Vision Enhancement

Laser & Refractive Surgery

Dr Andrew Apel is an accomplished, highly-esteemed refractive surgeon. There are many different surgical approaches available to correct vision errors, which enable patients to enjoy clear vision without the need for glasses or contact lenses. Patients with long-sightedness (hyperopia), short- sightedness (myopia), astigmatism and presbyopia may all be suitable candidates for surgical vision correction. An eligibility assessment is required to determine whether there are any exclusion factors present, and to determine which surgical approach is most appropriate for the individual.

Important Information About Laser and Refractive Surgery Consultations

  • Allow 1 hour for the assessment
  • Wear your spectacles
  • Leave your soft contact lenses out for at least 3-4 days prior
  • Leave RGP/hard contacts/Ortho-K lenses out for at least 2-3 weeks prior
  • Bring sunglasses: your eyes will be sensitive to the light and glare
  • DO NOT DRIVE after the assessment as your pupils will be dilated. During the assessment we use eye drops which will dilate your pupils. This effect can last up to 24 hours. Reading vision will be blurry for 3-4 hours.

Laser Surgery

Popular laser surgery techniques available include LASIK (laser assisted in situ keratomileusis), SMILE (small incision lenticule extraction), and PRK (photorefractive keratectomy) Surface LASIK. There has been much research into which approaches are safest and provide the best long-term results with minimal risk to the patient. PRK Surface LASIK is a revolutionary laser surgery procedure. It is flap free, blade free, and a biomechanically superior laser approach then other techniques available. A greater percentage of patient’s are suitable for this procedure than traditional LASIK or SMILE.

In PRK Surface LASIK, the eye is anaesthetised using local anaesthetic eye drops. The surface epithelial cells on the eye are gently removed and a laser is used to reshape the cornea and remove the refractive error. The procedure takes about 10-15 minutes, and recovery is about 3-5 days while the epithelial cells regenerate.

Other laser surgery approaches involve creating a corneal flap or using a blade to cut the cornea, while PRK Surface LASIK is a flap free and blade free technique. Because the biomechanical strength of the eye is unchanged following surgery, the cornea is not structurally weakened. This means that any blow to the eye or other type of eye injury can be treated as if the eye never had surgery. This would not be the case for eyes treated with traditional LASIK or SMILE.

The procedure takes approximately 20 minutes to perform, though you will be at the day surgery for around 2-3 hours. Anaesthetic eye drops are used to numb the eye, and a mild sedative given to keep you at ease during the procedure. The most common side effect of PRK Surface LASIK is that patients may experience some dryness of the eye in the months following surgery, which is easily managed by the use of artificial lubricating eye drops until this subsides.

PRK Surface LASIK is performed at

QLD Laser Vision Centre
33 North Street
Spring Hill, QLD, 4000
Get directions

To have your free suitability assessment please call (07) 3831 8299 or TOLL FREE 1800 662 020 or visit the Queensland Laser Vision website.

Intraocular Contact Lenses (ICLs)

This procedure is a great alternative for people who are not suitable for standard laser surgery. Some reasons people may not be suitable for laser treatment include thin corneas, dry eyes, or large pupils. We can treat high degrees of short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism using ICLs. Implantable Contact Lenses (ICLs) are like a permanent contact lens, except that the lens is placed inside the eye, rather than on the surface. The procedure is a day surgery.

Recovery is about 48 hours off work and one week off strenuous exercise. Once implanted, the lenses will remain there indefinitely, however if vision changes over time, they can be removed or replaced.

Refractive Lens Exchange

Refractive lens exchange (RLE), also called “clear lens extraction”, may be a better option than PRK Surface LASIK or Implantable Contact Lenses for people with presbyopia and high hyperopia (farsightedness).

RLE replaces your eye’s natural lens with an artificial intraocular lens (IOL) to correct your refractive error and achieve sharper focus, reducing your need for reading glasses, bifocals or progressive lenses.

The procedure for RLE is virtually identical to cataract surgery. The difference is that in RLE, the lens being replaced is clear, rather than a cloudy lens due to a cataract. As a bonus, patients who have RLE surgery will never develop a cataract, as the natural lens where a cataract would develop has been removed.

Intraocular Lens (IOL) Implants

As in cataract surgery, two types of IOLs are available to replace your natural lens, depending on your vision needs and the health of your eyes. They are:

  • Monofocal IOLs. Monofocal lenses provide clear vision at distance, intermediate or near ranges — but not all three at once. Toric IOLs to correct astigmatism also are classified as monofocal IOLs.
  • Multifocal IOLs. These implants are highly specific and customised to the individual, providing clear vision at distance, intermediate and near simultaneously. They can also be used to correct astigmatism.

    These implants work differently from multifocal/progressive prescription glasses, in which the prescription changes from the top to the bottom of the lens. In Multifocal IOL implants, the powers are distributed in concentric rings throughout the lens. This allows independence from glasses for all viewing distances without the need for conscious thought about head or eye positions.

The pre-op workup for RLE patients is a crucial component to ensuring the desired visual outcome is achieved. A number of highly specialised instruments are used to collect precise information about your eye, which allows for accurate calculation of the intraocular lens that will be placed in the eye during surgery.

We encourage patients to who wish to understand more about their options for post refractive surgery vision outcomes to make an appointment with our Clinical Optometrists for further discussions.

About Refractive Lens Exchange Surgery

Refractive Lens Exchange usually takes about 15 minutes and is performed on an inpatient day procedure basis. Each eye is done separately. There are no stitches or patches required during the surgery. Recovery is about 48 hours off work and 2 weeks off strenuous exercise.

Numbing anaesthetic drops and twilight anaesthesia are used during RLE, so typically there is no discomfort, and most people report immediate vision improvement after surgery. Full vision recovery takes about 48 hours once the pupils have returned to a normal size again.

After Surgery

Final visual outcomes of RLE can take up to several weeks, and you may notice vision disturbances such as blurry vision, halos and glare, or a “scratchy” sensation as your eyes heal. You should be able to return to work and resume driving within a week of surgery, dependent on the individual circumstances.

Normally, you won’t feel an IOL in your eye, in the same way that you don’t feel a dental filling for a cavity. Also, since the IOL is situated inside your eye and not on the surface like a contact lens, it is not visible to the naked eye.

The artificial IOL is a permanent replacement for your natural lens and is designed to last the rest of your life. Additionally, as IOLs are not affected by age-related changes, there is minimal risk of regression (loss of corrective effect or deterioration of vision) over time.

Dr Andrew Apel and his Clinical Optometry team have perfected the Refractive Lens Exchange technique and are proud to deliver consistent, superior clinical results and excellent patient satisfaction after the surgery.

An external audit on The Eye Health Centre’s clinical results and patient satisfaction on vision outcomes for patient’s receiving multifocal intraocular lenses is currently underway, as we are proud to present the consistent success of this refractive surgery option. The results will be published on the website in late 2019.

Disclaimer

No procedure is entirely risk free. Adverse effects from any eye procedure include infection, bleeding and further eye problems. Dr Andrew Apel and his staff will be happy to discuss these with you at any time. The information provided on this website is for general education only and should not be construed as individual medical advice. For advice relevant to your particular situation, please speak to Dr Andrew Apel.