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LASIK And TransPRK

A DxD Session with Dr Tony Ho


Ended on Wed Jan 23 2019
Ended

Top Answers


Hi Anonymous,

The main added concern with LASIK for patients with high myopia is the risk of cornea thinning. This is because with the LASIK procedure, a cornea flap is cut first with the femtosecond laser before the doctor can proceed to correct your high myopia with the excimer laser. Due to the cut flap in LASIK, there is an added risk of corneal thinning.  

You may want to consider the alternative no cut flap, surface-based “Trans-PRK” procedure. In TransPRK, there is no need to cut a cornea flap as the excimer laser vision correction is done on the surface. Instead of a cut corneal flap, a protective bandage lens is places on the surface to promote surface healing and removed after five days.

Thus, there is no concern about cornea flap complications and also less risk of cornea thinning.  

12 Feb 2018

No, myopia will not come back after a TransPRK treatment.

After TransPRK, your cornea is reshaped by a laser called the Excimer laser to change the way light bends into your eye, enabling you to see clearly again.

Here's how the laser works:

TransPRK Singapore

The laser goes on the treated zone to reshape the cornea curvature to correct the refractive power in one step seamlessly.

This effect is permanent! You can be rest assured that your myopia will not come back again.

Getting blurry vision years after undergoing a laser vision correction procedure is a result of mild myopia regression, and not the original myopia returning. Mild myopia regression that is often caused by long hours spent in front of the computer screen or prolonged near vision work.

Thus, it is always important to adopt good eye care habits such as the 20-20-20 rule: every 20 minutes of near vision work, look at objects 20 feet away for 20 seconds!

Other ways to reduce eye strain include maintaining a comfortable distance between your eyes and reading materials, working in well-lit areas, having a good sitting posture, and eating healthy.

If the myopia regression is less than 0.50 dioptre or 50 degrees, it is best to leave it alonel. If more than that, one can consider the option of enhancement laser vision correction if the cornea is thick enough.

Less commonly, blurry vision years after laser vision correction may be due to development of an eye disease such as cataract, cornea keratectasia (a pathological thinning condition of the cornea) or retinal problems.

30 Jul 2018

The cost of TransPRK in Singapore ranges from $3,500 - $4,500 for both eyes. 

Laser vision correction in Singapore is very much dominated by private clinics and one will most definitely notice a variation in the cost of TransPRK amongst the private clinics.

The cost varies because each clinic charges according to their own running costs and branding. Some clinics throw in fringe services, which results in a much steeper price.

What is covered under the cost for each clinic also vary greatly. Thus, patients should always find out beforehand what exactly the costs of TransPRK cover.

Here are some questions you should ask:

  • Does the price include GST?
  • Is it for one eye or for two eyes?
  • What is the experience of the surgeon doing the procedure, is he a veteran surgeon with Lasik experience on over thousands of eyes?
  • What is the type and model of Excimer laser used to carry out the procedure?
  • Are the medication costs and post-op review charges covered?

Hope this helps!

30 Jul 2018

If you are considering laser vision correction but you have dry eyes or tend to rub your eyes a lot, then TransPRK is the most ideal laser vision correction method for you.

This is because TransPRK has the lowest risk of dry eyes and zero risk of cornea flap dislocation complication.

Unlike the other laser vision correction methods, TransPRK do not cut any flap or internal lenticule making it a true no cut procedure. There is thus also no cutting of the thousands of cornea nerve endings.

As such, there is zero risk of flap complications simply because there is no cut flap. For these reasons, advanced surface ablation laser vision correction procedures such as TransPRK is the only military-approved laser vision correction procedure.

30 Jul 2018

It is a myth that the recovery process for TransPRK is “much slower and really uncomfortable”. With modern TransPRK, the cornea treatment surface area is only about a small 8 mm diameter area.

After treatment, a protective high oxygen permeable contact lens is placed immediately upon the treated cornea surface to protect and to promote good and fast surface healing for four to five days after which it is removed. At the same time, NSAID eyedrops, antibiotic and steroid eye drops are prescribed.

recovery process lasik singapore

Following TransPRK, most patients will experience discomfort and transient blurring that is described as mild and tolerable. This lasts from 2 to 3 days. Almost all patients go back to work on the 5th day after the protection contact lenses are removed.

With modern TransPRK, only a minority of patients will describe the discomfort as moderate or beyond.

TransPRK patients recover faster from post-op dry eyes and often feel no need for lubricating drops after two weeks. They can also resume active rugged sports earlier. For example, a MMA or boxing enthusiast can even resume full sparing after two weeks.

However, all TransPRK patients have to be careful to wear eyeshades when outdoors in the sun and to use the prescribed eye drops to prevent cornea haze for six weeks.

