Frequently Asked Questions regarding Laser Eye Surgery in Perth

Treatment related

Can I go to sleep during the operation?

All laser vision correction is performed by numbing the eyes using topical anaesthesic drops. We require your active cooperation during the surgery so that the Laser machine can correctly focus on your eyes. It sounds daunting but the process is fast and smooth. Most patients are surprised that it’s already over. "Is that all?" is what we hear at the end of the treatment over 90% of the time.

Lens implant procedure are different. You can choose to have full general anaesthesia if you wish.

What if I blink during the treatment?

That is not a problem as there will be gentle sticky dressing and a small spring keeping your eyes opened during the procedure. Depending on the procedure choice, you eyes may not even have to be fully opened.

What if I move during the treatment?

The laser lock on to the image of your eye and track your eye movements during the treatment so that the accuracy is maintained despite eye movements. At certain steps of the procedure we may also apply a suction device on your eye to prevent movements. The equipment we use at our facil-ities are very gentle so that this part of the procedure is not painful at all.

Will I see everything that you are doing during the procedure?

As your eye is illuminated and the instruments are so small and close you’ll only essentially see light, colours and shadow during the procedure. Most laser procedures require minimal instrumentation and manipulation during the treatment.

Is it painful during the procedure?

All the operations we offer are not painful. You may feel touch, movement and sometimes pressure but no pain. The sensation does differ depending on the option chosen.

Does it take long?

These are very short procedures. The surgical time does depend on the treatment choice. To put it in perspective, we perform up to 14 cases in each operating list lasting 4 hours.

Recovery related

How long will I be wearing an eye-patch?

In most cases there is only a clear shield over the operated eye for 12 hours after the procedure.

Will I be able to drive afterwards?

You will need to be picked up after the procedure. Depending on the type of procedure, you may be able to drive the very next day.

Is it painful after the surgery?

Most of the time there is only some minor irritation and tearing on the same day after the procedure. This discomfort is almost completely gone the next day. There are some procedure such as PRK which is more uncomfortable for a period after the treatment. We will discuss it fully if this is the choice chosen.

How quickly can I see well and go back to work?

Most of our procedures offer very quick vision recovery. Useful vision returns the next day after surgery and continue to improve over the following days. LASIK in particular can be magically quick in recovery. ICL and SMILE also provides remarkable vision even on the next morning.

Long Term Outcome related

I heard I might go blind from laser eye surgery. Is that true?

There are many urban legends about this technology. Some of these claim go back to surgeries performed over 20 years ago with old technique and technology.

Also, in eye surgery we have around 20 laser procedures for various problems including blinding problems such as retinal detachment, macular degeneration, glaucoma. For instance, we have 5 different types of lasers within our practice and 2 are in Dr Chan’s consulting room. Therefore when someone claims to have gone blind from laser eye surgery, it is most likely not from laser vision correction but possibly other laser treatments.

Over 20 million people around the world have had laser vision correction. The numbers are over 10 times greater for lens surgery. The risk for blinding problems are extremely low. Commonly quoted figures are 1 in 10000 eyes for lasers surgery. On the flip side, contact lens related blinding risks are also about the same depending on the number of years and schedule of contact lens wear.

I heard that Laser surgery has lots of risks. I’m waiting for the technology to get better. Is the technology ready and is there a new break through around the corner?

Laser vision correction technology is definitely a mature treatment. This is backed up by numerous clinical trials around the world some even with over 10 years of followup data. LASIK and PRK has over 20 years track record. Even the latest generation SMILE procedures has over 5 years of ex-perience behind it. The latest break through, SMILE, is already here.

I heard I need luck to see well after laser eye surgery. Is that true?

Modern laser treatments are remarkably accurate. Over the last few years, consistently only 0.5% of our laser vision patients require any enhancement surgery after the initial procedure.

Does the treatment effect wear off and when do I have to have it again?

All our vision correction procedures including laser vision and lens implants are long term treatments. The correction effects are not expected to wear off. However, over time your eyes do change in shape just as a you may expect a slight change in your prescription glasses every 2 years.

Cataract surgery is only performed once in a lifetime. Cataract do not recur.

Collagen cross-linking for keratoconus is also only expected to be performed once only in most cases.

I heard dry eyes can be a problem, will my eyes be dry?

All forms of eye surgery cause a degree of dry eye in the first few weeks. This is part of the recov-ery. It goes away most of the time if the eyes are supported with lubricants and other drops appro-priately after the surgery. Different surgical procedure have different risks for long term dry eyes. Overall, SMILE and Lens Implants have lowest dry eyes risk. As a corneal specialist, Dr Chan often sees referred cases with dry eyes from surgery. He is very mindful of the risk of dry eyes. He will guide you towards the appropriate treatment with least dry eye risk.

