Eyes Right

Posted: Monday 27 September 2010 02:15pm

You feel good, you look good – or at least you think you look good when you squint at yourself in the mirror. Yes, you know that the scrunching up of your eyes, and the wrinkle-inducing effect that can have, isn’t exactly adding to your looks, but you’re tired of glasses and contacts. So you’re thinking: am I a candidate for laser eye surgery?

The Long and The Short of the Problem
Those who have trouble seeing objects close up suffer from hyperopia, or long-sightedness, while those who have trouble seeing objects in the distant suffer from myopia, or short-sightedness. Another common sight problem is astigmatism, or refractive error, where the shape of the cornea, the part of the eye that focuses light so that it can create an image, is not symmetrical, leading to blurred vision for both near and far objects. All three conditions are readily treated using laser eye surgery – as millions have world-wide have discovered in the past 25 years.

The Right Light
Dr. Con Moshegov, principal ophthalmic surgeon at Perfect Vision in Sydney, says laser vision correct has been refined and improved in those years. “From the start, we knew it was a very beneficial procedure and there have been incremental improvements to it as time has gone by,” he says. “But the fact remains that there is a limit to how much treatment the cornea will take. If it’s not thick enough, for example, or the correction is too great we look at alternatives or we simply don’t do it all.”

“We know more about what we can and can’t do now and it has become safer from the technical side through the advancement of the lasers we use. For example, we have very sophisticated tracking applications that we can apply now.”

These computer applications can cope with even the most extraordinary situations, says Dr. Moshegov, “such as a patient having a coughing fit during a procedure or sudden movement of the eye.”

The most commonly used laser eye surgery applications are PRK, or photorefractive keratectomy, the original form of laser surgery, and LASIK, or laser-assisted in-situ keratomileusis, which was first used in Australia in 1994. With PRK, the laser is applied directly to the cornea’s surface while in LASIK the surface of the cornea isn’t treated, but simply folded back with treatment applied to the tissue beneath the flap.

Dr. Moshegov uses a procedure known as iLASIK. It involves two lasers – Intralase, to create the corneal flap, and VISX Star 54, to reshape the exposed cornea. He prefers LASIK to PRK because patients experience less post-treatment discomfort and recover more quickly. “If you can get that instant improvement, it gives a lot more gratification.”

Still, there are procedures where PRK can prove to be the best option. For those who have their doubts about exposing their eyes to laser surgery, he suggests they make a full investigation of all that’s involved – from cost and details of different procedure to recovery and possible complications, no matter how minimal.

The Holy Grail of the vision correction industry world-wide is finding a fix for presbyopia, the gradual loss of the eye’s ability to adjust its focus from far to near as we become older. In other words, it’s part of the ageing process and becomes more of a problem over time – between the ages of 40 to 50 is when it tends to become an issue as the use of reading glasses and bifocals takes over.

Current laser surgery procedures have limited application in treating presbyopia. “We do have a few options up our sleeve – but none of them are the golden chalice, if you like,” says Dr. Moshegov, keeping up the Holy Grail analogy. But it will come, he says. “So much time, effort and money is being poured into it now because it’s potentially the biggest chunk of the market. If you walk down the street today, how many people do you see wearing glasses … and how many of them are more than 45?” The answer to bother questions: lots of them.

by Jenni Gilbert

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