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LASIK & Refractive Surgery Co-Management

Happy Woman Listening to Headphones No Glasses after LASIK


LASIK - Laser-Assisted In Situ Keratomileusis - is the most common refractive eye surgery today. As of 2019, over 1 million LASIK procedures have been performed in Australia and as of 2019 over 28 million have been performed worldwide.

LASIK, often referred to as laser eye surgery or laser vision correction, is one type of refractive eye surgery for the correction of myopia, hyperopia and astigmatism. Other forms of laser refractive surgeries include PRK and SMILE. LASIK surgery is performed by ophthalmologists who specialise in this procedure and uses a laser to reshape the eye's cornea in order to improve visual acuity. For most patients, LASIK provides a permanent alternative to glasses or contact lenses.

Each of the various laser refractive surgeries vary slightly.  LASIK requires the formation of an epithelial flap, which is folded back into place after the laser procedure. PRK removes the epithelium entirely, which grows back and SMILE removes a piece from inside the cornea. All these options represent advances over radial keratotomy (RK) in the surgical treatment of refractive errors of vision.

For patients with moderate to high myopia or thin corneas, which cannot be treated with any of these laser-based vision corrective surgeries, there are two effective options: ICL (implantable contact lens), where a lens is placed into the eye, and RLE (refractive lens exchange), which replaces your original lens with a new intraocular one.

LASIK is the premier surgery for vision correction. It is quick, almost painless and there is little or no discomfort after the procedure. Vision recovery is rapid – patients report seeing 20/20 within 24 hours.

LASIK corrects nearsightedness, farsightedness and even astigmatism. With a technique called mono-vision, it can reduce the need for reading and computer glasses among patients over age 40 who need bifocal or multifocal lenses.

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Who Are The Optimal LASIK Candidates?

The best candidates for LASIK are aged 21 or over, with a stable prescription for at least one year and have healthy eyes with adequate corneal thickness. This is necessary because LASIK procedure removes tissue from the cornea to reshape the curvature.

Chronic dry eye, corneal disease or other abnormalities may disqualify a candidate from LASIK surgery. A comprehensive eye test is required to be sure. For your convenience, we are happy to provide LASIK pre-operative exams and consultations at our practice.

Note that LASIK is an elective procedure and proper consideration must include the weight of personal needs, potential gain, financial costs and willingness to accept the risks involved.  There are no guarantees that LASIK will absolutely succeed to your expectations. The results are not always perfect vision. In some cases, your vision after LASIK may be permanently less clear than it was with glasses or contact lenses before LASIK. Your optometrist and eye surgeon will discuss all the factors that need to considered before deciding on LASIK surgery.

Certainly there is upside to having clear vision. In normal circumstances and conditions LASIK can reduce your dependence on glasses and almost always gives you the ability to function well without the need for glasses or contact lenses.

Specifics of The LASIK Procedure

LASIK is a relatively quick procedure. You walk into the surgery centre, have the procedure and walk out a few hours later. The surgery procedure is approximately 20-30 minutes for both eyes, but allowances should be made for additional hours for your pre-surgery preparation, post-surgical recovery and to receive the instructions and medications from the staff for use afterwards.

For a brief description of LASIK, firstly, the surgeon uses a laser to create a thin, hinged flap of tissue from the front layer of your cornea, the epithelium. This flap is folded back so the laser reshaping of your cornea can begin. After laser treatment, which lasts a few minutes, the flap is repositioned back in place and the surgeon proceeds to your other eye.

What Is Wavefront LASIK?

Wavefront LASIK, wavefront-assisted, wavefront-guided or custom LASIK - uses laser treatment (ablation) mapped by a 3D computerised analysis. Wavefront-guided procedures can be more precise than ablations determined by using a standard procedure. They can correct subtle optical imperfections of the eye called “higher-order aberrations” that regular ablations generally do not allow for. Studies show wavefront-guided ablations often provide sharper vision than conventional, non-wavefront LASIK and can improve night-vision, eliminating or reducing the risk of halos or glare.

After The Surgery

Following the LASIK procedure, you will use medicated eye drops and clear protective shields to cover your eyes. You can open your eyes and see well enough to walk without glasses, but you must not drive yourself home.

You will use a few medicated eye drops several times a day for a week or more to prevent infection and speed up the healing process. You may also use artificial tears to keep your eyes moist and comfortable.

You should rest your eyes as much as possible the day of your surgery. You may find it more comfortable not to watch TV and leaving the house lights on low dim.

Over the next few days, your vision and comfort will improve and you might even see well enough to drive and resume some of your normal activities. Use care though not to rub your eyes until it is safe to do so.

You may be asked to return to visit your eye surgeon the following day for an eye test. Your optometrist will want to check your vision and be sure your eyes appear to be healing as they should. You will be given any additional instructions, such as advise on the eye drops and/or artificial tears and when your visit will be scheduled. You can ask the surgeon any questions you may have.

Postoperative care may be performed by an optometrist, which is referred to as co-management. We are happy to provide post-operative care for you at our practice through a co-management agreement with your surgeon. Ask us for further details.

If My Vision Is Blurry After LASIK...

Though most patients see clearly within a day or so after LASIK, it can take several weeks or months before your eyes and vision completely stabilise. Until then, improvements in your vision can still occur. If at any stage your vision is still blurred, be sure to communicate this with your optometrist. It may be appropriate to have a second LASIK surgery -an enhancement- to sharpen your eyesight further.

If an enhancement is not required, glasses or contact lenses may be used to help. We will be happy to examine your eyes and discuss the options available to you.

After LASIK Eyewear

Even if your vision seems perfect after LASIK, you may still require or be more comfortable with eyewear.

When outdoors, it’s optimal and sometimes urgent to protect your eyes from the sun’s strong and sometimes harmful rays. Use sunglasses that provide 100% UV protection. For sports-sunglasses, the lenses need to have poly-carbonate for extra strength and protection. Anytime you work with power tools or do any activity where eye injury is possible, be sure to use safety glasses with poly-carbonate lenses.

If you’re over 40 (or close), it’s likely you’ll need reading or computer glasses after LASIK. Many LASIK patients benefit from prescription glasses for night driving. Even a mild prescription will make your vision sharper for added safety and comfort at night.

After LASIK Eye Care

Remember to continue to schedule routine eye tests post-LASIK. Even with perfect vision you still need to have your eyes examined by an optometrist for dry eyes, glaucoma and other potential problems on a regular basis. Routine eye tests will help ensure that your vision remains clear and stable for many years.