I heard some patients see well in day-time but driving is very difficult at night due to halos.

Again, these are side effects mainly from older laser treatments. Older lasers can only treat a small part of the cornea leaving problems at night when the pupil is much larger. Modern wide optical zone treatment and wavefront optimised treatment that we use essentially has removed most of these side-effects. Also SMILE and ICL treatments are even better at reducing the risk of halo with patients who need higher power optical correction.

Is it true that I am too old for treatment? Have I missed the chance when I was younger?

We have the full range of treatment available and the oldest person who had laser correction with us was 91 years old. Oldest patient who had lens surgery was over 100 years old. Having said that, these treatments have different advantages for patients of different age and different situations. Those who wear reading glasses or have early cataracts have different requirements. We can guide you towards the best solution available.

Choice of Laser Vision Clinic or Procedure

I heard that SMILE Laser eye surgery is not US FDA approved

This statement is incorrect.The Zeiss Visumax laser that is used to perform SMILE laser eye surgery has been US FDA approved for many years. The SMILE procedure has been US FDA approved since 2016.

In any case, FDA approval only applies to the USA. The medical device regulator in Australia is TGA.  SMILE has been Australian TGA approved and European CE marked for many years. On the other hand, there are Lasers in Perth which are not FDA approved or even TGA approved. It is important to check if the laser used on you is approved by government regulatory departments.

LASIK has been quoted as the gold standard for laser eye surgery.

why should I choose other options?

Lasik has a long record of success and it remains a great option. We still perform many LASIK in Perth.  However, every procedure has it's advantages and disadvantages. For instance, PRK can be better for patients with thin corneas even though it is more uncomfortable.  We do believe that SMILE is a more advanced option in a range of situations. There is no doubt that there isn't a single vision correction procedure that is perfect for every situation.

The important take home message here is that, every patient requires an assessment to determine which of the current procedures is the best for his or her condition. It is therefore important to seek an opinion from a clinic that provides all current options and therefore all available choices would be considered. For instance, there are clinics that does not offer any other laser procedure other than PRK/TEMLA in Perth. In this situation, patients are only guided towards one option.

Every Laser Eye Surgery website says that they have the latest Laser.

WHy should I believe you have the most advanced technology?

Despite the confusion created by these marketing claims, it is important to make sure that the laser surgery equipment in your clinic of choice is up to date. There are only a few large manufacturers for these highly technical machines. As long as the lasers are from one of these manufacturers and are up to date then it is safe and accurate. Just as a current BMW is roughly the same in performance as a current Mercedes or Audi in a similar class. 

On the other hand, if the laser manufacturer doesn't even have a current website then you can expect the laser equipment to be questionable in reliablilty. We are the only provider of SMILE in Perth. SMILE is also a fundamentally more advanced method of delivering laser vision correction. Naturally we do have the latest and most advanced treatment capability in Perth currently.

How many laser eye surgeries has your clinic performed?

Dr Chan has been performing laser eye surgery since 2007. There have been thousands of cases since then. We have also been performing SMILE laser eye surgery since 2015. The truth is that, laser eye surgery for common refractive error is relatively simple. Vision correction treatment on high astigmatism, irregular, scarred corneas and corneal transplants are more technically demanding.  

Financial issues related

Is my treatment covered by my health fund?

In Australia, only treatment items listed on the medicare benefit schemes are covered by the majority of health fund policies. These items include cataract surgery, therapeutic laser keratectomy, treatment for irregular astigmatism and corneal transplantation. In these cases our charges are in-line with major funds and there is minimal to no gap fees for our services.

If you have an excess on you policy then you may have to pay this co-payment at the eye hospital.

For laser vision corrections, ICL and collagen cross-linking, there are currently no broad health fund cover as these are not procedures on the Medicare benefit schemes. However, for some high level polices such as HBF ultimate and BUPA ultimate cover these procedures are also covered. Also, you may be able to use some ancillary cover dollars and Gapsaver dollars from your HBF policy to partially fund the surgery. There is also some scope for a tax deduction claim for your surgery depending on your situation.

Do I have to pay it all at once?

We can guide you towards a finance option. Depending on the treatment and finance option laser vision can be as little as 50 dollars per week.

Are there any other hidden costs?

As for health fund covered items such as cataract surgery, we will bill you health fund directly for your operation and there is usually minimal out of pocket costs if you are with a major fund. This will cover your followup visits during a normal recovery period.