What is laser eye surgery?
Laser eye surgery is a refractive surgery that reshapes the cornea to change the focusing power of the eye.
The most common kind in New Zealand is Laser in-situ keratomilensis (Lasik), which can treat myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism - where the cornea is more oval than round.
It is a permanent procedure but does not stop presbyopia, which is the natural ageing of the eye.
Where do I start?
If you are thinking seriously about the procedure you should start by talking to your optometrist.
They can discuss some of the pros and cons with you and some can also carry out a pre-operative assessment to tell you if you are a suitable candidate for the procedure.
They can also point you towards your nearest clinic.
Both Laservision Eye Clinic and Fendalton Eye Clinic in Christchurch make regular trips to other centres to carry out pre-operative assessments so it's worth calling to see if they will be in your area at some point.
If you are considering having the surgery overseas, check the reputation of the clinic and the qualifications of the person performing the surgery (it might not always be an ophthalmologist as in New Zealand).
Who can have laser eye surgery?
Clinics will not do the procedure on people who have conditions that could prevent a successful result or lead to damage of the eye.
These include people who:
• Are pregnant or breast feeding
• Are under 21 years old
• Have had a change in glasses or lens prescription in the past two years
• Have a corneal disease or an eye condition such as glaucoma or cataracts
Ultimately, the decision whether to go ahead with the procedure lies with the surgeon.
Every patient has an examination with an ophthalmologist before surgery is approved to see if they are suitable.
"New Zealand is a small place. A surgeon is not going to risk his reputation or the health of the patients' eyes for $4750," says Laservision marketing manager Vicky Coates.
"Ninety-nine percent is about the health of the person's eyes. If the pre-op [examination] is OK the likelihood of anything going wrong is minimal."
In this examination, the surgeon will check the thickness of the cornea, the contours of the eye and discuss what you can expect from the surgery.
For example, your corneas may be thick enough for one procedure but not for any enhancements later on if the eyes have been under-or over-corrected.
You will also be told of all the potential risks no matter how small the chances of them occurring.
Is it dangerous?
As with any elective surgery, it is up to the individual to feel comfortable with the risks involved.
Do some research before making your decision - talk to people who have had it done, discuss it with your optometrist or laser eye clinic and look on the internet (but try to stick to New Zealand sites, especially if you are reading about things that can go wrong, as the regulations here are different from other countries).
There is some debate over the long-term effects of the surgery so consider this when deciding.
The risk of serious visual loss is extremely low but there can be some side effects, which in most cases are only temporary. These include:
• Dry eyes
• Halos or starbursts at night
• Light sensitivity
• Hazy or blurry vision
• Over-correction or under-correction
• Difficulty with night driving
According to laser eye clinics, most of the temporary side effects are resolved within the first three months.
If the over-or under-correction still exists once the sight has stabilised they can offer further treatment.
"About 2-3% come back for an enhancement free of charge," Mrs Coates says.
Do I need to do anything before surgery?
If you have contacts you will need to stop wearing them before the procedure (two weeks before for soft lenses and at least six weeks for hard) as lenses can affect the curvature of the cornea.
What should I expect during the procedure?
Before the surgery the patient is given anaesthetic eye drops and in some cases a mild sedative.
There are three stages to the surgery - creating the flap, shaping the cornea and replacing the flap.
The flap is created either with a microkeratome (a computerised blade) or with a laser depending on whether you choose a clinic that offers Lasik or IntraLase-initiated Lasik.
The curvature of the cornea is then reshaped - flattened for myopia, curved for hyperopia and made more round for astigmatism.
The flap is then put back and starts to heal within minutes.
The procedure does not hurt but may feel uncomfortable as your eye is held open by a speculum during surgery.
What happens afterwards?
After the procedure you need to rest for 20 minutes or so then the surgeon will fit protective shields to your eyes and you can go home.
You will need someone to drive you and look after you a bit as you need to take it easy and rest your eyes.
The next day you will return to the clinic and the surgeon will examine your eyes to see if they are healing properly and to measure the visual progress.
According to Laservision, most people experience an immediate improvement and 98% can see well enough the next day to legally drive.
Your eyesight will stabilise in the first few months after the surgery.
Later checks at one week, one month, three months and six months can be performed by your own optometrist and are included in the cost of the surgery.
After surgery, your eyes may feel gritty, as though there is sand in them, but it is important not to rub them.
Also, avoid eye make-up, swimming and exercise for one week and contact sports for up to three months after Lasik surgery.
You may want to wear sunglasses as your eyes could be more sensitive to light.
You can expect to be back at work two to three days after surgery but you may need to use approved eye drops at first, especially if you use a computer or work in an air-conditioned office.
How much does it cost?
The price varies depending on where you go.
At Fendalton Eye Clinic each eye costs $2900, including pre-operative and post-operative checks.
Laservision charges $2375 per eye, including pre-operative and post-operative checks.
The clinics use slightly different technology so investigate which you prefer before making a decision.