Marsden Eye Specialists

Your gateway to better vision begins here at Marden Eye Specialists.



	LATEST NEWS Home www.marsdeneye.com
	Email: admin@marsdeneye.com

	Practice Hours:

	Monday - Friday 8am to 4:30pm

Contact numbers:

Parramatta:02 9635 7077
Castle Hill: 02 9634 6364 Penrith: 02 4731 1811
Lasik Clinic: 02 9635 6964

Free Lasik
Consults are available.

	1. Introduction
	2. Our LASIK Specialists

	3. Frequently Asked Questions
	4. Relevant Information For Your LASIK Procedure
	5. Our LASER & Technology
	6. Our Patient's Experience and Results

4. RELEVANT INFORMATION FOR YOUR PROCEDURE

LASIK:

A.		What is Lasik?
B.		Pre-operative information
C.		Post-operative information
D.		Patient Informed Consent

REFRACTIVE LENS EXCHANGE:

What is Refractive Lens Exchange?

PRK / PTK:

A.		What is PRK?
B.		What is PTK?
C.		Pre-operative information
D.		Post-operative information

1. What is Lasik?

A. What is The Lasik Procedure?
At the Marsden Eye Laser Clinic we use the latest laser technology procedure and equipment available. The preferred technique used at the clinic is LASIK (Laser Assisted in-Situ Keratomileusis) which is safe, quick and virtually pain free. It involves creating a "flap" of the cornea with a specialised instrument called the microkeratome. Once the flap is made a light beam from a cold laser (eximer laser) reshapes the cornea to each individual's needs for short-sightedness, long-sightedness, and astigmatism. The flap is then replaced to its original location, bonding securely, without the need for stitches. The eye heals within the first 24 hours and patients can generally resume work the day after surgery.

B. Pre-operative information:
Please note the following instructions in preparation for your LASIK procedure:

The DO NOTs:

•		Do not plan to drive after your procedure. We strongly recommend that you have an escort to take you home.
•		Do not wear your hard contact lenses for 4 weeks and no soft contact lenses for 1 week prior to your procedure.
•		Do not wear any eye make-up, perfumes or after-shave lotion on the day of your procedure.

The DO's:

•		Do wash your hair and face before your procedure to comply with theatre requirements
•		Do wear comfortable warm clothing (no woollen or fluffy jumpers).
•		You may eat a light meal and fluids before your procedure.
•		Do plan to have a restful day and evening after your procedure.
•		Do come back for your 1-day, 1 week, 1 month, and 3 months post-operative consultations.

PLEASE:

•		Please complete and bring back the Lasik consent form with you on the day.
•		Please bring a pair of non-prescription sunglasses with you on the day.
•		Please note that we will call and confirm your Lasik surgery time, 1-day prior.
•		Please note that the total fee is payable on the day of your procedure.

During the Lasik procedure:

•		You may be required to spend about 1 – 1.5 hours at the Marsden Eye Laser Clinic.
•		A tablet will be given to help you relax prior to the procedure.
•		The Lasik procedure takes approximately 5 -10 minutes for each eye.
•		Pre-operative administration and preparation takes about 20 minutes.
•		You will be in the operating theatre for approximately 10-15 minutes.
•		After your Lasik procedure, you will be offered tea or coffee and rested for about 10-15 minutes.
•		Your eyes will be checked under the microscope by the surgeon prior to discharge.

C. Post-operative information:

•		We strongly recommend you go home and rest or go to sleep after your procedure.
•		It is normal for your eyes to feel gritty, scratchy or watery, however these symptoms will improve every hour. Any significant pain is unlikely to occur, if they do please take some Panadol or equivalent.
•		For the first two weeks:
•		Do NOT rub your eyes
•		No swimming
•		No eye make up
•		Try and avoid smoky or dusty environments
•		Avoid contact sports or long overseas air travel
•		Normal activities including driving can be resumed 1-2 days after Lasik. However, the recovery process varies from patient to patient so take particular care when driving.
•		Remember to contact the RTA to amend your license if it currently states that you wear glasses or contact lenses.
•		Enjoy your newfound independence from your glasses and /or contact lenses!

