Lasik (Laser assisted in Situ Keratomileusis) Laser Eye Surgery is becoming an extremely popular choice for patients with vision disabilities. With each step forward in technology, the procedures success rate increases, the patient’s level of discomfort lowers, and the cost comes down. Truthfully, the cost of laser surgery has come down in the long term, but it is a gradual decline due to the rapid advancements in the laser eye surgery field requiring practitioners to invest multiple hundreds of thousands of dollars per year to lease the most up to date equipment.
If you do decide to become one of more than 10 million people worldwide that have had laser eye surgery, you can expect to be in and out of the actual laser eye surgery in as little as 30 minutes, and take as little as 24 hours to be recovered enough to return to work and even drive your car. Occasionally people will experience ‘dry eyes’ for up to a month, but almost all facilities include provision for this in their post-op care – all inclusive in the original cost.
Advances in Lasik Laser Eye Surgery
The most exciting advance in recent years by far is the IntraLase FS laser. IntraLase enables the LASIK eye surgery experience to be totally blade free. Rather than using the traditional microkeratome – a hand-held surgical instrument to slice a flap on the cornea, a femtosecond laser (the IntraLase) performs this part of the operation by applying computer controlled short light pulse technology to create microscopic bubbles within the cornea at a predetermined level. By using this method, thousands of bubbles are precisely positioned side by side causing the corneal tissue to separate – the result is a corneal flap of exact diameter, depth, location and hinge position.
IntraLase offers patients a 100% blade free procedure that minimises complications, and allows a wider range of patients who didn’t previously have enough corneal thickness to undergo laser eye surgery.
How Lasik Laser Eye Surgery Works
Lasik is a procedure involving reshaping the surface of the cornea to refocus light correctly onto the retina. Step one is to cut a flap of the corneal cap and lift it up and away. Following this, ultraviolet light and high energy pulses from an excimer laser to reshape the internal cornea. Once the reshaping of the corneal tissue is complete, the corneal cap lifted earlier is folded back down to its original position.
Traditionally a microkeratome resembling something of a miniature guillotine would make the initial incision. However as mentioned above the IntraLase FS laser has made a massive improvement to step one of the laser eye surgery process, reducing the risk of complication immensely. Additionally the IntraLase has made laser eye surgery viable for many previously unsuitable patients with thin corneas etc.
Thanks to the incredible natural bonding and healing capabilities of the cornea, within only minutes of replacing the flap – it has already begun to fasten avoiding the need for stitches. Owing to computer controlled accuracy; medium to high myopia (Short sightedness) and medium levels of astigmatism and hyperopia (long sightedness) can usually be corrected. However other factors such as defects in the shape of the eye and corneal thickness do factor in to eligibility.
Lasik Laser Eye Surgery Risks
As the practice advances, the risk of serious vision threatening complication gets lower and lower, most practices validly boast 99% success rate with no lasting complications. The range of possible side effects is quite diverse, ranging from temporary side effects of the healing process through to significant over or under correction.
Whilst it is sad to say, it is important to be aware that the below incidence rates include statistics collected from subpar facilities in some Asian countries where people can often fly in, have the surgery, and fly out for less than the cost to have the one eye done in a local clinic. As a result, don’t be concerned if your local clinic is boasting much higher success rates than the figures below.
Under Correction and Over Correction
Some form of over correction is to be expected as the cornea stabilises through the healing process, lasting symptoms can also be corrected.
Incidence of significant over correction: 1-3%.
Incidence of significant under correction: 2-3%.
Regression
Modern day Lasik attempts to foresee any regression and account for it however it is an individual healing characteristic. Essentially the eye tends to move toward its original refraction after the procedure, in cases where regression occurs an enhancement may be necessary.
Loss of Visual Sharpness
As few as 1% of myopic (short sighted) patients, and 2% of hyperopic (long sighted) patients experience some minor loss of visual sharpness. Typically the sharpness returns within 6 months however most clinics offer advanced services to handle and predict the likelihood of this scenario.
Flap Complications
With an incidence rate of 1 in 800, serious flap complications are extremely rare, you can prevent most by following the recommended guidelines – not swimming for 2 weeks, avoiding rubbing for 3 days, avoiding contact sport for 3 months, etc.
