Designer specs are great but maybe you’d still rather go sans glasses. Wondering if you’re a good candidate for LASIK or ReLEx?

LASIK and ReLEx can treat myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism, reducing your dependence on glasses and contact lenses.

Clinical Associate Professor Mohamad Rosman, Head & Senior Consultant from the Refractive Surgery Department at Singapore National Eye Centre (SNEC), a member of the SingHealth group, gives detailed answers to your questions.

Question by ried1990

Hi. i have a high degree myopia about 600 plus in each eye. and previously i went for a check to see if im suitable for lasik. the specialists say i have a thin cornea and lasik might not be suitable as the chances are 40%unsuccessful to 60%successful. They also reccomended ICL.

What about ReLEx/Flex? is it a better alternative for thin cornea cases? and what about PRK and Epilasik?

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

ReLEx (Refractive Lenticule Extraction) is a type of refractive surgery procedure to correct short-sightedness. Unlike LASIK, which involves using excimer laser to ablate (vapourise) part of the cornea, ReLEx uses femtosecond laser to create a lenticule within the cornea and this lenticule is removed en-bloc. However, as both LASIK and ReLEx correct myopia by reducing the cornea thickness, ReLEx is not a better alternative for patients with thin corneas for whom LASIK is already contraindicated.

PRK and EpiLASIK may be suitable in some patients with thin corneas. In PRK and EpiLASIK, the most superficial part of the cornea (the epithelium) is removed before the excimer laser is applied to thin the cornea. As there is no need for a corneal flap (unlike LASIK and ReLEx), more cornea tissue is preserved as thus, can be performed on a thinner cornea. However, in general, PRK and EpiLASIK are not suitable for short-sightedness greater than 600 degrees as the risk of corneal scarring is higher.

Question by p1071663

Hello.

My 9 year-old daughter has been wearing glasses for two years. However, from early this year, I noticed that one of her eyes kept going out of focus. The optometrist said that she should wear her glasses all the time , even when watching TV.

The problem is, her eye is still getting out of focus.

Can Lasik/ ReLEx help?

Does she need to be reviewed by a specialist first?

Thank you, Rafeeda

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

The minimum age for LASIK and ReLEx is 21 years old. As such, LASIK and ReLEX are not suitable options for your daughter.

If wearing the appropriate spectacles prescribed by an optometrist does not improve your daughter’s vision, it may be advisable that she be reviewed by an ophthalmologist.

Question by marycheong

Hi. I am 54years old female. My myopia is very high, both eyes are 1050 deg. Astigmatism is 50 for both eyes. Using Bi focal spectacles now; my hyperopia is 200 deg. Am I suitable to do Rasik.

Thanks you

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

Base on your history, you have high myopia and presbyopia. Eventhough your myopia is high; LASIK may be possible if your cornea is sufficiently thick. However, LASIK will not correct your presbyopia and you will still need reading glasses after LASIK. Another factor to consider is your age. You are at the age group when cataracts start developing. As such, the effect of LASIK may not be long as cataracts will affect your vision once it develops. It is best that you consult an ophthalmologist who can advise you on the various options available.

Question by gracehobbs

Hi, I'm currently breastfeeding my 6 months old baby. I heard it's not advisable to do LASIK while breastfeeding, is that true?

thanks.
Grace

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

Yes. Pregnancy and breastfeeding may cause fluctuations in your refractive status (ie your myopia and astigmatism) due to hormonal variations. As the calculations for excimer laser ablations during LASIK depend on accurate measurements pre-operatively, these fluctuations in refractive status may result in less predictable outcomes. LASIK should be performed a minimum of 6 months after pregnancy or breastfeeding, whichever is later.

Question by siem

Good morning Doctor

I'm 55 years old and have had cataract operations on both eyes a few years ago. They are stabilized now however they are between 50 to 100 degrees off with some astigmatism. Prior to that they were between 600 and 1200. I would like to know if there are any LASIK or anything else that is available that can give me good long and short range vision.

