Top 30 FAQs

GENERAL QUESTIONS

Q1: Which procedure is suitable for me?
Today, there are 3 main laser vision correction options – TransPRK, LASIK, ReLEx SMILE. Whilst each technique has its own pros and cons. You should do some research to be able to make an informed decision.
An experienced, capable surgeon is of paramount importance to a successful surgery. A veteran eye surgeon can perform the surgery within a shorter time, ensuring comfort and accurate results. The likelihood of complications will also be kept in check.
You can begin by searching on the internet for an eye surgeon who has an established track record and proficiency in your procedure of choice. Cross check your findings with friends or relatives who have undergone the procedure as well as blog posts by those who have had the procedure done. The surgeon’s years of experience and track record of the clinic he practices in are further important points to consider.
Laser vision correction can be used to correct myopia (short-sightedness), hyperopia (far-sightedness),
astigmatism and presbyopia (middle-aged onset far sightedness).

SUITABILITY FOR TRANSPRK PROCEDURE

Q4: What is the minimum and maximum age suitable for TransPRK?
You must be at least 18 years old to undergo TransPRK, and have a stable degree for at least for the
past three years. Parental consent is needed for patients who are 21 years old and below.

There is no maximum age limit, but those over 60 years of age may have underlying eye medical problems, for example cataract, and should undergo a medical eye examination first.

Women who are pregnant or breastfeeding are not advised to go for the procedure because the eye prescription may be affected due to hormonal changes. Medicated eye drops that are prescribed (e.g. antibiotics and steroids) may affect the foetus or infant even if it is in microscopic quantity. You can only undergo laser vision correction at least 3 weeks after you have stopped breastfeeding.
You will need to make an appointment for a Laser Vision Correction (LVC) evaluation to determine if
you are a suitable candidate for the procedure. The LVC evaluation would consist of detailed tests & eye measurements followed by a medical eye examination & consultation with the eye surgeon himself.

Some factors that will determine your suitability include your cornea thickness, cornea curvature, keratectasia risk, total refractive power, and any existing eye conditions such as glaucoma, cataracts,etc.

Yes, you should stop contact lens wear for both the evaluation and surgery. For soft contact lens wearer, you should stop for at least 3 days (or at least 10 full days for hard contact lens wearer). This is to minimize the risk of infection and to ensure that your cornea shape returns to its natural shape.
As your eyes would be dilated during the LVC evaluation, thus it is not advisable to have both the evaluation and the procedure on the same day. Instead, the earliest date you can have the surgery is the very next day after the evaluation day. If you delay the procedure for more than 6 months after the evaluation, most centres would require you to repeat the tests.
Corneal Cross-Linking (CXL) is a safe, non-invasive, low-risk cornea strengthening treatment that may be recommended to be incorporated into your TransPRK/ LASIK procedure. Unfortunately, it cannot be incorporated into the ReLEx SMILE or ICL procedure. CXL provides additional safety for patients with thin cornea, high myopia and astigmatism to prevent a corneal medical condition known as keratectasia.

CXL is a simple two-minute procedure that involves 2 steps:
1. Riboflavin (Vitamin B2)* eye drops are applied to the cornea and left to soak into the cornea for 1 minute.
2. The riboflavin-soaked
cornea is illuminated with
ultra-violet A (UVA) light
for 1 minute using advanced
technology of the Avedro KXL® System, and this treatment cross-links the collagen fibers within the cornea, thus strengthening the cornea.

All laser vision correction procedures will result in the cornea being thinner. If the cornea becomes too thin, it might be pre-disposed to a cornea medical condition called keratectasia, in which the cornea progressively become thinner. This will in turn lead to blur and unstable vision. Hence, CXL is indicated for patients whose cornea would be significantly thinned out as a result of treatment for high myopia or astigmatism, or who have thin cornea to begin with.

Your eye doctor is the best person to advise if you will need CXL or not.

Do not wear any makeup, aftershave, perfume and deodorants on your surgery day, as the odours and vapours will affect the accuracy of the laser machine. General hygiene is very important as infection is a feared complication of any surgery. Have a good bath before coming down for the procedure, including a good hair wash. There is no need to fast, but avoid having a heavy meal. The laser treatment room might be cold, so you may want to dress warmly, but not in tight-fitting clothes.

You can see reasonably well after the procedure, but it is still not advisable to drive.

