LASIK, or laser-assisted in situ keratomileusis, is a type of eye surgery that uses an excimer laser to ablate and correct the cornea, and thus provide permanent treatment without the aid of external devices like eyeglasses and contact lenses. Overall, it is the best type of eye surgery for treating various eye conditions (including myopia, hyperopia and astigmatism) as it can be done quickly and with minimal pain.
There are different types of LASIK surgery. However, the three best and most commonly performed types today are conventional LASIK, Epi-LASIK, and IntraLase LASIK. Each of this type of procedure follows the same general procedure and shares a similar core technology, but has some unique aspects that make one treatment type more suitable than the other, depending on the desired outcome, and the patient’s profile and preferences.
Conventional LASIK
Procedure: The first phase of a conventional LASIK procedure is the creation of a corneal flap, which is done using a suction ring (to hold the eye and place) and a mechanical microkeratome metal blade to cut the cornea. The second phase is laser remodeling, where the stromal layer of the cornea is corrected using an excimer laser. The third phase is the careful repositioning of the corneal flap.
Advantages: The main advantage of a conventional LASIK treatment is that it requires a shorter downtime, with most patients fully recovering after a night’s rest. This means that patients also achieve corrected vision almost immediately.
Disadvantages: More risks are associated in a LASIK treatment that creates a corneal flap, especially if a mechanical blade is used. Deep corneal flaps may also alter the intended effect of the excimer laser. Additionally, conventional LASIK is not suitable for patients with thin corneas.
Epi-LASIK (epithelial laser in-situ keratomileusis)
Procedure: This procedure attempts to merge the desirable features of older LASIK treatments, including conventional LASIK, PRK and LASEK. In this procedure, a thin sheet of epithelium is removed instead of creating a corneal flap. This is then followed by laser remodeling using the excimer laser. Lastly, a special contact lens is used to protect the eyes and help it to heal.
Advantages: Because Epi-LASIK does not create a corneal flap is created, the structure of the eye is preserved. This means that the eye is less prone to being injured when it sustains a blow in the future. Additionally, patients of Epi-LASIK have better options when taking other eye treatments in the future.
Disadvantages: Compared to other LASIK treatments, Epi-LASIK involves more discomfort and requires a longer time to recover from. Some patients also experience temporary hazy vision.
IntraLase LASIK
Procedure: IntraLase LASIK, or iLASIK, follows the general procedure of conventional LASIK with the major difference being that it uses a femtosecond laser (instead of a mechanical blade) to create the corneal flap. Like in other treatment types, an excimer laser is used to correct the cornea. The flap is then carefully placed back and the patient is made to rest to let the eyes heal.
Advantages: IntraLase LASIK has all the advantages of conventional LASIK, with the added advantage that it has less chance of developing complications and IntraLase LASIK patients generally heal faster. Also, because laser is used to create the corneal flap, the incision is more accurate.
Disadvantages: Similar to conventional LASIK, IntraLase LASIK has the same disadvantages caused by the creation of a corneal flap, including the cornea being more susceptible to injury and patients having an increased chance of the cornea thinning or bulging.
Candidates
The ideal candidate for any LASIK treatment are individuals 18 years old and older, has stabilized vision (has had the same prescription for at least two years), and do not have a medical condition that may impair healing.
Recovery
Patients of conventional LASIK and IntraLase LASIK usually fully recover after an overnight rest, although minor discomfort may last for a few days. Epi-LASIK patients may need up to a week to recover and regain perfect vision.
Cost
The cost of treatment varies, depending on its type and the expertise of the doctor or treatment provider. On average, the cost of treatment per eye is SG$2,000.
Side Effects & Complications
During the first few days after the treatment, patients normally feel some pain, which can be remedied with over-the-counter medication. The eye may also feel irritated or itchy, but will quickly normalize. Like any other surgical treatment, there is a chance of complications, but its occurrence is very rare.
