Despite being one of the most in-demand types of surgery in Singapore and throughout Asia, LASIK is considered by many to be a mysterious and even frightening medical endeavour. Fear not, however.
Dr Tony Ho is here to cast a big bright light on the subject. He has garnered 25 years of specialty experience in the Singapore refractive surgery arena and is a respected figure in the field. In 2004, Dr Ho had the opportunity to perform the surface-based, no cut and no flap Advanced Surface Ablation (ASA) method, now known as epiLASIK. He is currently the head doctor at Clearvision Eye Clinic & LASIK Centre.
DoctorxDentist Sessions featured Dr Ho's expert answers to reader questions concerning TransPRK, LASIK and more, from the best ways to go about it to facts about the treatment that you might not know of. Here's what he had to say.
LASIK or TransPRK? Which one should you opt for?
TransPRK, which stands for Transepithelial photorefractive keratectomy (try repeating that 10 times) is a type of refractive surgery that can correct myopia (which is a fancy word for nearsightedness), hyperopia (which is another fancy word for farsightedness) and astigmatism.
Are you the type that likes to rub your eyes for fun because you're weird? Do you like wrestling or other rugged contact sports?
If you answered yes to any of the above then congratulations, then you would most likely be more suitable for TransPRK as compared to LASIK. This is because TransPRK does not create a cut flap, which means that there is no risk of incurring flap dislodgement or dislodgement injury.
According to Dr Tony Ho, this is why patients who are military personnel or active sportspeople (such as MMA enthusiasts) would opt for TransPRK over other laser vision correction procedures.
If you tend to develop dry eyes, then TransPRK may be for you as well since LASIK has the highest risk of post-op dry eye complications due to the cutting off of nerve endings from the thousands of nerves innervating the sensitive cornea. Another point for TransPRK!
The only downside here is that TransPRK can lead to a longer recovery period and longer medical leave (which your boss may not be too overjoyed about) since you need to avoid exposure to UV rays for six weeks post-op.
Myopia does not return after TransPRK
Dr Tony explained to a reader who had a friend that had TransPRK but claimed that her vision is blurry again, that the effects of the treatment are technically permanent!
The doctor mentioned that after TransPRK, your cornea is reshaped by a laser called Excimer laser to change the way light bends into your eye and help you see clearly again.
So quite technically, it's impossible for the original myopia to return. What the reader's friend was experiencing was most probably mild myopia regression which can return years after undergoing a laser vision correction procedure.
How? Well, sitting directly in front of a computer screen for hours watching cat videos may be one reason.
Take better care of your eyes! Laser surgery is no excuse to go right back to horrible eye care habits and after every 20 minutes of near vision work, look at objects 20 feet away for 20 seconds. That should do the trick.
Infection is, unfortunately, still a thing with TransPRK
Almost every surgical procedure is prone to at least a slight possibility of infection. TransPRK is no different, despite all the awesome perks that come with it. Infection can be a nasty complication that you'll want no part of, warns the doctor, which is why he advises patients to stop wearing contact lenses at least three days before coming for the procedure and to take at least four days of rest after the op to recuperate in the (hopefully) clean confines of their own home.
TransPRK in Singapore ranges from $3,500 - $4,500 for both eyes
A reader was interested to know how much TransPRK procedures could possibly cost in Singapore and what the factors were surrounding these costs. Dr Ho answered with a range from $3,500 - $4,500 for both eyes. This is due to the laser vision correction practice in Singapore being mostly dominated by private clinics that charge varying costs.
These costs are based mostly on running costs, branding and maybe some other fringe services (wild nights on the town not included) which could result in steeper prices. It's worth asking questions before you commit to a clinic, like whether the price includes GST, if it's for one or two eyes and if medication costs and post-op review charges are covered. Don't be shy to interrogate the surgeon (leave the truth serum at home) on his experience, just don’t annoy him too much, your eyes may literally be in his hands after all.
Recovery after TransPRK is not that bad. Seriously
The assumption that TransPRK recovery process is much slower and really uncomfortable, is all a myth. A reader was fear-mongered by his friends who kept telling him that LASIK was a faster and painless recovery while TransPRK was slower and uncomfortable, to which Dr Ho reassured him this was not the case.
The cornea treatment surface area for modern TransPRK is only about a small 8 mm diameter area, after which, a protective high oxygen permeable contact lens is placed upon the cornea surface to protect and promote good and fast surface healing for the next four to five days. It is then removed. Concurrently, NSAID eyedrops, antibiotics and steroid eye drops are prescribed.
Only a minority of patients will describe the discomfort as moderate or beyond.
How old is too old for LASIK surgery?
A 46-year old reader claimed to have myopia, hyperopia and astigmatism. He wanted to know if there were any age restrictions with regards to LASIK.
Dr Ho said that theoretically there is no age limit for LASIK surgery. In reality, though, patients above the age of 65 usually have serious cases of cataract that would be better treated through a cataract operation.
If you are 46 and suffer from myopia, presbyopia (lao hua) and astigmatism, you can go for LASIK or TransPRK.
Eye surgeons may advise mono-vision laser vision correction for patients aged 40 or above. This treatment entails the correction of the dominant eye for better near sight, while the non- dominant eye is corrected to leave a small amount of residual myopia (about 1.50 dioptre or 150 degrees) to see well for near distances.
So there you have it! A number of these questions answered by Dr Ho are very common and are often asked by a majority of people interested in corrective eye surgery. If you know any people who’d like to learn more, feel free to share this with them so they can see the full picture (no pun intended).
Ever wanted to ask a health question to a specific renowned specialist in Singapore? DoctorxDentist Sessions are when these expert doctors answer all your questions, for free!
- (2016). Single-Step Transepithelial PRK vs Alcohol-Assisted PRK in Myopia and Compound Myopic Astigmatism Correction. Medicine, 95(6), e1993.
- de Ortueta D, von Rüden D. et al. [Transepithelial photorefractive keratectomy : Results and clinical experiences]. SpringerLink