, medications, post-operative visits and any enhancements (if required) for the first 24 months. It doesn t cover the initial assessment. How long will the results of my procedure last? The results of your procedure will be considered long term. However, as everyone ages, our near vision naturally deteriorates. This will also happen to you (there are also surgical treatments available for this). Can I claim any of my laser eye surgery on my private health insurance? Although laser eye surgery is not covered by most Australian private health insurers, Vision Eye Institute and Medibank Private have negotiated an agreement to allow eligible Medibank Private members who have their LASIK or ASLA surgery performed by a Vision Eye Institute surgeon to receive a 15% reduction on their surgical fees*. This offer is available to all Medibank Private members who have Top Extras or Ultra Health Cover, including their corporate equivalents and selected Overseas Visitors Covers #. Please go to visioneyeinstitute.com.au/medibankprivate for more details. *for LASIK or surface ablation (ASLA) procedures, excludes initial assessment fees. # for Intermediate 70 and Top 85 Visitors Health Insurance and Top 85 Working Visa Health Insurance. Do I need to go into hospital? Laser vision correction procedures are performed at a Vision Eye Institute laser suite most likely the same clinic where you had your initial assessment. Page 18 Page 19
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