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LASIK

LASIK


What is LASIK?

LASIK (laser-assisted in situ keratomileusis) is a vision correction procedure that has gained popularity and acceptance by spectacles and contact lens-wearers. To date, more than 15 million LASIK procedures have been performed worldwide and the numbers are increasing. Many people who have been using some form of vision correction, either spectacles or contact lenses, have benefited from this simple procedure. They are now free from the daily hassle of cleaning and maintaining their contact lenses. Sport enthusiasts can finally be spectacle-free to fully enjoy their activities. Undergoing the LASIK eye surgery is a lifestyle choice. Where LASIK does not cure more serious eye problems which cause blurry vision, it has definitely improved the quality of life for many. This is specially so for those who are familiar with the inconvenience of wearing thick lenses on their spectacles or to put on contact lenses which often gives sensation of dryness and discomfort of the eyes especially with prolonged wear.


How is LASIK done?

There are 2 steps involved in the LASIK procedure.


Step 1 The first step involves creating a thin corneal flap which will be folded at a hinge to prepare the eye for laser correction. Traditionally, hand-held mechanical blades also called microkeratomes are used to create the corneal flap. The oscillation of a mechanical blade forward and backward produces the flap. This method is still used by some eye surgeons to perform LASIK. Potential flap complications which may occur with a microkeratome LASIK are cutting of an incomplete flap, a button-hole flap (where the microkeratome cut missed the central cornea) and a loose flap (where the flap is cut off totally without a hinge). More recently, femtosecond lasers have become the preferred choice of LASIK surgeons worldwide. One such popular laser is the IntraLase iFS which is available at Lee Hung Ming Eye Centre. Dr Lee Hung Ming, an experienced LASIK surgeon in Singapore, now performs about 95% of IntraLase LASIK for his patients. The IntraLase method decreases the risks of post-surgery complications that can occur as the blade incision into the cornea heals. Although such complications with LASIK surgery are rare, they do occur and Dr Lee is all about keeping these risks to the absolute minimum. The IntraLase method is a 100% blade-free approach to corneal flap creation – the crucial first step in the LASIK procedure. Instead of creating the flap with a microkeratome, a tiny, rapid-pulse laser of light is used, passing through the top layers of the cornea and forming microscopic bubbles at specific positions in the eye. The corneal flap is then created as the surgeon separates the tissue where the bubbles formed. What Dr Lee likes about this procedure is that it is extremely precise and the cut is smoother than using a microkeratome. The result is a lower risk of complications as the flap heals, better quality of vision, and the ability to tailor the procedure to each individual patient’s eye. Incorrect healing, on the other hand, can lead to vision problems such as astigmatism. The table below compares the differences between the blade-free IntraLase method and a traditional microkeratome.

Better vision1 Better safety2 Highest degree of precision and predictability3 Individualized flaps3 Fewer retreatments4 Ability to be used in more eligible patients2 Patient preferred5*

IntraLase Method â„¢ (Blade Free)

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Microkeratome (Blade + Laser)


Step 2 The second step in LASIK is to correct the refractive errors of the eye with an excimer laser. After the corneal flap has been created, the surgeon folds the flap to one side and focuses the excimer laser beam accurately on the centre of the eye. This laser reshapes the cornea to achieve the targeted vision correction and this step usually takes about 15 to 30 seconds. After completion of the excimer laser treatment, the surgeon will put back the corneal flap in place. After a few drops of antibiotic eyedrops, the whole LASIK process is completed. Read more about our new 5th Generation IntraLase iFS here. The videos below show LASIK treatment with the IntraLase technology.

Blade-free Lasik with IntraLase


Who are the suitable candidates for LASIK?

Most people who need glasses and contact lenses to see well are potential candidates for LASIK. The LASIK procedure has been approved to treat myopia, hyperopia, astigmatism and presbyopia. Before proceeding with the surgery, the patient undergoes a comprehensive eye check-up to determine that the eyes are healthy and suitable for LASIK. This pre-LASIK assessment usually takes about 2 hours and involves the measurements of refractive errors, curvatures and thickness of the cornea, intraocular pressures and pupil size. The optometrists and nurses accompany the patient through these measurements. Then, eye drops to dilate the pupil is instilled and the patient waits for 20-30 minutes for the eye drops to take effect. Next, the patient consults Dr Lee for examinations of the health of the eye. For looking at the outer to the inner layers of the eye, different diagnostic equipment are used to determine that a patient’s eyes are healthy. After reviewing all data collected, Dr Lee is able to advise the patient on the suitability for LASIK. To book an appointment for pre-LASIK assessment, please click here. Sometimes, a patient may be deemed unfit for LASIK. The possible contraindications for LASIK are:

  • Thin cornea
  • Unstable refraction for the past 1-2 years
  • Active or chronic infection/inflammation of the anterior ocular surface
  • Pre-existing corneal degenerations
  • Glaucoma
  • Retinal detachment

For people with very high refractive errors and/or thin cornea, there is the option of a surface ablation laser refractive surgery (epi-LASIK, LASEK, PRK) or implantable contact lens (ICL). Dr Lee has performed these procedures safely and successfully for patients who were unsuitable for LASIK.


