The first step, ideally, is research. You can also phone or e-mail us to ask questions or to order a free brochure. Don’t forget to ask you doctor for another opinion on refractive eye surgery.
Before going any further, you need to find out whether you qualify for the surgery. If you live in or near Vancouver, you can call us to schedule a consultation. When you come for this appointment, it is helpful to bring us your prescription (or have your doctor fax it to us in advance). We will examine your eyes to ensure that you are a good candidate for the treatment. You will be shown an educational video, discuss the risks and benefits of refractive surgery with a patient counsellor, and then meet with our surgeon. Our goal is to help you develop a full understanding of your condition so that you can make an informed decision about whether to proceed with the surgery.
If you unable to visit us for a consultation, then you can discuss refractive surgery with you eye doctor (optometrist or ophthalmologist) before booking your surgery with us. If you do not have a regular eye doctor, we may be able to recommend one near you home. Have your doctor fax us your prescription and other relevant information.
If you qualify and decide to proceed with the surgery, the next step is to schedule the surgery appointment. We recommend that patients take at a week away from work or studying. Also, keep in mind that you will probably be unable to see well enough to drive for a few days after the surgery.
The cost for surgery depends on your prescription. Cost includes your pre-operative tests on the day of surgery, one-day post-operative check up and patient care kit. You must also arrange for follow up care with an eye doctor. If your regular eye doctor is unavailable for this purpose, we may be able to help you find another. Note that follow up care is a separate cost; please enquire with you regular eye doctor to determine their fees.
Since contacts lenses tend to warp the cornea slightly, time is needed for the cornea to relax into its natural shape to ensure maximum accuracy during refractive surgery. Hard or gas-permeable contact lenses must be removed at least one month before surgery. Soft contact lenses must be removed at least 5 days before surgery.
On the day of surgery, another eye examination is performed to help us re-confirm the exact details of the modifications to be made to your eye(s). This information is then programmed into the system which controls the laser. All consent forms and full payment for the procedure is due on the day of surgery.
After the initial examination, you are brought into the preoperative room where you will be prepped for surgery. Instructions and expectations will be reviewed by a surgical technician. Anesthetic eye drops will be applied to the surface of the eye(s). You are then brought into the laser room and positioned comfortably under the laser. During the procedure, there is a blinking fixation light which you are instructed to look at. There are several key steps in the procedure, such as when the laser is firing, when it is especially it is especially important to look steadily at the fixation light. The non-operative eye is patched to help you concentrate.
In a PRK operation, an eyelid holder is put in place to help keep your eye open. Then the surgeon places a few marks on your cornea and removes the epithelium (outer skin) with a laser. During this time, the fixation light appears to distort and to move around.
In SmartSurfACE PRK, an eyelid holder is put in place to help keep your eye open. The laser then takes over. The laser tracker finds your correct eye position and the corneal surface is sculpted by the laser, completely touchless! The laser makes a clicking or buzzing sound as it fires. The amount of time the laser is fired is approximately 40 seconds, depending on the degree of correction. If our eye wanders during this time, no worries as the laser tracker will still track your eye throughout surgery to have a perfectly centered treatment. When the laser is finished, the surgeon places a contact lens on your eye as a bandage, and then removes the eyelid holder.
If you are scheduled to have both eyes done on the same day, the second eye is done immediately after the first. When the surgeon finishes the operation, you are taken into a nearby examination room for further testing.
A patient counsellor will review post-operative instructions and you are given a kit with post-operative medications.
Following surgery, you are encouraged to go home and rest. The next day you return for a post-operative check by your surgeon. If you do not live in the Vancouver area, we ask only that you stay overnight in Vancouver so we can monitor you the next day. (We can supply information on accommodations).
You may experience some temporary discomfort within the first 24 hours after surgery. Your kit contains ophthalmic drops to promote the healing process. The drops should be taken as instructed but could vary with each patient. We will have a detailed post–operative instruction sheet which we go over with you before you leave.
Immediately after surgery, SmartSurfACE PRK, the vision is remarkably functional! After lubricants, vision is usually good enough to check your phone for emails and messages. You may also exercise today. The key is to avoid getting sweat in your eyes. To avoid this, usually a cap or sweatband works well.
Blurriness often gets worse over the course of the third or fourth day. Do not expect to see well enough to drive during this time. You may also experience extra light sensitivity. You should wear good sunglasses outside during the daytime.
Avoid poking or rubbing your eye(s). Also avoid getting any water in them as it may contain contaminants. When taking a shower, keep water-tight goggles on. We recommend after showering with goggles to dry your hair, face and rims of the goggles prior to taking you goggles off. This prevents tap water from getting into your eyes. Swimming pools and hot tubs should be avoided for two weeks.
After the first day there is usually no more discomfort. One week after SmartSurfACE PRK you must visit your doctor to have your bandage contact lens removed. We do not recommend removing the contact lens yourself because the newly-healed surface is still susceptible to possible infections. At this time, SmartSurfACE PRK patients will begin a two month regimen of steroid drops to control the healing your eye.
Vision after SmartSurfACE PRK is not good enough to drive for the first few days. Noticeable daily improvement usually begins around the fifth day, and continues for several weeks.
After SmartSurfACE PRK, it can take as much as three months for your vision to stabilize. Steroid drops must be taken strictly according to the prescribed regimen for up to two months. Deviations from this regime may contribute to haze and/or regression.
You should see your doctor one month, two months, three months, six months and one year after surgery. This is important after SmartSurfACE PRK to see whether the steroid drops are causing an increase in eye pressure, and to deal with this if necessary.
For most patients, this is the end of the story; complete freedom from or less dependence on, glasses or contact lenses.