THE TRANSPRK PROCEDURE

Q12: Is the procedure painful?
No. Anaesthetic numbing eye drops are administered just before the procedure, so you would not feel any pain. After the anaesthesia wears off, you might feel a slight discomfort. Your eyes might feel scratchy and watery. However, this is only a temporary symptom and does not pose a problem for most patients.
You will be awake and numbing eye drops will be instilled into your eyes. A device will be placed to help keep your eyelids open. Rest assured that with TransPRK, there will be no surgical instruments that will be placed on your eyeball. All you need to do is simply to fix your gaze at the blinking green light. Try to keep both eyes open and do not be afraid. Try not to squeeze your eyes hard as that will cause the eyes to roll. The actual treatment time is usually short (around 10 to 50 seconds). You will hear some clicking and whirring noise, and you may detect a faint burnt smell. Before you know it, the treatment is over!
When laser vision correction first started, the industry standard was to do one eye at a time. However with modern technology, it is a common practice now to have both eyes done at the same time. If patients opt to do one eye at a time, they should be aware that they will experience the discomfort and disruption of having imbalance vision during the interim period between the first and the second eye.
For TransPRK, the total surgery time would only take about 3 to 5 minutes for each eyes. However,
the actual laser treatment time is about 10 to 50 seconds per eye.

POSSIBLE RISKS AND COMPLICATIONS

Q16: What are the risk and complications of TransPRK?
Rest assured that the TransPRK procedure is safe and problem-free in the vast majority of cases. Unlike LASIK & ReLEx SMILE procedures, there is no risk of flap-related complications that is the frequent cause of serious complications in laser vision correction.

The most feared complication common to all the various laser vision correction techniques is infection. But with modern safety standards, the real on the ground experience is significantly less.

The next feared complication for TransPRK is corneal haze. Fortunately, this is unlikely to occur if the patient adheres strictly to the prescribed eyedrops regime, and wear sunglasses when outdoors in the sun, especially within the first month after the TransPRK procedure.

Other complications such as glare, halos and star-bursts complaints are now much less common with today’s modern lasers and techniques.

In theory, yes, but in practical reality, the chance of going blind from laser vision correction is
very unlikely.

For TransPRK procedure, we are most concerned with complications from infection and haze due to exposure to uv rays. If the patient adhere to the eyedrops regime that is prescribed, keep good eye hygiene and stay away from excessive sunlight especially during the first month, the risk of complications that can lead to blindness is very unlikely.

For TransPRK procedure, you should refrain from rubbing or squeezing your eyes after the surgery so that the protection bandage contact lens does not become dislodged. For the first 5 days, it is not advisable to apply eye make-up and facial lotions close to your eyes. During this period, you also have to take care not to splash water into your eyes when washing your face or during baths.

It is important to wear your sunglasses and a cap when you are outdoors for the first month to reduce uv exposure to the eyes.

Standard MC is four days (including for the day of surgery), but patient can request for maximum of six days. Your vision will not be perfect yet, but it will be functional vision, that is you will be able to see well enough to go back to work.
For TransPRK, your operation day is considered as Day 1. Your post-operative consultations will be scheduled on Day 3, Day 6 and Week 3. Follow-up consultations after the first month will be further advised by the doctor depending on your recovery. Most patients are usually discharged after the third or fourth month.
Your vision will be fairly clear immediately after the procedure, however, it is not advisable to drive for the first week. Although the use of handphones and computers are not harmful to the eyes, you may experience some difficulty with near-vision work. Some bluriness in vision may be experienced on Day 3 to 5 when the surface healing is nearing completion.

Most patients see well enough to return to work on Day 6.

Full vision recovery will greatly depend on the power corrected. Patients with low myopia power can expect to see very well by end of first month, moderate myopia power by end of second and those with high power after three months. Generally, most patients are discharged after the third or fourth month.

After your TransPRK procedure, you can resume light sports activities (e.g. jogging, gym exercises, cycling, etc) after 5 days. However, if you participate in strenuous/ rugged/ contact sports (e.g. rugby, MMA, etc), as well as water sports (e.g. swimming, water polo, diving, etc), you can resume after 2 weeks.

However, especially for the first month of the recovery period, you should remember to avoid exposure to the sun’s ultraviolet rays. Hence, engage in outdoor sports only before 8 am and after 630 pm.