Thank you and best regards
Siem

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

Base on your history, it appears that you have some residual short-sightedness and astigmatism after cataract surgery. You also have presbyopia. Unfortunately, currently there are no procedures which can correct BOTH short-sightedness and presbyopia at the same time in someone who has undergone cataract surgery. LASIK may be able to help eliminate the residual short-sightedness and astigmatism, but you will still need reading glasses for near vision.

Question by john

I am a 50 year old man, wearing specs and contacts for short-sightedness and astigmatism ( 400 degrees) . Now I also have to put on reading glasses for table menus, etc. Sigh.

Can Relex or the new Lasiks fix all my problems once and for all?

Or can I do the cataract surgery, which I understand involves replacing the lens, so I can see near and far ...forever..?

Is that true?

What are the pros and cons of each option please.

Thanks

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

LASIK or ReLEx may be able to correct your myopia and astigmatism. However, they cannot correct your presbyopia at the same time. You may still need to use reading glasses if you undergo LASIK or ReLEx.

If you have cataracts, cataract surgery with multifocal intraocular lenses may be able to correct your shortsightedness, astigmatism and presbyopia at the same time. This procedure involves removing your natural cataractous lens and replacing it with an artificial lens. While cataract surgery is a relatively safe operation, it is not without its risk. Some of the potential complications include infection, inflammation, retinal detachment etc. Some potential side effects of multifocal intraocular lenses include poor night vision, reduced contrast sensitivity, requiring bright lights to read etc. It is best that you consult an ophthalmologist who can assess you and explain whether you are suitable for cataract surgery and explain the risks in detail.

Question by twin_sheep

Dear Doctor, I have gone for scelra buckling on one eye because of retinal detachment about 10 years ago, currently my degree is approx 1000 on both sides. Can Lasik help?

Thank you
Jean

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

In general, LASIK can reduce your dependence on spectacles or contact lenses even if you have had retinal detachment surgery and high myopia, as long as you have sufficiently thick corneas. However, you will need to be examined more thoroughly to ensure that you are suitable to undergo LASIK.

Question by shirleyhuang05

I have a minor cornea abrasion earlier and continue to experience dry eye syndrome. One of the doctor suggested that I can consider lasik. Would this really help ? Or should I take up relex instead ? I am totally confused about the type of the operation available in the market. Please advice

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

Both LASIK and ReLEx are surgical procedures to correct refractive errors. They do not prevent corneal abrasions nor can they treat dry eyes. In fact, one of the common side effects of LASIK and ReLEx is worsening dry eyes. However, if your cornea abrasion and dry eyes are related to chronic contact lens use, LASIK and ReLEx may able to help reduce your dependence on contact lenses are thereby solve your problems. However, in this scenario, LASIK and ReLEx should only be considered after you have stopped wearing contact lenses for a period of time and your cornea abrasion and dry eyes have been treated.

Question by rudin9898

A lot of people will have to wear glasses after 10- 20 years after the lasik surgey, is this true ? What are the risks involve in lasik / relex operation ?

Answered by Clin Assoc Prof Mohamad Rosman, Head & Senior Consultant, Refractive Surgery Department, Singapore National Eye Centre (SNEC)

Almost all LASIK patients will have to wear reading glasses once they develop presbyopia around the age of 40 and above. This is similar to a normal person who is not short-sighted to begin with. A smaller proportion of LASIK patients may require spectacles some time after LASIK which is not due to presbyopia. This is due to regression (recurrence of short-sightedness or astigmatism). However, patients with regression may still undergo another LASIK procedure (also called enhancements) to correct this additional shortsightedness or astigmatism as long as there is sufficient corneal thickness.

Common side effects of LASIK or ReLEx include worsening dry eyes and degradation of night vision with symptoms of glares or haloes. However, these side effects tend to be self-limiting. Rarer, but more important complications of LASIK or ReLEX include, infection, inflammation, corneal ectasia ( excessive corneal thinning) etc. The list is not exhaustive as you should discuss with your ophthalmologist on the pros and cons of LASIK or ReLEx.

Ref: L20