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Ask the Experts
Excimer Laser
Imagine not having to experience life from behind lenses. Imagine waking up in the morning, and starting your day without wrestling with contact lenses or hunting for your glasses. Imagine being able to wear prescription free sunglasses without having to fit them over your spectacles. These scenarios are all possible through the modern medical marvel of laser eye surgery.
The world of laser eye surgery is attractive to many patients, providing clarity, convenience, and freedom from glasses or contacts. But like any surgery, not every procedure is right for every patient. There are three main corrective surgeries: LASIK, LASEK, and PRK. All three of these procedures are designed to reshape your cornea wih the use of the Excimer Laser. But all three of them vary quite a bit in terms of method.
What is Excimer Laser surgery?
Excimer laser surgery involves using a laser, which is computer controlled to reshape the cornea. The surgery is designed to treat imperfect vision or in other words, refractive errors.
Until recently only myopia (short sight) and mild astigmatism (uneven shaped cornea, which is more steeply curved in one direction than the other) could be treated. However, thanks to improved laser technology, hyperopia (long sight) and more acute astigmatisms are now routinely treated.
Our online consultants will advise if Excimer Laser surgery is suitable for you. Excimer Laser treatments may not be possible for patients with diabetes, rheumatoid arthritis or lupus (a disease affecting the immune system).
The Procedure
The Excimer Laser is a ‘cool’ type of laser. It doesn’t burn tissue, but vaporises small amounts of the cornea every time a beam of the laser is pulsed onto the surface of the eye. The diameter of the laser beam and the number of pulses that are directed onto the cornea are carefully controlled using computer technology, so that the surface of the cornea is reshaped.
The procedure is performed using local anaesthetic eye drops and takes around 5 minutes per eye. However, the time taken for the reshaping of the cornea with the excimer laser is usually less than a minute.
Different sight problems require different treatments. For example:
- Myopia – the central apex or peak of the cornea must be flattened to reduce the degree of short-sightedness.
- Long-sightedness – the central apex of the cornea needs to be made steeper. This is done by applying the excimer laser to the edge of the cornea.
- Astigmatism – this occurs when the cornea is more curved in one meridian (or axis) than the other so the laser is applied to make the cornea more evenly curved.
After a successful procedure, the cornea is able to focus light rays directly onto the retina at the back of the eye, rather than in front of or behind the retina.
The reason why most people choose to have laser eye surgery is that they find that the consequences of wearing glasses or contact lenses are very disabling or they have a huge negative impact on the quality of their lives.
One of the most common reasons we see are people who do a lot sports. They find that wearing glasses is impossible due to either being outside and it being raining, or the fact that they do contact sports, it is just not safe to wear glasses.
Other people who wear contact lenses find that they cannot swim with their contact lenses in because it is simply not safe to do that, or again they do contact sports and if there are any blows to the eye, there is a risk of either dislodging and losing the lens or, if it is a hard lens, of that shattering in the eye.
Some other common reasons for people to have laser eye surgery are that they become intolerant to their contact lenses, so we have many patients, who have worn contact lenses for many years, but after a period the effect of wearing a lens on surface of the eye, causes the eye to become inflamed or uncomfortable, or simply for them to have gritty sore eyes at the end of a day of wearing contact lenses and that is a very common reason for people seeking laser eye surgery.
Laser eye surgery is an attractive option to fix your vision because it is permanent. You can give up dealing with glasses and contact lenses with one quick and safe surgery. Most patients experience their new corrected vision by the day after the procedure. The recovery time is minimal.
There are a few rare cases where vision could change after laser eye surgery. For example, if your genetics indicate that your vision may continue to change over the years. In that case, the one-time surgery will not prevent that from happening. However, this is an extremely rare occurrence.
If your eyeglasses prescription has not been stable for at least a year your vision could also change after surgery. Patients must wait to have the procedure until after their prescription is stable.
A more common type of vision change is the kind that can come with age. Patients may experience loss of near-sighted vision as they get older. If this happens, patients may qualify for Lens Replacement. This procedure helps people with an age of 50-plus see without reading glasses or varifocals.
The good news is that for a vast majority of patients, laser eye surgery is permanent. They can live their life without worrying about glasses or contact lenses again.
The recovery time following laser eye surgery varies depending on which type of laser eye surgery you have. With the first generation of laser eye surgery which is PRK or LASEK, the full recovery typically is one week and therefore we advise patients not to drive for at least a week. Some patients after LASEK can take longer to reach the driving standard but in general, the vision is entirely stable and has reached its pre-operative levels with glasses by one month after surgery.
The visual recovery after LASIK and SMILE is far more rapid and these are the second and third generations of laser eye surgery.
Typically by the following morning after surgery, i.e. the first day after surgery the patients can see 20/20 or close to it, and far exceed the legal standards for driving so usually the patients are cleared to go back to driving and back to work the day following surgery.