Post-Operative Discomfort
Ongoing Discomfort is uncommon, and any form rarely lasts beyond 1 month. Symptoms usually include sensitivity to glare, dry eyes, and watering. Unfortunately Lasik laser eye surgery (including modern IntraLase ) can increase the discomfort level for someone with a pre-existing dry eye condition, fortunately drops can be applied to ease the irritation until it settles.
Incidence:
- Scratchy and mild discomfort: 1 in 50
- Severe discomfort or pain: 1 in 500 for the first 6 hours post op.
- Dry Eye: More prominent in older females, can last up to 3-6 months
- Glare: Significant glare can last up to 3 months: 1 in 1000
Post Operative Corneal Haze
Almost everyone suffers at least a minor level of haze, it is the result of the forming of collagen protein on the surface of the eye, and is commonly called healing haze. It is rarely prominent enough to noticeably affect a patient’s vision, in fact only 1 in 2000 suffer from serious healing haze.
Infection
All clinics provide antibiotic eye drops for use during the first week after your surgery to prevent infection. As a result, incidence is extremely rare at 1 in 5000. High quality clinics are quite commonly found to have as few as 1 in 50 000 patients suffer any infection as the level of pre and post op care and education is of an extremely high standard.
Lasik Laser Eye Surgery Costs
The costs of laser eye surgery have a dramatic variance. In my home country of Australia basic Lasik laser eye surgery involving the latest IntraLase technology starts at approximately $2300 per eye. This can scale to in excess of $5000 per eye. As technology advances, more and more challenging corneal landscapes and eye shapes can be successfully treated, however the more complicated the shape, the more complicated the procedure – hence the extreme variation in pricing. If you are prepared to spend at least $4500, then the next step is for you to contact a local clinic and have a consultation, most clinics offer a full obligation free consultation at no cost. You will leave your consultation knowing your eligibility, the risk of any complications, and an accurate estimate of the costs involved.
The prices may seem high, but the benefits are twofold: if you have the surgery in your 20’s you will most likely ultimately save money by having laser surgery. The cost of buying glasses every few years will eventually topple the $5000 upfront cost attached to having laser surgery. However for most people the saving is irrelevant, laser surgery grants a freedom otherwise impossible – for example the ability to actually see ones children when playing in the pool is a priceless benefit!
Eligibility for Lasik Laser Eye Surgery
Eligibility can ultimately only be determined through a consultation with a qualified surgeon, however the base level factors to consider include:
- Generally at least 20 years of age
- Stable prescription for 12 months or longer. If your eyesight is still progressing, laser surgery cannot correct prevent the further degeneration of your eyesight.
- Not pregnant
- Free of particular corneal diseases
- Retina in good healthy shape
If you meet the first 3 conditions, and wish for the freedom laser eye surgery can grant you, then get in contact with a local clinic and book a consultation – you won’t regret it!
What to Expect as a Lasik Patient
During your consultation, you will be informed of the likely outcome of your operation. It is important to remain realistic. While laser eye surgery with its modern advances such as IntraLase aims to provide the best result possible, total removal of reliance on corrective lenses (glasses and contacts), it is not always possible – perfect vision cannot be guaranteed.
As a patient you can expect your experience to somewhat match the following:
- Initial consultation to assess eligibility and probable outcome.
- Checkups as early as 1 month prior to the operation, stop wearing contacts 5-21 days out.
- The actual procedure will generally take less than 30 minutes, you will be lying back in a reclining chair experiencing little to no discomfort.
- You will be administered with numbing eye drops before the IntraLase laser precisely cuts away a flap from your cornea.
- The excimer laser will then pulse light into your eye to modify its shape, thus correcting the focal point.
- Following the procedure you may feel itchy or as if there is something in your eye. You must avoid the instinct to rub your eye as this will likely dislodge the corneal flap.
- You will be provided with antibiotic eye drops to control the chance of infection, these are normally applied for a week.
- It can take up to three to six months for your vision to stabilise, so be prepared for fluctuations including issues with glare, haze, and potentially discomfort from dry eyes. But remember that the actual occurrence rate of these side effects is quite low. Most people experience more discomfort wrapping a pair of glasses around their face every day than they will experience beyond the first 3 days after surgery.
- Long term, usually after the age of 40 when presbyopia can start to set in, you will likely start to need reading glasses.
Included are 2 graphs demonstrating ideal guidelines for preparing for surgery, and what to expect following surgery: