Throw away your glasses

More and more Thais are gleefully throwing away their glasses, thanks to developments in the refractive surgery industry. Technology is improving, and prices are falling as competition among centres increases.

What does refractive correction surgery involve?

"Lasik" (laser in-situ keratomileusis), the latest development in refractive surgery, can correct myopia (short sightedness), hyperopia (far-sightedness) and astigmatism – but not yet presbyopia, which all people over 40 will develop.

While the patient is under a topical anaesthesia, the ten-minute (per eye) procedure involves creating a flap in the top one-third of the cornea, prior to exposing the underlying cornea to an excimer laser. This effectively changes the shape of the cornea. The flap is then repositioned closed, where it is left to adhere without sutures. Due to the lack of disturbance on the corneal surface, recovery time is quick – it takes about six hours for the wound to heal.

Lasik has largely replaced PRK (photorefractive keratectomy), where an excimer laser directly reshapes the cornea. "The procedure results in an open wound, which takes around four days to grow back," explains Dr Chate Kietrsunthorn from Bumrungrad Hospital. This makes Lasik more optimal in the majority of cases.

The risks

Lasik surgery is reputed to be the safest in the history of eye surgery – but low risk does not mean no risk. The presentation shown to prospective patients at the Refractive Surgery Centre (TRSC) is sobering. "No one has ever gone blind from Lasik, but you can always be the first," warns Dr Ekktet Chansue, the centre’s director.

Anoma Rutnin Sethpornpong, executive director of the Rutin-Gimbel Excimer Laser Eye Centre, says that it’s a very personal decision. "If you are happy with glasses or contact lenses, stay with them. But your lifestyle can change a lot as a result of surgery."

There is a 1 in 5000 risk of developing a serious infection, and a one in 100 chance of developing serious complications – both of which could lead to a loss of vision.

Other risks include:

· developing a permanent "dirty windshield" type problem (more common with PRK);

· a reduction in night vision;

· developing night glare, where starbursts or halo patterns can be seen around lights;

· a complication in creating the corneal flap; and

· several minor side effects such as tearing, burning and dry eyes, which usually go away within a few days.

There are also no guarantees when it comes to achieving perfect vision. "Your eyesight will not be any better than what it is with your current glasses," says Dr Ekktet.

Mr Amatzia Sadan, 61, is one of Bumrungrad’s happy customers. He considered the risks, but the thought of life without three different pairs of glasses – for reading, long distance, and the sun – was too good. "Within two minutes of stepping outside after the first consultation, I said, ‘I’m going to do it!’ Now I still need my glasses for reading, but not all the time, and I wear sunglasses but without any number. I would recommend the operation one hundred per cent."

Not suitable for all

To be a suitable candidate, you need to be over 18, have had stable vision for at least one year, and not be pregnant. Up to ten per cent of prospective patients may be turned away due to other existing eye problems or characteristics.

Choosing a centre

"Find a friend who can recommend a good doctor," advises Rutnin-Gimbel’s Anoma. "Check how many eyes your doctor has done, how many complications there were, and ask what the worst complication was. Check that they are up to standard."

Rates of success in achieving certain levels of vision varies, so do check this as well.

The TRSC’s Dr Ekktet also encourages patients to ask as many questions as they like. "There is a lot of information available – possibly more than you can digest quickly. Find out as much as possible and ask questions – no questions are too dumb."

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