D. LASIK Consent Form

Although the majority of patients who have had refractive surgery are extremely happy with the result there are complications that can occur in approximately 1% of patients. These complications include:

PROBLEMS WITH VISION:

1		There is a small chance that after surgery your best-corrected vision may be slightly worse than it was prior to surgery.
2		The outcome of vision can be predicted fairly accurately for those patients with "middle range" of myopia (short-sighted), hyperopia (long-sighted), and astigmatism. With higher ranges it is less predictable and therefore may be slightly under or over corrected. Although the majority of patients who have refractive surgery can legally drive a car without glasses or contact lenses, there may be a need for some patients to wear glasses/contact lenses for certain circumstances e.g. night driving or close work.
3		An enhancement is possible on most patients who are under or over corrected. It is required in approx 5% of patients and involves the lifting of the existing flap. The risks involved with an enhancement are essentially the same as those with the original procedure.
4		A relatively common complaint with post-refractive patients is experiencing difficulties with night vision. These patients usually report seeing halos or "scattered light" around headlights of cars. For most people this is only temporary.
5		Some patients experience a reduction in their quality of vision in different lighting situations e.g. dim lights. This occurs more in higher prescriptions treatments.
6		Laser surgery does not correct age related decrease in near vision (presbyopia). Presbyopia is a condition that occurs around the age of 45 when the lens inside the eye no longer has the ability to focus for near.
7		Lasik surgery may cause dry eye symptoms post-operatively. This is helped by the use of artificial tear drops after your procedure.

DURING SURGERY
Most complications involve the creating of the flap. Although this is rare, a serious complication may affect your best-corrected vision.

•		Incomplete flap – this is where a flap is made partially and has exposed some of the corneal surface. The surgeon may decide that the surgery can still be performed safely (if the area exposed is large enough for the laser) or may decide to postpone the surgery for a later date.
•		Free flap – this is where the entire flap has been removed. The surgeon will decide whether surgery is possible on the day. The flap can usually be replaced without any complications; however, in rare cases this may cause distortion in the vision.

AFTER SURGERY:

•		There is a chance of infection with any surgical procedure. A severe infection after refractive surgery may cause partial loss of sight, complete blindness or the need for a corneal transplant.
•		Epithelial cell ingrowth may appear underneath the flap and cause a reduction in vision. If this occurs, the flap can be lifted and the cells be cleared.
•		Inflammation may occur and cause distortion or reduction in the vision.
•		Steroid drops are used post-operatively. There is a very small risk of complications such as an increase of the pressure in the eye, lens opacities, or drooping of the eyelids.

If you have any questions relating to any of the above, please speak to our assistant and/or surgeon.

2. What is PRK?

A. The PRK Procedure
Photorefractive Keratotomy (PRK) permanently changes the shape of the cornea, allowing images to be more sharply focused on the retina. The surgery is performed under topical, or eye drops anaesthetic and involves the use of the highly accurate and precise excimer laser. The eye is exposed to the laser’s cool ultraviolet light beam and high-energy pulses for less than one minute, with no discomfort to the patient. There are no incisions to the eye (like in LASIK where a flap is created). PRK is performed in the comfort and convenience of a laser surgical suite. The goal of PRK is to improve vision to the point of not being dependent on glasses or contact lenses. Hundreds of thousands of patients have had the PRK procedure performed on them successfully, although there are no guarantees. Additional procedures, glasses or contact lenses may be required to achieve fine vision. PRK will not prevent you from developing naturally occurring eye problems such as glaucoma, cataracts, retinal detachment or degeneration.

B. What is PTK?
The excimer laser may provide a novel modality in the treatment of a number of superficial corneal disorders. This treatment is known a phototherapeutic keratectomy or PTK. Whether PTK is used alone or as an adjunctive strategy in traditional corneal surgical techniques, a number of disorders affecting the corneal surface may be successfully treated by taking advantage of the excimer laser's ability to meticulously remove superficial corneal tissue. These include a variety of corneal degenerations and dystrophies, corneal irregularities, and superficial scars. While some of these conditions, heretofore, could be treated by mechanical superficial keratectomy techniques, PTK may minimize tissue removal and surgical trauma. The smoother stromal surface achieved by the excimer laser procedure may improve surface smoothness of the cornea, improve postoperative corneal clarity and decrease postoperative scarring, and facilitate subsequent epithelial adhesion. Moreover, superficial corneal disorders which, in some cases, would otherwise require corneal transplant may be amenable to treatment with the PTK procedure. Unlike the excimer laser PRK or LASIK technique for correction of nearsightedness, PTK treatments will vary with different corneal disorders, and the clinical goals of the procedure may, likewise, vary depending upon the patient's symptoms. However the pre-operative and post-operative care is similar to that of PRK treatments and they follow the same protocol.

