Laser eye surgery — will it do more harm than good?

Monday, November 13, 2006
There's nothing our reporter Dr Andrew Rochford loves to do more than getting out on the court and shooting a few hoops. But without his glasses — he's rubbish!

"Well, I can do a lot of things without my glasses, but clearly basketball isn't one of them. I've tried contact lenses — they don't work for me either. So there's one last thing, laser eye surgery. But it has always scared me. Is it safe? How do they do it and does it really work? Well there's only one way to find out. I'm going to get it done," says Andrew.

Amazingly, almost 50 percent of Australians can't do without the specs. The alternative is contact lenses, but they don't suit everyone — they can fall out, irritate your eyes or even cause infections.

But imagine being able to throw the whole lot away! Well, here's a bloke who's going to show Andrew how.

Dr Darryl Gregor is an ophthalmologist on the Gold Coast. It doesn't take Darryl long to discover Andrew's myopic. In other words, short-sighted. But the doc reckons he can fix it with the latest in laser eye surgery.

"We've actually made it much simpler, and much safer and much easier for the patient," says Dr Gregor.

And here's how it works. A laser cuts a flap in the front of the eye. The flap's folded back and a second laser reshapes the cornea to make a lens that's the right shape and focus. Then the flap is put back. So how risky is it?

"There's a one in 5000 chance you might get a terrible infection in your eye and you could even potentially lose your eye," says Dr Gregor.

Hang on. Did he say lose an eye? That's pretty serious. Andrew also discovers he could end up seeing halos around lights at night.

Andrew: "This is more risky than I thought"

What else could go wrong?

Andrew: "Will I have to wear glasses again?"
Dr Gregor: "Yes you will, when you're about 43, you will need glasses for reading, whereas if you didn't have the surgery, you wouldn't need glasses for reading."
Andrew: "So the trade-off is I don't wear glasses at all between now and my mid-40s, but when I reach mid-40s I'll need reading glasses."
Dr Gregor: "Yes you will."

Like everyone, Andrew's eyesight is going to go downhill when he is in his mid-40s. But that still potentially gives him 15 or 16 years without glasses.

Andrew: "Definitely worth it!"

Mind you, some people's surgery only lasts half that time. Priya Chandra lined up for her laser surgery back in the '90s.

"After I had both eyes done it was just so liberating to be able to open my eyes and see without the aid of contacts or glasses."

But only eight years later, Priya's eyes started going back to how they used to be.

"Nowadays I'm finding I have to wear the glasses much more often, to watch movies, even during the day to drive. It's becoming more common for me to wear glasses than not. I don't have any regrets about doing the surgery, none whatsoever, it just helped me so much," she says.

And now it's Andrew's turn. But is he ready?

Surgery day

"So it all feels not real. I still feel like I'm just doing a story, it's not actually me who's about to go and get the surgery. So it's still freaking me out a bit, but anyway I'm sure it will all be fine."

So it's scrub up, and eye drops in.

"As I head into the operating theatre, the thought rolls through my head. One in 5000 people get complications from this and I really hope I'm not going to be one of them," says Andrew.

"I don't mind admitting, this is all pretty scary."

Dr Gregor: "So a little gadget now just to hold your eyelids apart, so it's mildly uncomfortable, [but] it shouldn't worry you much at all"

Andrew: "This is totally surreal … I've got local anaesthetic in my eyes, my face is numb … and I'm fully awake for the whole thing — I suppose it's too late to back out now!"

Dr Gregor: "You can see a little wave of bubbles go across in front of the eye as the flap's created."

Andrew: "Everything's gone completely black. I can sort of feel something's happening to my eyes. But there's no real sensation. It's hard to believe a laser is actually cutting into my cornea and changing its shape."

Dr Gregor: "Andrew, that's your left eye all done, so we're just going to repeat the same process now on the right eye."

Soon enough, Andrew's right eye is plunged into darkness. Twenty minutes after it began, the operation's over.

And the good news? Andrew's vision is slowly starting to return.

Dr Gregor: "We'll get you to sit up now, so it's like looking through smeary glasses … but you'll be able to see a little bit out of it."

Nurse: "What can you see on the chart there Andrew?"

Andrew: "This is weird. I'm seeing letters here that I could never have seen without my glasses before."

Andrew needs to wear see-through covers over his eyes, for the next 24 hours, to protect them from germs, but other than that, it's all over.

Andrew: "I'll admit to feeling a little bit overwhelmed … I think tomorrow morning is when all that roller-coaster of what I just went through will fade away and hopefully I'll be able to see. But for me, that's what the experience of laser eye surgery was. Now I just really need to close my eyes."

Twenty-four hours later …

It's the morning after Andrew's Lasik eye surgery to correct his short-sightedness.

A quick check in with Dr Gregor to see if things really are as good as they seem.

"I'm really happy with Andrew's operation, it went so well. The eyes look perfect this morning, no inflammation, everything just looked really good and he saw the 6/6 or 20/20 line [on the] chart and I don't think there's anything this operation will limit him from doing in his future life," says Dr Gregor.

Now, if you're thinking of getting laser surgery for your eyes, bear in mind that it doesn't suit everyone.

  • You need to be over 18, and your sight needs to have been stable for two to three years.
  • You can't have cataracts and you can't be pregnant, because your eyes change shape during pregnancy.

And remember, ophthalmologists are the only people who can do the operation.

It'll cost around $3000 per eye and, sorry folks, it's considered cosmetic, so Medicare doesn't cover it.

A week later …

It's a week after the operation and Andrew's back on the court, shooting hoops — even getting a few in!

So his decision wasn't a bad one, at least, so far.

"What the future holds for my eyesight, I'm not sure anyone can give me a definite answer. But for me, the benefits they far outweigh the risks. You might feel differently, that's the beauty of your health — the decisions are entirely up to you," Andrew says.

Fast facts

  • Did you know that colour blindness affects one in 10 men, yet only one in 200 women? It's genetics. Take red-green colour blindness, it's linked with a defective X-chromosome. Since the ladies always have two X-chromosomes, the chances of both being defective are much slimmer than for blokes, who only ever have one.

  • What is it with "red eye" in photos? What causes it, and how can you avoid it? It's because light reflects off the blood vessels in your retina when your pupils are wide open. That happens when it's dark or if you've been drinking alcohol. So try turning some lights on or take photos earlier in the night, when people have had less to drink.

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