MISCELLANEOUS QUESTIONS

Q23: Can TransPRK be used to correct presbyopia (middle-aged onset far-sightedness)?
Yes, TransPRK can be also be used to correct Presbyopia, also more commonly
known as middle-aged Farsightedness or “Lao Hua“ in Chinese. The most
common strategy is called “Mono-Vision treatment“, but I would personally prefer
the term of “Blended Vision treatment“. With this strategy, the dominant eye (yes,
we all have a dominant eye same as we all have a dominant hand and dominant leg)
will be corrected to see clearly for the distance, and the other eye (your non-dominant eye) corrected to see better for near vision. If the difference in the refractive power between the two eyes are kept at 1.50 Dioptres and below, the phenomenon of “Blended Vision“ occurs where for distance vision, the dominant eye helps the non-dominant other eye to see well for far also, and for near, the non-dominant eye helps the dominant eye to see better for near. Thus, rest assured that it is thus not a case of having only one eye see for far and one eye see well for far also, and for near, the non-dominant eye helps the dominant eye to see better for near. Thus, rest assured that it is thus not a case of having only one eye see for far and one eye see for near as the term Mono-vision Treatment suggests.
If you have very high myopia of more than 11.00 Dioptres (1,100 degrees) and/or astigmatism of over 3.00 Dioptres (300 degrees), you may not be suitable for TransPRK because there will be too much sacrifice of cornea tissue needed to correct your power. If you have unusually thin cornea or central cornea scarring, you may also not be suitable. Less commonly, those who suffer from severe dry eyes or certain auto-immune disorders on immunosuppressant medications may also not be suitable. For these cases, Implantable Collamer Lenses (ICL), where a crystalline lens is inserted in between the iris and in front of the natural lens, can be considered. Your eye doctor is the best person to advise on this.
No, as the entry wound for cataract surgery is at a different part of the eye. It will also not bring on earlier development of cataract. But your eye surgeon will need to factor in your new cornea curvature shape measurement when he does the calculation and selection of the intra-ocular lens implant for the cataract surgery.
Following TransPRK, your cornea is re-shaped to put your spectacles lens refractive power onto the cornea curvature. This effect is permanent and very unlikely to change especially for those older than 25 years.

Nonetheless, always adopt the good eye care habits listed below:

1. Minimise eye strain
Placing too much strain on the eyes can cause discomfort and fatigue.
One of the best ways to prevent eye strain when doing near vision work
is to follow the rule of 20-20-20. This simply means that every 20 minutes of near vision work, you should look at objects 20 feet away for 20 seconds!

2. Do not hold reading materials too close to the eyes Maintain a comfortable distance between your eyes and reading materials. For reading, the ideal distance is 2/3 of an arm’s length away.

3. Work in well-lit areas
It is important for one to work in bright spaces with sufficient and suitable lighting. Whilst dim lights will not directly damage your eyes, they can tire them out more quickly and cause eye strain symptoms and headaches.

4. Your sitting posture matters
Maintaining a proper sitting posture while working is important as well. Refrain from slouching! You should adopt a correct but comfortable sitting posture with the back straight and shoulders relaxed.

5. Maintain a healthy lifestyle
To keep your eyes healthy, it is important to consume nutritious food or supplements that has beneficial effects for the eyes. Spent sufficient time outdoors daily to engage in exercise or leisure activities daily.

TransPRK is an accurate procedure. For many patients, they will not need to wear glasses or contact lenses anymore!
However, for some patients, the doctor may not be able to achieve full correction due to limitations brought about by their high myopia, astigmatism or thin cornea. This category of patients may require low-power glasses to achieve perfect vision.
Yes. Soft contact lenses, including cosmetic lens, can still be worn but only after one month. Hard
lenses cannot be worn as they tend to slip due to the altered cornea curvatures.
Enhancement surgery is not common with modern laser vision correction and in particular TransPRK. With TransPRK, the enhancement rate is less than 3 percent. Generally, enhancement is not recommended to be done until after a waiting period of at least six months for full and complete eye healing and eye power stabilization. When indicated, it is also subjected to the pre-condition that the remaining central cornea stroma thickness exceeds the standard safety limits.
In general, as laser vision correction is considered as a “cosmetic” op, medical insurance and Medisave will not be claimable.