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Suitability for
laser surgery
Suitability depends on several factors, these are:
- A glasses prescription that has been stable for approximately 12
months. Therefore it is preferable to be at least 18 years of age.
There is no upper age limit.
- Realistic expectations - if you have a low or moderate degree of
refractive error you should expect very good results. Those with
high degrees of refractive error may still need a reduced correction
for some activities.
- No ocular disease.
You will need to undergo a consultation which will include a thorough
eye examination. This involves an examination of the health of your eyes
and assessment of your suitability for surgery.
Benefits of Laser
Surgery
There are many benefits associated with refractive surgery. The
benefit one receives depends mainly on the person and their visual
requirements.
Some of the potential benefits include:
- Less or no dependence on glasses or contact lenses.
- Free of the visual limitations associated with glasses or contact
lenses.
- Occupational reasons - some jobs (eg. police) require the employee
to reach a standard of vision without glasses or contact lenses. It
is important to check with the relevant authorities to make sure if
laser surgery is accepted as an alternative.
- Enjoyment of sports such as surfing, football, tennis and skiing
without the burden of correction.
- No worry about glasses or contact lenses being broken or lost.
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Effects and
Complications:
Refractive surgery is an elective procedure. The surgery will result
in a permanent change in the curvature of the cornea. With any type of
surgery complications are possible. This is also true in refractive
surgery.
As each person has a different prescription and healing rate it is
not possible to guarantee the result after surgery, but the surgeon is
able to predict, fairly accurately, your expected result.
Some of the complications that can occur are:
Under/Over Correction:
It is possible to have a residual refractive error, and be under or
over corrected. Re-treatment is possible in most but not all cases.
A slight under correction will not seriously affect your vision, but
if the under correction is visually significant then we will look at an
enhancement procedure if clinically indicated.
Over-correction can occur, and will usually settle down within the
first two to three months. This may make your vision blurry for reading
etc. It is important to remember that normally your reading vision will
take a little longer to clear than your distance vision.
A few patients with high errors will need further surgery to correct
residual error. 2% of patients will feel they need glasses occasionally.
This percentage will vary depending on the magnitude of the initial
refractive error.
Minor Decrease in Best-Aided Visual Acuity:
It is possible that LASIK could affect your best corrected vision,
this is the level of vision you can currently achieve with your glasses
or contact lenses. If so, your best vision, with glasses, may not be as
good after surgery as it was before. This loss of VA may not be able to
be corrected with a retreatment or with glasses or contact lenses. This
means that your vision may not be as sharp, and that you may lose one or
two lines from the bottom of the vision chart. Your vision will not be
as crisp as it was prior to surgery with your glasses.
LASIK Flap Complications:
Corneal flap problems occur in about 1% of LASIK procedures. This may
require a second procedure the day following surgery or some weeks
later. These may also delay your visual recovery by some weeks.
Glare and light sensitivity:
People are sensitive to the sunlight and glare after the LASIK
procedure. This usually always settles within a few days.
Starburst/Night Haloes:
People may experience haloing around street lights and car lights at
night. This does get less and less with time, but may not disappear
completely.
Post Treatment Discomfort:
There is no pain during the LASIK procedure. It is unusual but some
people do experience some pain after the LASIK procedure. This is
usually helped with pain tablets that are given to you at the time of
your procedure. Patients may experience problems with watering eyes and
swollen lids during the initial post operative period, this is not
uncommon.
Infection:
There is always a slight chance of getting an infection. The chance
of this is probably no more than with long term contact lens wear. An
infection may lead to severe scarring and in extreme cases the need for
a corneal transplant and possibly blindness. The risk of this is
greatest in the first 48 hours. You are given antibiotic drops during
surgery, and for the first week after surgery, to minimize the risk of
this.
Severe loss of vision:
Due to infection or scarring about 1 in 10,000 eyes have severe loss
of vision.
Unknown long term side effects:
The long term side effects of LASIK are unknown but studies to date
show no untoward side effects.
Once your eye has healed you are no more susceptible to injury or
infection than anyone else.
Fluctuations:
Fluctuations in your vision are quite normal and are part of the
healing process. These usually last for approximately 1 month. You
should always maintain a good level of vision.
Reading Glasses:
Presbyopia is a condition that reduces the ability to focus on near
work, is age related, and will occur whether you have laser surgery or
not. It means that following surgery you almost certainly will require
glasses for reading from your mid forties onwards, unless you opt for
monovision.
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