Laser Eye Surgery QLD | Eye Surgery

Laser eye surgery is a procedure to remove diseased eye tissue or reshape the cornea. It involves using a beam of light (laser) to correct vision. In many cases this is a good alternative to glasses or contacts.

The cornea bends (refracts) light into the retina at the back of the eye. Patients with long sightedness or short sightedness will experience bent or blurred vision because this light isn’t being directed precisely. Laser eye surgery aims to reshape the cornea so that light is refracted more accurately.

Astigmatism

The cornea is held in place by a strong ring of fibrous tissue, which joins it to the back of the eye. Changes in the shape, in one area of the cornea, such as flattening of the corneal curve, results in an equal and opposite steepening of the corneal curve at right angles. Measuring the difference between the steepest and the flattest curve of the cornea so defines astigmatism. The net impact of astigmatism is to distort an image. Most easily appreciated as a streak from a point source of light, in the distance, when viewed at night when you have astigmatism in your eye.

Astigmatism can be regular when spectacles can fully correct the distortion in vision. When the cornea warps in a non uniform way, such as in the disease keratoconus, this is known as irregular astigmatism. Irregular astigmatism can not be corrected fully in glasses, which is why with increasing severity of keratoconus, spectacles no longer help. Further more, that is why hard contact lenses create an artificial regular front surface of the eye to eliminate the irregular astigmatism (in keratoconus) and thus, correct the vision.

Treatment

Regular astigmatism can be corrected surgically by laser or implant technology. A rotational alignment of the laser delivery or implant is important in the success of these interventions and becomes critical for high levels of regular astigmatism.

Irregular astigmatism can not be fully corrected by anything else other than a hard contact lens. Due to contact lens intolerance or lifestyle choices, both laser and implant technology can still provide considerable improvement in the functional unaided vision. Disclaimer: Correcting irregular astigmatism requires additional determination of corneal stability before and after any procedure.

Reading Glasses

SPOILER: Don’t Panic!

In the event that you grow disgracefully old enough to need reading glasses, all is not lost. Various surgical options to minimise your reading glasses and contact lens dependence exist. Presbyopia (the need for reading glasses) is a condition associated with aging in which the eye exhibits a progressively diminished ability to focus on near objects. If you are long sighted this becomes apparent as early as age 35 and if you are short sighted this is delayed until 45 or slightly later. Reading glasses have been a simple and effective stopgap for eons. In an alternative universe if spectacles and implant refractive surgery came along at the same time, spectacles would never make it off the drawing board [Betamax vs VHS or Fax vs Email]. Several options in modern Refractive Surgery allow you to exercise greater spectacle independence as a lifestyle choice.

Treatment

Laser Eye Surgery and Lens Implant Surgery (Refractive Lens Exchange or Refractive Lensectomy) can be used to maximise your binocular relative spectacle independence. Laser Eye Surgery utilising monovision and Refractive Lens Exchange using either monovision, accommodating lens implant or multifocal lens implants can be used to create the desired bespoke functional range of vision based on your lifestyle requirements.

Monovision leaves one eye with good distance vision and the other eye with near vision. The greater the degree of separation of the two eyes, the greater the breakdown in the co-ordinated 3-D vision between the two eyes. The lesser the degree of separation of the distance and near vision eyes, the greater the residual 3-D vision, but the less near vision you will have.

Accommodating lens implants remain relatively unpredictable with more patients requiring a fine tuning with a laser as a secondary procedure. The degree of near vision obtained is also variable and tends to be less than the full reading correction obtained with other implants. Most patients, one year out, still require reading glasses for fine near work. The speed of change from distance to near focus can also be frustrating. Good 3-D vision over a range of distances is relatively easy to achieve with this type of lens.

Multifocal lens implants can achieve great distance and near vision as well as excellent 3-D vision at each focus point. The speed of focus from distance to near is almost instantaneous. Generally appreciated compromises with this lens type include ghosting around an image, particularly noticeable at night when the pupil is more dilated. With advancements in lens implant technology, we have seen improved satisfaction and wider application of the latest generation of multifocal implants. As always, the correct choice of procedure for an individual relates directly to their personal visual needs.

Long Sightedness

Long Sightedness or Hyperopia is where both distance and near images are blurred. This is of no help to anyone unless you are studying stars in another galaxy. Long sightedness leads to the premature need for reading glasses. People with long sightedness, from an early age are also more likely to have a lazy eye.

Treatment

Contact Lenses, Laser Eye Surgery, Intraocular Contact Lenses and Lens Surgery. The correct option depends on one’s age, the degree of your long sightedness, defining your own ocular dominance and the presence and degree of amblyopia (lazy eye). Options overlap and thus individual counselling is required to arrive at the bespoke outcome. For other than small amounts of long sightedness, Laser Eye Surgery is not a great option here.

Short Sightedness

Is a condition in which close objects are seen clearly, but objects farther away appear blurred. Short sightedness is also known as Nearsightedness or Myopia.

Treatment

Surgical options to dispense with spectacles includes Laser Eye Surgery or implantable lenses that add to your natural lens power or replace your own inadequately performing natural lens in the eye. The correct option depends on one’s age and the degree of your short sightedness. Options overlap and thus individual counselling is required to arrive at the bespoke outcome. Laser Eye Surgery options includes surface based refractive surgery such as Photorefractive Keratectomy (marketing pseudonyms include: ASLA, LASEK, EPI – LASIK and Transepithelial PRK). Flap Based Procedures such LASIK and SMILE. The flap in LASIK can be made with a blade or another laser (Femtosecond Laser). With surface based treatments you can not have the complications that could occur when you make a flap. Surface based treatments are more uncomfortable overnight and visual blur persists for a few days after the procedure. Flap based treatments are often referred to as the Day 1 WOW! effect, as they are relatively painless and the vision is very good within a few hours. A common side effect of both surface and flap based treatments is dry eyes. Flap based treatments cut through the corneal nerves and this is why it is relatively painless where as surface based treatments minimally disrupt the corneal nerves which is why it is initially relatively uncomfortable. Few other surgical procedures have been studied in such detail and been found to be so successful. (NICE – Guidance for Patients).

Normal Cornea

LASIK

Laser Eye Surgery