What are the potential side effect and complications of LASIK?

LASIK is generally a safe procedure. The first generation of LASIK patients has not reported serious adverse effects to the eyes to date. The most common side effect after LASIK is temporary dry eyes, which can be treated using lubricating eye drops and artificial tears. The other common side effect is seeing glare and halo effects initially. All these effects rarely last for more than 3 months, though a minority may experience it for up to 6 months. The eye may also be over- or under-corrected after LASIK. The refraction results are usually obtained when the vision usually stabilizes after 2-3 months. Most patients are discharged at this stage without problems. Should the refraction results show residual refractive errors which correspond with some blurring of vision as reported by the patient, an enhancement treatment can be performed. This procedure is similar to the initial LASIK surgery except there is no cutting of corneal flap again. Rare complications of LASIK are corneal infections, retinal detachment and glaucoma, which may result in the loss of vision. Therefore, it is of utmost importance to choose a LASIK surgeon based on the doctor’s experience, track records and the technology used.

My LASIK Journey

This flowchart brings you through the journey through LASIK. It’s time to say goodbye to your glasses and contact lenses!

Contact Us
  • Fill up contact form on website, or
  • Email us at contact@leehmeycentre.com.sg, or
  • Call us at 64703366
Pre-LASIK Assessment
  • Lay off contact lenses before assessment day (3 days for soft lenses and 7 days for hard/rigid gas permeable lenses).
  • Session takes 2 hours.
  • Pupils will be dilated and vision will be slightly blurry for 3-4 hours. Please do not drive to the clinic.
Before coming for treatment
  • Prepare to spend 2 hours in the clinic on treatment day. Do not drive but please arrange for someone to pick up. May also take a taxi home on your own.
  • Read up information leaflets and pre-and post-op care.
  • Arrange to be away from school/work for 2-3 days after LASIK depending on the nature of job.
Treatment Day
  • Shampoo hair before going to the clinic. Do not apply perfume/cologne/hair or body sprays. Do not apply make-up.
  • Arrive on time. May have your meal as per normal.
  • Go through signing of consent form, eye test, payment and counselling on post-op eye care.
  • Treatment takes 15-20 mins. Rest for 30 minutes and may go home after Dr. Lee examines the eyes.
At home after LASIK
  • Rest/Sleep for the first 2-3 hours. The initial tearing and discomfort will improve after resting.
  • Apply eye drops every 2 hours when awake. Continue until next day review.
  • Vision is hazy for first 6 hours and will improve after that.
Post-LASIK Reviews
  • Mandatory to return for next day review.
  • Second review is in 1 week’s time.
  • Usually the last review is in 6-8 weeks’ time.

*In a clinical survey of LASIK patients who had their corneal flaps created using a blade in one eye and the IntraLase Method in the other, the vision in the IntraLase-treated eye was preferred 3-to-1, among those who stated a preference.

Reviews of LASIK surgeries online might give ‘unrealistic expectations’ about what the procedure can fix. Whether you seek bladeless LASIK surgery, Epi-LASIK, LASEK or a PRK procedure in Singapore, Dr Lee’s advice to patients is to *“avoid centres that hard-sell you the procedure or a surgeon who does not have time to see you for your most important pre-operative and post-operative consultations.”

Visit the Lee Hung Ming Eye Centre to get an eyesight correction recommendation in Singapore.


REFERENCES:

  1. Durrie DS. Laser versus manual keratectomy. Cataract Refract Surg Today. March 2004 (suppl):1-2.
  2. Will B, Kurtz RM. IntraLase is best. In: Probst LE, ed. LASIK: Advances, Controversies, and Custom. Thorofare, NJ: SLACK; 2004:397-402.
  3. Durrie DS. How IntraLase raised the bar in refractive surgery. Cataract Refract Surg Today. July 2003 (suppl):1-2.
  4. Mahdavi S. IntraLase : coming of age. Cataract Refract Surg Today. October 2005:117-120.
  5. Durrie DS. Randomized prospective clinical study of LASIK: IntraLase versus mechanical keratome. Subsets presented at: Meeting of the International Society of Refractive Surgery of the American Academy of Ophthalmology; November 14 15, 2003; Anaheim, Calif; American Society of Cataract and Refractive Surgery Symposium; May 1 5, 2004, San Diego, Calif; refractive Surgery 2004: International Refractive Surgery: Science and Practice; October 22 23, 2004, New Orleans, La; American Society of Cataract and Refractive Surgery Symposium, April 15 “ 20, 2005; Washington, DC.
  6. Khalik, Salma. “MOH Concerned over Misleading Lasik Ad Claims.” MOH Concerned over Misleading Lasik Ad Claims. The Straits Times, 22 Nov. 2007.