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New laser refractive treatment, Health & Wellness - THE BUSINESS TIMES
JUN 4, 2016 5:50 AM
New laser refractive treatment
by Cheah Ui Hoon
Just about six years ago, patients who wanted to correct their eyesight with laser refractive treatment had only two procedures to choose from.The first generation laser treatment was Surface Ablation (or PRK, LASEK and Epi-LASIK), and the second, LASIK.
Now, the latest laser refractive eye treatment, ReLEx®SMILE (small incision lenticule extraction), is available in Singapore. It takes the best of the two procedures and is less invasive.
A brief overview of the two earlier treatments: In PRK, where the surface of the cornea is scrapped off so that the laser can be used to reshape the cornea, the problem is the downtime – almost a week – for the cornea to heal and the patient to return to normal daily activity.
In LASIK, a 22mm circumferential cut (or sidecut with a cleavage plane) is made to create a flap in the cornea, after which the laser is used to reshape the cornea. The downtime is about 3 days.
However, the flap doesn’t reattach completely, so it is a potential weak link. In a small percentage of patients, there can be an inflammation under the flap and even years later, if there is direct trauma to the eye, there is potential for the flap to shift or be dislodged.
When the flap is made, it also cuts the nerves of the eye that are connected to the tear glands, which in LASIK is associated with increased risk of dry eyes. “The whole corneal integrity is also weakened to a greater degree in LASIK than Surface Ablation,” explains Dr David Chan, Senior Surgeon of Atlas Eye Specialist Centre.
The main advantage of LASIK compared to PRK or Epi-LASIK is the faster healing time, but the downside is a large wound, potential of dry eyes and corneal weakening.
When doctors learnt of this, they tend to lean towards Surface Ablation, although it has a longer healing time and is associated with more pain and discomfort.
In the latest generation treatment, ReLEx®SMILE, which is suitable for individuals aged 18 and above with myopia and astigmatism, the surgery is less invasive and relatively painless. Only a small 2-4mm laser sidecut is made on the cornea.
“The surface of the cornea is largely kept intact except for the small sidecut so there’s no risk of flap dislodgement. Because there’s no flap, the cornea is left stronger as well. So it has the benefits of PRK in preserving corneal structural integrity and the similar comfort and speed of recovery of LASIK,” Dr Chan explains. The smaller incision also cuts down dry eye conditions as fewer nerves are damaged.
The short laser time of 24 seconds and surgery time is the same whether you have a low or high degree of myopia and that allows for more consistent results.
Patients now have 3 options for laser vision correction, each with its own limitations and benefits. You should learn more about them and find out which best suit your needs for today and the future.
Official Lasik/ Relexsmile Thread