30 Jul 2018

A main concern for glaucoma patients undergoing other laser vision correction procedures like LASIK or ReLEx SMILE is the use of the suction ring intra-operatively, which will cause a sustained increased eye pressure for a minute and this may cause irreversible damage to the already damaged optic nerve.

However with TransPRK, there is no suction ring device applied to your eyes. If your glaucoma is mild to moderate and is well-controlled with medications, you should be suitable for the TransPRK procedure even if you have glaucoma.

Of course, if you are considering the TransPRK procedure, you should first go down to the clinic for a detailed eye evaluation and a consultation with your eye surgeon. He would be the best person who after assessing your eyes’ condition decide if your eyes are suitable or not for the procedure.

30 Jul 2018

In fact, to the contrary, with wavefront correction TransPRK you can look forward to better night vision than before!

The reports that you have read online are probably reports on early PRK surgery that precedes modern wavefront TransPRK. There are no scientific studies to date stating that modern TrransPRK can cause poorer night vision.

My experience is that patients with pre-existing night vision complaints may still have similar complaints after laser vision corrections be it LASIK or TransPRK. This is because these patients may have inherent contributing factors such as abnormally large pupils in the dark or abnormal retinal sensitivity.

30 Jul 2018

You should first consider if you are one of those who like to rub your eyes or who intend to do rugged contact sports. If yes, then TransPRK will be strongly recommended over LASIK as with TransPRK there is no cut flap and thus no fear of incurring flap dislodgment or dislocation injury.

This is why MMA enthusiasts and professionals alike seek TransPRK as their preferred procedure of choice. TransPRK is also a Singapore military approved procedure unlike LASIK.

Next you should consider your risk aversion towards developing dry eyes. Of the various modern laser vision correction procedures, LASIK has the highest risk of post-op dry eye complications that may in some cases become a chronic lifelong problem.

This is because in cutting the open cornea flap, LASIK cuts off the nerve endings of the thousands of nerves innervating the sensitive cornea.

With TransPRK, there is no cut nerve endings and it has the lowest risk of dry eye complications. In my experience with thousands of patients, TransPRK patients do not have dry eye complaints two weeks after surgery.

Next you should consider your risk aversion towards developing a flap-related post-op complication. Despite the advances of modern LASIK, cornea flap related complications still remains the main cause of significant post-LASIK complications.

If you do active sports or lifestyle activities, the risk of sustaining a flap-related trauma or problem is naturally higher.

With TransPRK, there is zero risk of flap related complication as there is no simply no cut flap.

Finally you should consider your ability to take medical leave for four days after the procedure and to stay away from outdoor activities in the strong sunlight for at least six weeks. This is because TransPRK has the disadvantage of requiring a longer period of medical leave as compared to LASIK and you have to be careful to avoid exposure to UV rays for six weeks post-op.

30 Jul 2018

As with any surgical procedure, infection is an important complication to watch out for. That is why all patients are advised 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 rest and recuperate in the clean confines of their own home.

After the procedure, patients must adhere to the regime for instilling the antibiotic and steroid eye drops. Fortunately, the overall risk of a serious eye infection following TransPRK is extremely low at 1 in 5,000 eyes.

The other complication to watch out for is cornea hazing. With modern TransPRK, this is very unlikely to happen as the eye surgeons will use Mitomycin C 0.02% intra-operatively and also prescribed steroid eye drops to use for six weeks or more.

Cornea hazing will happen if the patient is not compliant to follow the post-surgery steroid eye drops regime or when the patient ignore the instruction to avoid outdoor activities in the hot sun and wear eye shades when outdoor in the sun for six weeks post-op.

30 Jul 2018

Dear Angeline,

Presbyopia occurs naturally as people who are around 40 years old, as the natural lens harden and muscle fibres becomes less flexible. As a result, you may feel that it is increasingly difficult to look at objects close to you.

Even if you have undergone LASIK before, it may still be possible for you to opt for presbyopia correction to reduce your dependency on glasses. However, the suitability for the correction would greatly depend on the remaining cornea thickness that you have left.

The most common strategy for presbyopia correction is the Monovision treatment, also known as the "Blended Vision treatment". In this case, your dominant eye will be corrected to see clearly for distance (objects far away from you), and your other, the non-dominant eye, will be corrected to see better for near vision (objects near to you). If the difference in both eyes' refractive powers are kept to 150 degrees or less, the "Blended Vision phenomenon" will occur as both eyes will complement each other to see both far & near at the same time.

If you would like to opt for presbyopia correction, you would have to bear in mind that presbyopia is a progressively dynamic condition, and that there are no treatments that can treat or cure the condition as of now. What doctors can offer are compromised solutions to the presbyopia problem to help you reduce your dependency on your glasses.

12 Nov 2018