LASER Eye Surgery at Perth Aculase Eye Clinic

Laser Vision In Perth Aculase Eye Clinic

State of Art Laser Suite with all 3 Generations of Options

We are the first in Perth to have a Zeiss Visumax Femtosecond Laser which is the most advanced laser of its kind. This is currently the only laser in the world that can perform SMILE and ReLEx Flex laser treatments. The Zeiss MEL 90 excimer laser is also the only laser in Perth to be able to offer Presbyond which is the next generation of Laser Blended Vision for those needing reading glasses. The combination of our cutting edge laser system and Dr Chan’s expertise offer the highest level of care and lowest risk available.

Best Results from the most Complete Range of Laser Treatments

Our Treatments

SMILE

LASIK

PRK TransPRK

LASEK TEMLA ASA

We are the only clinic in Perth to offer the complete range of Laser Vision correction procedures. This includes SMILE 3rd generation laser, LASIK (2nd generation) and PRK, TransPRK, LASEK, ASLA, TEMLA (1st generation). We also offer all forms of lens implant surgery as well. Just as one pair of glasses cannot fit every person, we cannot expect one type of treatment to be the best choice for every patient. You can be sure that Dr Chan can guide you towards the best option specific to your circumstances.

What is Laser Vision Surgery

The refractive error of a patient’s eye could be modified by changing the shape of the cornea. This can be achieved by targeting a refractive excimer laser or femtosecond laser treatment on a patient’s cornea. This treatment plan or treatment profile is determined by the patient’s refractive error, target outcome and other variables.

Treatment Range

Myopia	Up to 10 Diopters
Hyperopia	Up to 6 Diopters (no hyperopic treatments for SMILE currently)
Astigmatism	Up to 6 Diopters

The treatment range in general is listed above. However this may not be applicable to all patients. This range may be limited in individual cases due to corneal thickness, corneal curvature and other pre-existing conditions.

Different laser vision surgery technique

Laser vision correction surgery to the cornea has been available for 25 years. During this period laser surgery has evolved from applying laser to the surface the cornea (PRK), then subsequently under a protective corneal flap (LASIK) and finally applying the laser directly to the inside of the cornea (SMILE). Nerve endings and epithelium (surface coating cells) are locate at the superficial layers of the cornea. Surgical damage to nerves causes severe pain and dry eyes. Injury to surface cells causes reduction in optical clarity. The superficial layers are also the strongest part of the cornea, damage here could lead to corneal structure instability (ectasia). One of the main improvement in the evolution of these laser procedures is the avoidance of collateral injury to the corneal superficial layers during surgery. The end result is reduced discomfort, dry eyes, improved recovery time and reduction of overall risk of long term issues.

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SMILE - 3rd Generation Laser Vision

- watch Smile video

SMILE (SMall Incision Lenticule Extraction) is a fundamently different technique to LASIK or PRK. It uses a femtosecond laser for vision correction where LASIK and PRK uses an excimer laser. The Zeiss Visumax femtosecond laser treatment creates a prescribed shape internal disc (lenticule) directly inside the cornea without affecting the surface of the eye. This disc (lenticule) is then extracted through a very small opening. One of the key differences with SMILE is the lack of surgical injury to the surface layers of the cornea. By avoiding collateral damage to nerves, surface cells and structural fibres, SMILE is the least invasive of the 3 options. The femtosecond treatment is also more accurate at higher power optical correction. SMILE is also more comfortable.

Please see our SMILE page for more information.

LASIK eye surgery in Perth Eye Hospital

WATCH LASIK VIDEO

(Laser Assisted Insitu Keratomileusis)LASIK treatment was first developed in the early 1990s. LASIK combines the use of an instrument to create a corneal flap, together with excimer laser treatment under this protective flap. The flap is hinged at the top (under the upper eyelid), then it is lifted and folded aside by the surgeon and laser pulses are applied to the cornea under the flap. Finally, the flap is then repositioned.

LASIK has the advantage of minimal discomfort and rapid vision recovery. We are the first to use the Zeiss Visumax for LASIK in Perth. For the first time in Perth Laser vision correction is completely comfortable due to the gentle, curved, low pressure patient interface used during surgery with this state of the art laser system. Most patients experience clear vision after 1-2 days after the procedure. As a result LASIK is the most common form of laser vision in Perth and overseas. Over 18 million LASIK treatments have been performed worldwide over last 20 years. However, the flap creation can increase the risk of dry eye and long term structural instability.

PRK _{^{(Photo Refractive Keratectomy)}}, TransPRK, TEMLA, LASEK, ASLA, Epi-lasik

WATCH PRK VIDEO

These are different names given to essentially the same procedure. We can consider these treatment as first generation laser vision surgeries. The Excimer laser treatment is applied directly over the surface of the cornea after the epithelium (skin) of the cornea has been removed using various methods (LASEK/ASLA-alcohol, TransPRK / TEMLA-laser, Epilasik-mechanical device). For simplicity we call this procedure PRK in our practice. PRK is the simplest and most economical form of corneal laser refractive surgery.

The reason for multiple names for PRK is that PRK had a reputation for pain and scarring in the 1990’s. PRK has improved with newer generation of excimer lasers. The risk of scarring is also lower with the use of anti-scarring drugs. This treatment has the advantage of lower cost and less cornea thickness requirements. It still has an important role in today’s Laser vision treatment options. In some cases such as thin corneas and dry eyes, this treatment can be the preferred choice.

PRK is simple and less invasive compared to LASIK, however, the vision recovery is much slower. This is due to fact that the corneal epithelium which is responsible for optical clarity has to re-grow and heal. There is also pain on the first 1-3 days. The cornea has a very high density of nerve fibres on the surface. Denuding the cornea exposes these nerve ending and the pain can be severe.

Treatment Choice

SMILE, LASIK and PRK are alternative procedures with overall similar long term results but slightly different relative risks. The choice of each procedure is guided by various patient factors and preferences. For example LASIK can only be performed if there is a reasonably thick cornea to enable the creation of a flap. Patients who require rapid recovery may choose LASIK or SMILE. Where there is asymmetry of the cornea many surgeons prefer SMILE or PRK and where there is an active lifestyle or contact sports, SMILE or PRK can be the preferred procedure. If a patient has higher risk of dry eyes then SMILE or PRK may be a more appropriate choice. Also patients with hyperopia cannot have SMILE currently.