Laser Vision FAQ

With the ability to correct most types of refractive errors, the first step is finding out if you are suitable for laser vision correction.

To be suitable for LASIK you should:

• At least 20 years old
• Have a reasonably stable prescription for at least 1 year, that is, no significant change in the strength of glasses or contact lenses required to see clearly.
• Know your visual goals – what are your expectations
• Good overall health
• Good eye health

Note that the LASIK procedure cannot be performed on pregnant patients.

If you are not suitable for LASIK or PRK, there is a good chance that you may be eligible for alternative refractive procedures to enhance your vision.

It’s a great way to start as it might save your time and ours. Our refractive phone consultants are clinical orthoptists who are all experienced in LASIK, laser vision correction and refractive assessment. They can advise if you should take the next step towards laser vision correction or other vision correction procedures and schedule an appointment with a doctor.

Patients who come in and meet the Hunter Street team to discuss laser vision correction rarely go elsewhere if they were serious to begin with.

They realise that we are friendly, professional, experienced, achieve excellent results, and have a passion for our work.

Our laser vision correction specialists like patients to be at least 23 years old, have a positive outlook on life and be ready to engage in a sensible discussion about both the benefits and realistic expectations of laser vision correction so they can make an informed decision.

The initial consultation takes approximately one and half hours. It involves a comprehensive eye examination, after which Dr Sumich will discuss with you your suitability for LASIK or other vision correction procedures.

The examination will also determine your ocular health and reveal any existing conditions such as keratoconus, uveitis, glaucoma, cataract, macular degeneration, and diseases of the retina. If any of these conditions are present, you will receive a recommendation for their treatment and management.

Perfect vision can be achieved in many, but not all our patients. As with any medical procedure, there are risks of which you need to be aware. These will be explained to you in detail at the time of your consultation.

• LASIK
• PRK

INTRALASE LASER EYE SURGERY – A LASIK breakthrough

With all the marketing that has been done for Intralase it has become very confusing for the average LASIK patient to research laser eye surgery.

Dr Peter Sumich explains:
“Intralase has been an exciting and proven method of creating the LASIK flap. Rather than a bladed manual keratome, the flap is created with a femtosecond Intralase laser. The accuracy is unprecedented, and it is certainly the safest means of creating a planar LASIK flap thus far.

Patients inevitably ask me is it worth the extra cost?

I can say that I believe that it is safer and further eliminates the risk of the serious (but rare) complications that can occur.

When Intralase is used with the SCHWIND AMARIS 1050RS laser and wavefront customised correction – the combination of technologies when brought together represent the gold standard of LASIK and laser vision correction technology.

Over 10 million cases have been performed worldwide in the past 15 years and the LASIK procedure has a proven safety record and is considered to be very safe.

Nevertheless, people interested in having the procedure need to keep in mind that it is not possible to exactly predict the level of vision that will occur after surgery. This is because, like any surgery, the healing characteristics of the eyes vary from person to person.

However, based on the clinical measurements obtained at the consultation, the surgeon will be able to closely indicate the expected result.

Laser vision correction is a very safe procedure but like all surgical or medical procedures there is a risk of complication. These are rare, individual, and usually minor if they occur. To reduce the risk to a bare minimum, as with any medical procedure, you must ensure that the surgeon is experienced, is a corneal specialist and that they use the latest state of the art technology. All known complications will be thoroughly discussed with you at your complimentary consultation.

Depending upon the procedure itself, there are varying preparations to make. A general guideline of these preparations is as follows:

• A friend or family member should accompany you to the clinic and take you home on the day of the procedure
• Perfumes and deodorants should not be worn
• Avoid having a heavy meal prior to the procedure

The laser reshapes the cornea in less than 60 seconds each eye in most cases. You will be in theatre for 15 to 20 minutes, and you will need to be at the centre for approximately 2 – 3 hours to ensure all pre and post-operative checks are carried out.

On the day of the procedure, you will recline in a comfortable chair and be given anaesthetic drops in each eye. Your doctor will ask you to focus on the light above you before commencing the procedure. You need not worry about making slight movements during the procedure as the laser tracks your eye movement in seven dimensions and adjusts appropriately for changes.

After the procedure, anti-biotic eye drops will be administered, and clear plastic shields will be placed over your eyes. These must be worn until waking the following morning to prevent accidental rubbing but will allow you to see with only minimal restriction.

We use a small device called a speculum to prevent you from being able to blink during the procedure – this little device is very effective in keeping your eyelids open from start to finish. We also use a laser that employs an active 7-D eye tracker which detects even microscopic eye movement and can redirect the laser beam as required. This system is the first one of its kind in Australia to track eye movements during the procedure in seven dimensions. Although the human eye can move at a rate of 15 – 20 times a second the laser technology tracks your eye at a far greater speed. The effect of tracking the eye to improve safety depends not only on the frequency of tracking but the speed with which the laser adjusts to the movement of your eye.

Yes, local anaesthetic drops are used and the procedure takes only minutes. You will be offered some minimally sedating oral medication before the procedure to further relieve any anxiety you may have. The procedure is virtually painless, and your eyelids are kept open for only a short period of time each.

Although your vision will not be crystal clear, you will be able to see well enough to be able to go home and carry on with most activities of daily living. You should not drive, however, until you have been examined by our staff the following day.

No, not totally. Clear shields are to be worn over your eyes overnight that does not impede sight.

It is always better to have somebody to accompany you before and after the procedure for a bit of support and try not to have any activities planned for the rest of the day. We advise that you take it fairly easy for a couple of days after your procedure, but Dr Sumich is always on hand to advice you when you can resume normal activities.

• No swimming for 1 week
• No eye makeup for 1 week
• Avoid rubbing your eyes for 2 weeks
• No Body contact sports for 1 month

Once corneal tissue is removed, and the cornea has been re-shaped it remains permanently modified in a vast majority of cases. There can be occurrences of regression in the first three months, which can be corrected with an enhancement procedure.

Near vision will, however, normally deteriorate with age in all people during their forties. This deterioration is called presbyopia and occurs in all people regardless of whether they do or don’t have surgery, were short-, or long-sighted, or started with normal vision.

A laser procedure will neither cause nor protect you from unrelated eye diseases such as cataract or glaucoma or unexpected refractive error change that would have occurred without the procedure anyway.

Even though you will feel that your vision is good enough to drive we suggest that you wait at least a day or two after your procedure before driving. Depending on your occupation, you may be fit for work the day after surgery. We will discuss this with you on the day after surgery at your check up. This will vary from person to person depending on the degree of visual error you had corrected and the type of work you do. Most patients can see well enough to drive a car the next day and usually patients go back to work the day after that.

This depends on your age, your visual goals and discussion between you and the surgeon.

No, not at all!

The first generation lasers were called ‘broad beam’ lasers. A laser beam the size of the area treated was used. The results were satisfactory and still today a few of this type of laser is manufactured and modified to work a little like the latest generation spot lasers. Broad beam (of the older style) lasers suffered from a problem of less smooth treatments and specific corneal irregularities known as ‘central islands’.

Dr Sumich has chosen to use the SCHWIND AMARIS 1050RS, the laser used in over 60% all laser procedures word wide. By incorporating variable spot scanning technology we can provide you with increased accuracy and safety with reduced risk of error and complications. This laser is versatile as it increases the treatment range so we can now treat higher refractive errors regardless of whether you are myopic, hyperopic, or astigmatic. This laser allows for increased accuracy by being able to vary the size of the beam spot giving Dr Sumich greater flexibility and allowing for faster smoother treatment with precise corneal shaping.

Recovery time is reduced because far less tissue is removed and smoother shaping achieved thus improving your visual outcome.

The SCHWIND AMARIS 1050RS incorporates customised wavefront-guided treatments. Essentially, the system allows the surgeon to take a fingerprint of your cornea to map out any abnormal contours that are unique to your eye and cater for them during your procedure. It allows the surgeon to accurately assess whether you are a good candidate for LASIK and what your visual results are likely to be, a uniquely tailored treatment for your eyes and reduces risk of problems with night vision such as night glare.

A vision assessment will help determine whether AbFree wavefront treatment (in conjunction with LASIK) will be beneficial to you. The SCHWIND AMARIS 1050RS does not require pupil dilation before your procedure. When the pupil is not dilated, it is easier for you to accurately view the fixation light during surgery and also allows the surgeon to centre the laser beam more accurately on your eye. For you this means that in comparison with other lasers the surgeon will increase accuracy to be able to centre over to your line of sight.

Dr Sumich believes in always using superior technology because this is the only way, together with experience, in achieving optimal results.

No, the level of experience of the individual surgeon is a major consideration and we encourage you to do your homework. Because there is no formal certification for this procedure, it is important to select a surgeon with extensive experience and who has the right qualifications. Dr Sumich performs over 650 laser vision correction eye procedures yearly and has more than 15 years’ experience. He is an independent surgeon with no quota or sales target.

As with any procedure there is a risk, however this risk is extremely low. Laser vision correction is a surface procedure, and the risk of complications is lower than that of internal eye surgeries such as cataracts or retinal surgery. You are more at risk of getting a serious eye infection wearing contact lenses than from laser eye surgery.

As we age, the natural lens inside our eye becomes less flexible and is no longer able to focus the eye on close work. This normal condition is called presbyopia and occurs in most people between the mid-forties and about 55 years of age.

Monovision is a term used when a refractive procedure is used to adjust each eye for a different purpose. It is when one eye is adjusted to enable the patient to read items at close range, while the other eye is adjusted for distance via a refractive procedure such as LASIK, PRK, or refractive lensectomy.

The procedure generally better suited to those patients who have needed reading glasses as their eyes have aged. The aim of this procedure is to provide patients who are of presbyopic age (43 years or older) with the ability to achieve good distance vision as well as the convenience of having good near vision, simultaneously.

Rest assured, if laser vision correction isn’t a suitable option for you, there are numerous alternatives available to enhance your vision and reduce your dependence on visual aids.

One such option is Refractive Lensectomy. This procedure involves removing the eye’s natural lens and replacing it with an artificial intraocular lens (IOL) while it is still clear and free of any opacities. Typically, this method is recommended for individuals whose vision needs fall outside the scope of traditional laser refractive procedures.

Essentially, LASEK, PRK, ASLA, NuLasik, EpiLASIK and Intralase are all “Bladeless Laser”- all these procedures reshape the cornea just as LASIK does and utilize the same excimer laser to do so. The main difference is which layer of the cornea is being re-shaped and how thick/thin the flap is.

It is very confusing and at Hunter Street Eye Specialist we will advise you on your very first consultation which procedure will suit your eyes the best.

ASLA, PRK – Advanced Surface Laser Ablation and Photo Refractive Keratectomy are exactly the same procedure a thin layer of corneal epithelium is removed, the excimer laser is then used to reshape the cornea and a bandage contact lens is placed on the eye/s for a few days to aid healing.

LASEK – Laser Assisted Epithelial Keratomileusis is a procedure where a very thin layer of corneal cells called the epithelium is set aside and the laser is then applied. The cells are then returned at the completion of the procedure. Unlike the LASIK procedure, a microkeratome (the instrument used to create a corneal flap) is NOT used, and the Excimer Laser is applied directly onto the cornea (front part of your eye) after removal of surface eye cells.

A contact lens is then placed over the eye to protect it over the course of several days and assist healing.

EpiLASIK, NuLasik – are essentially the same procedure – an Epi-Lift Epi-Keratome is used to create a thin flap instead of a microkeratome that is used in LASIK. The EpiLift Epi Keratome is a separator which is used to mechanically separate the epithelium (the front layer of cornea) from the stroma (the middle layer of the cornea). As with LASIK & PRK the excimer laser is then used to reshape the cornea after which the flap is then returned.

INTRALASE – Creates a flap for LASIK procedure.

LASEK and PRK procedures compared to LASIK procedures.

LASEK and PRK can be considered safer than LASIK from one viewpoint as there is no need to create a corneal flap.

On the other hand, vision takes longer to return to optimal standards and a slightly greater degree of discomfort can be expected in the days following the procedure when compared to LASIK.

Certain eyes are better suited to a particular procedure and Dr Sumich will discuss with you all the pros and cons of these procedures and there is no pressure to have any surgery.

SILK  stands for small incision lenticule keratomileusis.

SMILE stands forsmall incision lenticule extraction.

These two laser vision correction procedures, change the corneal shape without the need for a traditional flap, resulting in decreased discomfort and quicker recovery.

This involves a femtosecond laser crafting a slender lenticule within the cornea and making a precise incision on the corneal edge, through which the lenticule is extracted to enhance vision without the need for visual hardware.

A laser eye surgery technique that eliminates the use of a corneal flap, minimising contact with the eye’s surface, resulting in a safer and less invasive vision correction procedure.