Top 20 Frequently Asked Questions

Most surgeons will set it as 18 years and above. Some will set it as 16 years and above but the eye power should also have been stable for the past two years. Parents’ consent will also be needed for the younger patients. There is no oldest age limit but those over 60 years of age frequently have cataracts developing and would be better served by a cataract operation.
You will need to make an appointment with the eye clinic and go for a “pre-op evaluation”. During this pre-op evaluation, you will receive counselling on the procedure. The clinic’s optometrists will also conduct various eye tests. This will be followed by a personal consultation with the treating eye doctor. General factors that will determine your suitability include (1) your cornea shape (2) your cornea thickness (3) your total refractive power (4) any existing eye conditions such as glaucoma, cataracts etc. The common causes of rejection are thin cornea, too high refractive power and other pre-existing eye diseases such as cataracts.
There is no minimum power i.e. people with 100 degrees of myopia can still go for refractive surgery. The maximum power for safe myopia correction is usually limited to 1,300 degrees. For astigmatism, we usually do not treat patients with more than 400 degrees of astigmatism. For hyperopia of more than 300 degrees or for those suffering from more than 1,300 degrees of myopia, lens implant or ICL surgery is the more suitable option.
With advances in laser vision correction technology, various options of LASIK, Advanced Surface Ablation (epi-LASIK, LASEK, advanced PRK), ReLEx SMILE and ICL are now available. Each technique has its own pros and cons. There is no single perfect procedure nor will there likely to ever be one. You can refer to the Table Summary (Pages 27-30) for more information to help you make an informed choice as to which is most suitable for you.
For every surgery, the surgeon is of paramount importance. You are more likely to have good results in the hands of an experienced and capable surgeon. For example, reduced time taken during surgery by an experienced surgeon will give more accurate results. The likelihood of complications will also be better kept in check. Ask friends or relatives who have gone for the procedure for references. Back it up with your own internet research. Make sure the surgeon is well experienced in laser refractive surgery and is board certified. Check if he has a good reputation in the community. MOH advertising guidelines for healthcare professionals do not allow eye doctors to proclaim the total number of procedures he has done but the reputation, years of experience and track record of the clinic he practices in are good reference points.
You should stop soft contact lens wear for 3 days before coming for the procedure. For hard contact lens wearer, a full 14 days of cessation is necessary.
All laser vision correction procedures are done under eye drops anesthesia. In other words, only numbing drops are used. There is no injections given and rest assured that the procedure is painless.
You will be awake and eye drops will be instilled into your eyes. A device will be placed to keep your eyelids open. Your attention will be required to fix your gaze at a blinking red light. Try to keep both eyes open and do not be afraid. Do not make any sudden movements or squeeze your eyes as that will cause the eyes to roll and result in inaccurate treatment. The actual treatment time is usually short (less than 20 seconds). You will hear the sound of the laser firing and may detect a burnt smell. Before you know it, the treatment is over!
Firstly rest assured that modern laser vision correction is safe and problem-free in the vast majority of cases. But there is no such thing as risk free surgery. The most feared complication common to all the various techniques is infection. But the risk of a serious sight threatening infection is less than one in 3000. Vision-related compli- cations such as glare, halos and starbursts are now much less common with today’s advanced lasers and techniques. They are also more likely to occur in patients who already have such complaints before undergoing the treatment and also in patients who undergo high power corrections. There are also risks and complications unique to the different individual techniques such as flap related complications in the case of LASIK. Refer to the Table Summary (Pages 27-30) for the complications specific to each of the different techniques.
Rest at home and observe good hygiene habits. Do not touch your eyes and eyelids with dirty hands. Apply the prescribed post-op eye drops only after washing your hands and follow the timing of the drops assiduously. Abstain from “dirty” activities like housework, cooking and spring cleaning during the first four days after surgery. After laser vision correction, the cornea is also very prone to scarring from the sun’s UV rays so always remember to wear your sun shades and even better still an added cap when outdoors for the first month after the procedure.
At the first sign of severe persistent pain or redness or abnormal eye discharges, you should contact your eye doctor for an immediate eye review to check for eye infection.
Depending on the techniques used, medical leave of three to five days is advised, including the day of the surgery. Many patients report that they see and feel well and are tempted to go back to work early. However, it is not advisable to go back to work the first three days after the operation so as to reduce the risk of infection and to apply the prescribed eye drops at the stated intervals for fast and safe recovery.
Most patients will find that they are able to see clearly without the need to wear glasses or contact lenses after laser vision correction. But there is no absolute guarantee that you do not need to wear glasses after surgery. For those patients with high powers, sometimes residual power remains that may require glasses to be worn to achieve 6/6 or perfect vision. When glasses need to be worn after surgery, they will be of significantly reduced power and dependence.
Enhancement surgery may be recommended for some patients who have significant amounts of residual eye power six months or more after the initial procedure. However, this depends on whether there is enough cornea tissue thickness to allow safe enhancement. For ReLEx SMILE patients, enhancement is possible only through a different technique i.e. Advanced Surface Ablation methods such as epi-LASIK. For LASIK patients who need enhancements, if the residual cornea thickness beneath the flap is too thin, Advanced Surface Ablation methods such as epi-LASIK can be done on the flap surface.
In theory yes, but in practical reality, very unlikely. It is like asking if you can die from a bicycle ride, possible but very unlikely!
When laser vision correction first started, the industry standard was to do one eye at a time. However with advances in technology and technique, it is acceptable and safe to go for bilateral laser vision correction as the risk of serious simultaneous bilateral complications is extremely low. Today, most patients (over 98%) will opt to do the surgery on both eyes at the same time for convenience in terms of taking medical leave and having to go through the discomfort of the recovery process twice. Furthermore, if patients opt to do one eye at a time, they will experience the discomfort and disruption of having imbalance vision during the interim period between the first and the second eye.
The procedure is contra-indicated in pregnancy. Women who are breastfeeding should not go for the procedure unless the baby is over eighteen months of age where the risk of eye drops medications affecting the child is low. But if you want to be completely safe, go for the surgery only after you have stopped breastfeeding your child.
n general, medical insurance cannot be used to claim for laser vision correction as the procedure falls under the category of a “cosmetic” op. CPF Medisave can be claimed if your myopia power is more than 1,000 degrees per eye or the difference in refractive power between the two eyes more than 300 degrees.
Yes, soft contact lenses, including cosmetic lenses can still be worn but only after three months. Hard lenses cannot be worn as they tend to slip due to the altered cornea curvatures.
No, as the entry wound for cataract surgery is at a different part of the eye. But your eye surgeon will need to factor in the new cornea curvature when he does the calculation and selection of the intra-ocular lens implant for the cataract surgery.
Yes. The most common strategy for those who have presbyopia is to aim for close to perfect vision in the dominant eye (usually the right eye) and deliberately aim for some under-correction in the other eye. This strategy is sometimes called “monovision correction”.