C. PRK & PTK Pre-operative Information

The DO NOT:

•		Do not plan to drive after your procedure or for the first 4 days after surgery because the eye may still be sensitive and/or painful.
•		We strongly recommend that you have an escort to take you home.
•		Do not wear your hard contact lenses for 4 weeks and no soft contact lenses for 1 week prior to your procedure.
•		Do not wear any eye make-up, perfumes or after-shave lotion on the day of your procedure.
•		Do NOT rub your eyes for 4 weeks.

The DO:

•		Do wash your hair and face before your procedure
•		Do wear comfortable warm clothing (no woollen or fluffy jumpers).
•		You may eat a light meal and fluids before your procedure.
•		Do plan to have a restful day and evening after your procedure.
•		Do come back for your scheduled post-operative consultations.
•		Take extra care and avoid getting anything in your eyes including water, soap or shampoo for the first 2 weeks.
•		Avoid swimming, wearing eye make-up or applying creams around the eyes for 2 weeks.

PLEASE:

•		Please complete and bring back the Lasik consent form with you on the day.
•		Please bring a pair of non-prescription sunglasses with you on the day.
•		Please note that we will call and confirm your Lasik surgery time, 1-day prior.
•		Please note that the total fee is payable on the day of your procedure.

D. PRK & PTK Post-operative Information

Contact Lenses: To assist with the healing of the surface treatment area, we have placed a bandage contact lens in your eye. The contact lens will aid with the pain and discomfort and it should not be removed. Your doctor will review the surface on your 1-day postoperative visit and may or may not need to remove the contact lens.
Eye Drops: Amethocaine (anaesthetic drop): you may instill one drop to the treated eye ONLY if the eye is in pain

Acular (Anti-inflammatory): instill one drop three times a day to the treated eye until bottle finishes. This is to help reduce inflammation and discomfort.

Tobrex (Antibiotic): instill one drop three times a day to the treated eye for one week.

Cellufresh (Lubricating eye drops): instill one drop three times a day or more into the treated eye for at least 3 weeks.

Celluvisc (Lubricating eye gel): instill one drop at night into the treated eye prior to going to sleep.
Medication: Panadeine Forte: take two tablets to help reduce any pain of discomfort. Allow at least 4 hours between doses. Phenergan (small green tablet): take one tablet to help you sleep.

3. REFRACTIVE LENS EXCHANGE

What is Refractive Lens Exchange?
Refractive Lens Exchange is particularly effective for people with very high myopia (usually greater than 10 diopters), high hyperopia (usually greater than 5 diopters) and are outside the acceptable range for LASIK surgery. Refractive Lens Exchange is essentially the same as the modern cataract extraction however; the natural lens is clear and not cloudy. With classic cataract procedure, the natural lens is cloudy due to age-related changes causing progressive blurring of vision. The procedure involves the removal of the natural lens of the eye and replacing it with an artificial lens of appropriate power to correct for any myopia or hyperopia. Clear lens extraction has a low complication rate but is considered by most ophthalmologists to be slightly more risky than other refractive procedures because it is an intraocular surgery.

What can I expect if I decide to have this type of surgery?
Surgery is usually done as an outpatient basis. You may be asked to skip breakfast, depending on the time of your surgery. Upon arrival for surgery, you will be given eye drops, and perhaps medications to help you relax. You will also be given an anaesthetic. The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your head. When the operation is over, the surgeon will usually place a shield over your eye. After a short stay in the outpatient recovery area, you will be ready to go home. You should plan to have someone else drive you home.

How is the surgery done?
The Refractive Lens Exchange procedure is performed with the same surgical technique as the cataract surgery which is the most common surgery performed in Australia. It involves a small incision made with microsurgical instruments and then with a phaco machine then fragments and remove the clear lens from the eye leaving the back membrane of the lens (called the posterior capsule) in place. A plastic intraocular lens (with the power of your prescription) is then implanted to replace the natural lens that was removed.