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Thinking of Lasik in a low myope is no different from deciding on refractive surgery for anyone else. Its best to choose an ophthalmologist that you trust to give you considered and tailored advice to your complete examination findings.
Yes, atropine 0. 01% is indeed licensed and legal in Singapore, and dispensed by private and public eye centres, such as the Singapore National Eye Centre. Do note that it is NOT used to TREAT myopia, ie it cannot REVERSE myopia. It’s purpose is to PREVENT the worsening of myopia in children, typically from the ages of 6 – 12 years old. The reason why it’s not available in other countries, is likely because Singapore was one of the first countries to demonstrate that very low dose atropine (0. 01%, as opposed to 0.
The fundamentals of laser surgery for myopia correction are heavily dependent on 2 factors – firstly the level of myopia, and secondly the thickness of your cornea. Conceptually, the higher our myopia, the more corneal tissue will be removed. Even with today’s advanced technology, LASIK can correct up to -10. 00 of myopia. Hence, if your myopia is more than -10. 00, it is likely that after LASIK, you will have some residual myopia. There are other options available which caters to individuals with myopia higher than what LASIK can correct. One option is Implantable Contact Lens.
Yes, generally speaking, the risk of regression is somewhat higher the higher a patient's pre-existing myopia before undergoing LASIK. Factors contributing to this include the fact that the corneal shape is changed more for high corrections, and also because some very high myopes may not fully stabilise even when they get older. Having said that, how high is high? Different studies give different results, but it is my experience that most patients with myopia up to around -7D or -8D (700-800 degrees) still get very good results.
Hi KennethAs the other doctors have pointed out, refractive surgeries such as LASIK and Implantable Collamer Lens (ICL) surgery are generally done for people who are above 21 years of age, and on a case by case basis for those between 18-21 years of age depending on stability of spectacle power. Having said that, the 2 main treatment options for high myopia and high astigmatism would generally be LASIK and ICL surgery.
This is a common question. It's important to stress that long-sightedness affects all of us after the age of 40 years. This is due to the loss of the lens-fiber elasticity so the normal lens in our eye loses the ability to change its refractive accommodative power (hence becomes unable to read / see near objects). Unfortunately there is no procedure that is able to correct the loss of lens flexibility.
In my clinic, patients with borderline LASIK suitability test results using cornea topography and tomography (i. e. cornea mapping) are usually carefully counselled before options presented for consideration. The possible options, depending on the post-LASIK ectasia risk profile, are: LASIK-EXTRA, LASEK, LASEK-EXTRA and ICL (implantable contact lens). SMILE-EXTRA had been tried out before too, although currently it is still much rarer than the other options, due to limited experience in the medical community.
Hi Karen! Thanks for reaching out. Your myopia sounds very severe! It’s important in patients who report severely high degrees of myopia to consider concomitant ocular or systemic disorders including Marfans, Weil-Marchesani, Sticklers / Wagners syndrome etcetera. Such conditions don’t automatically disqualify you from refractive surgery, however a comprehensive assessment would be required to exclude these conditions. Even patients with severe myopia alone may have concomitant problems like retinal holes or detachment, early cataracts or retinal pathology.
Yes you are still a possible candidate for LASIK! While it is true that you will need evaluation of your cornea thickness to be absolutely sure whether you qualify for LASIK, you can be assured that your high myopia does NOT make the outcome or experience worse for you. LASIK has been done successfully for people with high myopia up to 1800 degrees. And yes, adjunctive cross-linking treating is also an option which is beneficial for even those without high myopia.
Your predicament is understandable. High myopia and astigmatism may be more challenging to treat when cornea thickness is not adequate. You may want to firstly find out why you are not suitable for ICL, as it is a better option for very high myopia and astig if you fulfill the anatomical requirements for ICL. Tissue-saving LASIK is a treatment offered by some LASIK excimer lasers (the flying spot lasers). Depending on the excimer laser used, the cornea tissue thickness requirement may be a little different. So, checking with a clinic that uses a different laser system may not be a bad idea.
Absolutely! The beauty of modern cataract surgery is that with new lens technology, and advanced IOL-calculation formulae, we are more precise and accurate in arriving at our desired refractive end-point, especially for patients with previous refractive surgery. This means that post-cataract correction of myopia, astigmatism and presbyopia is more precise than it has ever been in the history of medicine.
Hi Wxuan97, Myopia in excess of -1000 degrees is certainly fairly extreme. In every patient considering refractive surgery, you should have a detailed eye assessment and detailed discussion with your ophthalmologist to determine the most suitable options available to you. Many patients find that if there is sufficient anterior chamber depth in their eye, an implantable collamer lens to correct their vision is an excellent, and safe option for them.
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: 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.
Looking at your question in totality, it appears that you have high myopia and want to achieve perfect eyesight with low risk of regression after refractive surgery. There are many great options available today, and if spectacles / contact lenses are not your thing, and you are considering surgery then any laser option with the combination of collagen cross-linking procedure (epilasik-extra, lasik-extra, smile-extra) or implantable collamer lens all offer the opportunity for excellent spectacle-free vision with low risk of regression.
Both Lasik and epi-Lasik are great options for visual rehabilitation in high myopes. Most people perform Lasik if they are suitable for it, as the visual recovery is much faster, and the time to stable refraction is much faster in comparison. However not all patients who are high myopes are suitable for Lasik. The main consideration is that of the corneal thickness. If the residual corneal thickness after Lasik is insufficient for stable corneal refraction in the long term, then Epi-Lasik is an alternative that patients consider.