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procedure is performed or which technique is used.

LASIK – one of Laser vision correction has within the last decade emerged as a safe and effective means of correcting near-sightedness, far-sightedness, and astigmatism. It has been accepted worldwide as a valid permanent alternative to glasses or contact lenses wear and over two million people undergo the procedure each year with satisfying results

PRICE (THB) 55,000

LASER EYE SURGERY

PRICE (AUD) $ 1,970

AUD$ prices are correct as of 15 June 2010 and can change according to currency rate fluctuations.

Introduction LASIK is a laser surgery technique used to correct refractive errors of the eye including nearsightedness , farsightedness and astigmatism . The word LASIK is an acronym for Laser In-situ Keratomileusis, which means, “to reshape the cornea with laser” The LASIK Procedure involved the use of a special type of laser called the Excimer Laser. The Excimer Laser creates a “cool” beam of ultraviolet light. This makes the Excimer Laser ideal for corneal surgery because it can vaporize (ablate) corneal tissue without causing thermal damage to surrounding tissue.

Advantages Reduce or eliminate your dependence on contact lenses or glasses No more having hunt for glasses or struggle with contact lenses Freedom to play sport. May even increase your performance edge when no optical lenses are needed. Ability to dive without the need for lenses prescription masks. Enjoy traveling without the need to bring along all of your extra glasses and contact supplies The procedure is less-invasive and convenient Consultation and surgery can be done in the same day Both e yes can be treated at the same time No injection, No suture, No hospitalization Little discomfort Rapid visual recovery High accuracy and safety Minimal regression r

Candidates Be at least 18 years of age with stable refraction Have healthy eyes that are free from eye diseases or corneal abnormality (e.g., scar, infection, etc.). Have documented evidence that your refraction did not change by more than 0.50 diopters during the year before your pre-operative examination. Be informed of LASIK risks and benefits as compared to other available treatments for nearsightedness with or without astigmatism. Be able to lie flat without difficulty. Be able to tolerate local or topical anesthesia. Be willing to sign an informed consent form as provided by your eye care professional. Be able to keep your eye accurately on the fixation light for the entire laser surgical procedure.


Contra-Indications Please advise and discuss with your doctor if: You are diabetic You have severe allergies and take medicines regularly. You have had a history of Herpes simplex or Herpes zoster keratitis

Initial Consultation You have a significant dry eye that is unresponsive to treatment You have a medical condition you are uncertain about

You are taking Isotretinoin (Accutane速) used for the treatment of acne because common side effects are dry eyes ,watery eyes conjunctivitis and lids inflammation. Prior to LASIK evaluation, please consult your doctor who prescribe this medication whether you have to stop using these medication at least 1 month before and after LASIK. Amiodarone hydrochloride (Cordarone速) used for heart rhythm control .Some patients develop symptoms of halos, photophobia, dry eyes or other sight-threatening ophthalmic abnormalities. Sumatriptan (Imitrex速) used for migraine headaches. This medication make wounds to heal harder and change in vision. Fortunately, sumatriptan is not for routine use, only to relieve your migraine headache as soon as symptoms of the migraine appear.

Preparation for Consult If you wear contact lenses, it is very important to stop wearing them and wear glasses only before consultation and treatment for the doctor to obtain a stable eye measurement. Failure to do this might produce suboptimal surgical results. Soft lens Rigid Gas Permeable lens (RGP) Hard lens (PMMA)

at least 1 week at least 2 week at least 4 week

Contact lens wear alters the microscopic structure and shape of your cornea so it may cause changes the measurements. Many dry eyes which resisted to every kind of treatments turn to be normal just because of leaving the contact lenses out for period of time.

A small fee of 1000thb (approx 35 AUD) is Charged for the Eye Examination. At this initial consultation you will have a detailed eye health history taken and a full eye examination. This thorough examination process will take approximately 1 hour. This will vary from person to person depending on the equipment used and tests you require.

If you wear contact lenses you may be asked to leave them out for a period of time prior to your assessment. Please see preparation for consult for guide. At your assessment your eye health history will be taken, including some of the following questions: Have you ever worn glasses? Do you wear contact lenses? Have you had ocular or systemic disease and medications? Have you had previous ocular problems? Have you any previous eye injury?

