Conversation with an Eye Doctor on Lasik
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Lasik has become a very common procedure among Singaporeans to correct their vision and remove the need for spectacles and lenses. To clarify doubts and myths about Lasik, we spoke to Dr Lennard Thean, Senior Consultant of the National University Hospital (NUH) Eye Surgery Centre, who gave us useful insights on this popular eye surgery.

Types of Lasik

Basically there are 3 types of eye surgery to correct myopia – Lasek, Epi-Lasik and Photorefractive keratectomy (PRK). For Lasik, one can undergo the blade method or the all-laser method. As such surgery optimizes the use of the latest technology, Dr Lennard thus assures that the “laser technology is very safe for treatment”.

“What drives us to decide which treatment to go for depends on whether you are in military, play rugby, water polo or contact martial arts,” Dr Lennard says. Those who fall under this category are recommended to do PRK, which involves the use of the new laser machines that are more accurate. PRK is a procedure where the front layer of the cells of the eye is wiped off, before a laser is used to reshape the cornea. As these cells need to heal back, visual recovery for patients who have undergone PRK is about 7 to 10 days. For Lasik, the visual recovery is about 90% after 6 hours after surgery.

However, PRK is less risky than Lasik, as Lasik procedures involve cutting a flap on the cornea, and certain activities (as listed above) may cause the lifting of the flap. Blade Lasik utilizes a machine to cut the flap, so patients cannot rub their eyes for about a month, as they run the risk of moving the flap. For all-laser, the flap is cut into the shape of a porthole, so it is more secure than that of the blade method.

While there is a 1 in 500 risk of flap complications for Blade Lasik, the all-laser method is much safer. However, contrary to popular belief, the patient will not lose his vision even if he has flap complications, but the problem lies in that he has to wait for 3 months before the complications can be corrected.

More sinister complications are infections, where vision can drop, or inflammation, which is otherwise known is diffuse lamellar keratitis (DLK). In an international study, it is revealed that the risk of infection is about 1 in 8000.

Examination for Lasik

To determine what kind of Lasik is suitable for a patient, the doctors would first examine the shape of the eye. “Indian eyes tend to be very large, so they can undergo any kind of Lasik,” Dr Lennard explains. However, people with small, slit-like eyes are not recommended to do Blade Lasik, as it would be difficult to cut the flap. “For patients with thin corneas and high power, to save tissue, we would recommend the all-laser,” he continued.

Of course, the conditions of the eye centre have to be good as well. “Centres which are purely financially driven may not be the best place to go for (Lasik), because they may cut corners to save costs as they want to maximize profits,” Dr Lennard asserted. “And next, is surgeon experience. The surgeon needs to be able to handle complications.”

Side-effects of Lasik

Possible side effects of Lasik include dry eyes, or halos and glare. The problem of dry eyes is due to the slow regrowth of the tips of the cornea that is cut off, and this condition will improve after 1 to 3 months. Halos and glare only occurs when standard Lasik is done (which is not carried out by NUH now), and “because of the sharp dropoff, when the pupil dilates at night, scatters of light may come in from the edges,” Dr Lennard explains. Now, the procedures are that when surgeons reshape the eye, it is shaped according to the shape of the cornea, so there is little risk of such a side effect.

Optimal Age for Lasik

The advisable age to do Lasik is from 18-40, as recommended by the doctor. Patients beyond the age of 50 may have cataracts, which may not be ideal condition in which they can undergo the surgery. The minimum required age is 18, as the powers of youths below 18 are still unstable and their short-sightedness may still increase.

To find out if one is suitable for Lasik, Dr Lennard advises patients to have a full eye assesment done, to check the powers and cornea, and to find out if the patient has cataracts or glaucoma.

Alternatives to Lasik include implanting collamer lens, which is more invasive but has lesser side effects, and a newer method Femtosecond Lenticule Extraction (FLEX), during which the laser will cut a small pocket and a section of the cornea away. FLEX will be officially launched this April.

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One Response to “Conversation with an Eye Doctor on Lasik”

  1. Mira Camui says:
    May 13, 2010 at 00:00

    This article explains in detail what you need to know about the different types of lasik procedures, the risks involved. A good read as a headstart for someone keen on lasik but does not have much of an idea about it.

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