Laser Eye Surgery

Many people have poor vision and need glasses or contact lenses to see clearly. In refractive laser surgery, lasers are used to correct the glasses prescription in order to give good vision without glasses or contact lenses.

In laser eye surgery, your specific glasses prescription is lasered into your cornea.  After surgery, many people who were previously dependent on glasses or contact lenses can see without any need for glasses.

See “About the Eye” for more information about eye anatomy.

Laser eye surgery can be used to correct 3 main focus problems that people find frustrating.  Laser can correct:

  • Myopia (short-sightedness): people with myopia can usually see near objects clearly but the distance is blurred
  • Hyperopia (long-sightedness): near objects are more blurred than distance objects
  • Astigmatism: objects in both the distance and near are blurred and can only be improved with glassed or contact lenses

The goal of laser surgery is to provide a long-term solution to get people out of their glasses.  Successful surgery usually means people no longer need glasses for distance or reading, although reading glasses will generally be needed in the future.  People over the age of 40 may still need reading glasses after surgery.

Occasionally people require a further procedure because of regression where part of their glasses prescription returns.  In those cases laser can often be repeated.

There are a number of different laser techniques available. Every person is different, so treatment must be tailored to the individual. The appropriate technique depends on factors such as the glasses prescription, the person’s age, their corneal thickness and the activities a person wants to do.
The most modern laser techniques are now bladeless and include LASIK, SMILE and PRK. Clear Lens Exchange is an alternative option for certain patients.

LASIK is the most commonly performed laser eye surgery.  It has been used extensively across the world and is a very good and safe option for many people.  The LASIK procedure involves cutting and lifting a flap in the cornea, then performing laser to the deeper part of the cornea, before replacing the flap.

LASIK is versatile and can be used for Myopia, Hyperopia and Astigmatism.  There is minimal pain.  Healing is fast and vision improves very quickly.

People with thin corneas may not be suitable for LASIK.  LASIK flaps may be at risk of damage in people who do contact sports or jobs where they may sustain eye injuries.  LASIK can worsen dry eyes.

SMILE is the newest technique available for laser eye surgery.  It involves using the laser to cut a thin sliver of corneal tissue then removing this through a very small incision in the cornea.  It is often referred to as “keyhole laser surgery”.

SMILE is currently available for myopia and astigmatism and is a very effective technique.  Like LASIK, visual recovery is usually very quick and there is minimal pain. Unlike LASIK, there is no flap and there may be less risk of dry eye after surgery.

In PRK, the prescription is lasered directly into the front of the cornea.  PRK is most suitable for myopia. Unlike LASIK, there is no need for a flap.  This gives the advantage that PRK can be used in thinner corneas.  It also may be more appropriate where people do contact sports or jobs where they may sustain eye injuries.

PRK takes longer to heal than LASIK and SMILE and is more painful after surgery.  The vision can take longer to recover than LASIK and SMILE.

In certain people, laser surgery is not appropriate.  An alternative to corneal laser surgery is to perform CLE.   CLE refers to early cataract surgery performed in order to reduce the requirement for glasses.  CLE involves replacement of the lens with an intraocular lens, prior to the development of cataracts.   This can be particularly effective for people with astigmatism, myopia or hyperopia.  People particularly suited to CLE are those with thin corneas and people above 55 years of age.

  1. Come for an assessment: An assessment involves checking your glasses prescription, performing numerous tests and then seeing your eye surgeon to assess your eyes.
  2. Discuss whether laser eye surgery is appropriate: You will discuss your goals and the test results to determine the best option for you.
  3. Organise surgery: usually both eyes can have surgery on the same day.

On the day of surgery you will come to the facility and have a chance to ask any specific questions you may have.  You will be given anaesthetic drops before surgery and then will be taken to the laser suite.  You will be able to talk to your surgeon up until the laser starts.  The laser itself is very quick and it is important to be still while it is performed.  Your surgeon will clearly explain when the laser is about to start.

After surgery you will be allowed to go home and you will need someone to assist you. You will not be able to drive. Once you get home you should rest as much as possible.

You will be checked the next day. You will need to use post-operative antibiotic and anti-inflammatory drops. You will need to avoid rubbing your eyes while the healing process occurs.

Laser eye surgery has been performed for over 30 years and is one of the safest elective medical procedures available.   As with any surgery, there are risks with laser eye surgery although serious complications are rare.  Occasionally people are over or under corrected after surgery and may require a “touch up”.  Dry eye and glare and halos can occur and are usually temporary.  Risks such as infection and inflammation are rare.  It is important to discuss the risks with your eye surgeon.