You will also be asked about you work and lifestyle needs to help us formulate the most appropriate vision correction strategy for you. You will then view a multimedia presentation that thoroughly explains the procedure and options prior to your eye examination. You will then receive a comprehensive eye examination. Dilating eye drops may be used as part of the examination. The drops can also make it difficult to read things up close for an hour or two after the examination. The examination combines computerised vision testing and sophisticated corneal mapping technology to determine the status of your eyes and suitability for laser eye surgery.


Initial Consultation Continued.. You will generally have the following assessments and tests performed: Measure any uncorrected vision you may have, and your vision as corrected by prescription lenses. Measure the size of visual error in each of your eyes in order to determine the amount of correction required, and to develop the appropriate surgical strategy. Make a map of the curvature of your cornea. The information will be used to link the shape of your cornea with refractive errors. The procedure will also detect any irregularities, abnormalities, or diseases you may have. Measure the thickness of your cornea. The result may affect the required amount of LASIK correction. Measure the size of your pupil in dim and room light. Night vision will be discussed with you. Measure the ability of your muscles to align your eyes. Examine your eyelids and associated membranes to see if they interfere with your cornea, and whether or not they properly regulate tear flow.

The Technology The CustomVue treatment establishes a new standard for the measurement and correction of the unique imperfections in each individual's vision. With the CustomVueT procedure, no two "prescriptions" are identical. This precise level of measurement and correction enables individuals to potentially achieve better vision than is possible with glasses and contact lenses. Advantages : Greater refractive precision. More detailed information previously unobtainable by standard methods for glasses and contact lenses. Distinct tailoring for personal best vision As shown in a clinical study, can produce better vision than is possible with glasses and contact lenses. PreVue? potential personal best vision. A unique capability that lets you "preview" an approximation of your potential Personal Best Vision before having the procedure. CustomVueT Results

Examine the lenses in your eyes to check for clouding (cataracts), and other abnormalities.

In the FDA Clinical Study, One Year After the Procedure:

Measure the pressure within your eye in order to detect glaucoma and related conditions.

100% of people could pass a driving test without glasses or contacts.

Examine the back of your eye, including the retina, optic nerve and blood vessels, in order to check for any eye or systemic disorders.

98% of people could see 20/20 or better without glasses or contacts.

After discussing and assessing your particular needs, you will then be explained the different laser eye surgery options available, as well as the benefits, alternatives, and possible consequences for you.

70% of people could see better than 20/20 without glasses or contacts. The VISX WaveScan WaveFront? System The WaveScan System is a tabletop diagnostic system that measures your eyes with specialized cameras. You will sit in front of the WaveScan System and look at a light through an opening in the system while it scans your eye. Your doctor may take more than one measurement and then choose the most appropriate measurement to use as the basis for the CustomVue LASIK treatment. The doctor will also take other routine measurements of your vision to help design your treatment.


WaveScan technology produces a detailed map of your eye. It was measured by Wavefront Technology. Much like a fingerprint, no two eyes are exactly alike . Wavefront error simple and complex focusing in the eye that are revealed by differences in the paths of light rays as they are bent by the eye. Wavefront technology was originally developed for use in high powered telescopes to reduce distortions when viewing distant objects in space. This technology has now been applied to laser vision correction. Before your CustomVueT LASIK treatment is programmed into the laser, you must have one or more WavePrint? measurements taken by the WaveScan? System. WavePrint® is a color map that displays wavefront error measured by the VISX WaveScan WaveFront® System The digital information is transferred to the VISX STAR S4™ Excimer Laser System which performs the CustomVue™ procedure. Your CustomVue treatment is “designed” to correct the unique imperfections of your vision. The excimer laser produces a beam of cool ultraviolet light. The doctor programs your information into a computer that controls the laser. The laser produces a series of rapid pulses that remove small and precise amounts of corneal tissue. Excimer laser light does not penetrate into the eye and leaves other eye structures (iris, lens, retina) undisturbed. The laser also contains an auto-centering eye tracking system which will automatically compensate for any of your eye movements during the CustomVue treatment.

The Procedure The laser operating room is precisely controlled for both temperature and humidity so light comfortable clothes are all that will be needed. It is better to have only a light snack and drink well prior to the operation as anxiety and a full stomach can make you uncomfortable when lying flat. Antibiotic eyedrops will be instilled in your eyes to prevent infection. Prior to the operation several drops of local anaesthetic will be inserted. These are the same drops used when you had your previously examined, they do sting a little for a second. Then you will be taken into the laser theatre and will lie flat on a bed with your head under a microscope. Initially the light from the microscope is a little bright but you will rapidly adjust and it should not be any problem. After the eye surgeon has cleaned your eye and eyelids with antiseptic she will use a sterile plastic drape to cover your eyelashes, eyelids, cheek and forehead. To prevent blinking a metal speculum is used to hold your eyelids held wide. This feels a little tight but does not hurt. Only once she is perfectly happy with your position will the operation start. The process is quite complex and the clininc have a series of safety checks in place. You will hear your surgeon talking to the staff as well as to you. She will endeavour to talk to you at every step so you know exactly what to expect and what she would like you to do. You can talk to her and ask questions as you proceed. There are some times when movement is not allowed and you will ask you then to keep still and quiet. A suction ring will be placed on your eye. This holds your eye steady and raises the pressure in the eye to enable the flap to be cut. As the suction is applied you will hear a sucking sound and feel slight pressure then your vision should grey then black out. This is a good sign as it means that the pressure is correct for creating the flap. The microkeratome is attached to the suction ring and the flap created. As the flap is created there is quite a loud vibrating buzz and it is much easier and safer if you do not squeeze your eye or move during the few seconds that this will take.


The microkeratome and suction ring are removed. If the surgeon is totally happy with the flap she will then proceed to the laser reshaping. There are a few steps getting organised and setting the laser to track your eye movements, then the laser treatment commences. The computer controlling the laser divides the treatment into a number of fractions and your surgeon will be monitoring your eye and telling you how the treatment is progressing. The laser makes a loud noise and does smell a bit but is painless and over in about 1 minute. On completion the flap is repositioned and washed with sterile saline. After about 3 minutes of drying the flap has adhered so the speculum and drape are removed. Antibiotic drops are instilled and a clear plastic protective shield is applied. Often, despite the after effects of the microscope light and the shield you may see quite well immediately. Once the anaesthetic wears off the eye will feel quite gritty and irritable for a few hours. You may find the best solution is to go to bed and get a good night rest, and keep both eyes still and closed. It is imperative that the eye should not be rubbed in the first week as the flap could be dislodged.

You will be mildly sensitive to light and have the feeling that something is in your eye for 1 to 2 days. Sunglasses may make you comfortable during this time. Prior to your departure from Phuket , you will need to attend another followup appointment. This is normally about a week after surgery. This can be somewhat flexible (from 5-7 days after surgery).Your attendance at this check up is important for checking your healing progress.

Recovery As your eye heals your vision may fluctuate during the first three weeks after surgery. It's not unusual to notice: # Occasional blurring of vision. # Greater sensitivity to light. # A gritty, irritated feeling. # Some difference in sensation or vision between eyes. However, the vision should always be at a reasonable level during this healing phase. Please keep in mind these simple guidelines while your eyes are recovering:

Next Morning Normally vision is quite reasonable the next morning and will improve over the next week. Most normal activities can be resumed immediately but remember that the flap is not secure for some time. Eyedrops are routinely used for up to 10 days to help the eye heal and prevent infection. It is not uncommon for the eye to feel a little dry and irritable for several months and during this time a lubricant eyedrop may be used for comfort. An appointment time and arrangements would have been confirmed with you to return to the Laser Centre the following morning. You May remove the eye shields and attend the clinic at the appointed time. Staff will clean arround the eyes and you will then be examined by your surgeon.

# Do not use eye drops other than those prescribed # Do not rub your eye vigorously for one month following surgery. # No body-contact sport for 4 weeks following surgery. # No swimming for at least one week (ocean or pool). # No eye make-up for one week. # Take extra care, for one week, when bathing or washing your hair to avoid getting soap or shampoo in your eyes. # Do not drive until your vision is adequate for both day and night.


Laser Eye Surgery