How do I go about having SmartSurfACE Laser Procedure (SLP)?
The first step is to determine whether you are nearsighted, farsighted, astigmatic or a combination of the above.
If you have never had any previous eye surgery, we will need information about your eyes including: your eyeglass and contact lens prescription.
If it is determined that you are a good candidate and you wish to proceed, a procedure date will be arranged.
A full pre-op examination will need to be arranged with your own eye doctor, as well as another comprehensive exam at Pacific Laser Eye Centre a few days before the procedure.
What determines my candidacy?
Generally, patients with a myopic prescription and adequate corneal thickness are candidates for the procedure. Exceptions include underlying eye problems and stability in prescription.
Why are hyperopes not good candidates for the procedure?
We do not treat farsighted patients at this time. While we have been involved with international studies of the treatment of hyperopia,
as of now, we are not fully satisfied with the outcome.
What other appointments do I need to make?
There will be several appointments at our office: one pre-op (usually done a couple days before your procedure), one follow up the morning after your procedure, and one 7 days after the remove the bandage contact lens.
There will also be a pre-op appointment at your optometrist’s office (can be done up to 3 months in advance, and no later than 4 days before the pre-op in our office), as well as follow ups 1, 2, 3, 6, and 12 months after the procedure.
I don’t have an optometrist or my optometrist is not open.
We can provide a list of optometrists that we have worked with in the past. Please let us know if you require this.
Do I need to be out of my contact lenses before the procedure?
Yes. This is very important. Prior to your pre-op at PLEC and before the procedure, you must be out of your soft contact
lenses for 5 days, toric contact lenses for 10 days, and hard or gas permeable lenses for 4 weeks or more.
Tell me about SLP and PRK (Photorefractive Keratectomy) and what are the differences?
SLP is a completely touch-less, non-invasive laser procedure. The whole procedure is done by the laser without the surgeon touching, scraping, or cutting the cornea.
After the procedure, a soft contact lens is placed on the eye to act as a bandage for several days until the epithelium re-grows.
The traditional PRK involves the use of scalpels/scrapping to manually remove the outer layer of the cornea (epithelium).
SLP is a quick, touch-less, non invasive-procedure which has faster visual recovery compared to traditional PRK. SLP is especially suitable for patients who play active sports and patients with thinner corneas or complex corneal topographies (maps) (such as keratoconus).
Tell me about LASIK (laser assisted intrastromal keratomileusis)?
We were the first clinic in BC to perform LASIK in 1994. With LASIK, a thin flap of cornea is first created with either a blade or a femto laser. The flap is then lifted and the underlying tissue is sculpted by the laser for the desired correction.
The flap is repositioned without sutures. In the past, the advantage of LASIK was quicker visual recovery compared to traditional PRK.
With the advancement of technology and techniques, the benefit of quick visual recovery with SLP, especially immediately after procedure, is almost equivalent to that with LASIK.
As the LASIK flap does not heal completely, blunt trauma may dislodge the flap even many years after a LASIK procedure. Meanwhile, long term follow-up have shown that LASIK can be associated with ectasia.
This is a rare condition where the cornea weakens uncontrollably and can be only treated with corneal cross-linking or a corneal transplant. Neither of these issues are associated with PRK or SLP.
To summarize, SLP offers higher safety compared to LASIK, with no flap complications, no intra-stromal complications, and no risk of ectasia (excessive weakening of the cornea).
What is a bandage contact lens?
This is a soft, non-prescription contact lens that is placed on your eye immediately after your procedure that acts as a bandage for your eyes to protect them during the initial healing process. This is removed at our clinic or with your optometrist approximately one week after your procedure. You will not need to change or remove the lens yourself.
How much does SLP cost?
The cost of SLP is based on your eye prescription, and a quote will be given to you based on the information we receive when determining your candidacy.
Is SLP covered by my medical plan?
Medical Services Plan does not provide coverage for vision correction, unless medically related.
Some extended health care plans may cover all or part of the cost. It may also be claimed as an expense on your income tax.
Why are your fees higher than some other clinics?
Dr. Lin and Dr. Holland are both corneal surgeons who are pioneers with laser refractive eye surgery. To maintain quality of care, our clinic invests in the newest and latest technologies.
We’re the only centre in North America to use a 1,000 Hz laser versus the traditional 400 Hz. Treatment time is approximately 40 seconds per eye.
The laser utilizes a 7 directional ocular movement tracking system which results in perfectly centered treatments even if the eye moves involuntarily during the procedure.
The results are entered into our database and used to better improve the predictability of future procedures.
Our re-treatment rate is less than 0.4%, offering one of the best results world-wide.
Do I have my post-op check-ups with my own eye doctor?
Yes, Dr. Lin and Dr. Holland work very closely with your eye doctor in your care and management. These important scheduled visits with your eye doctor are usually 7 days (bandage contact lens removal), 1 month, 2 months, 3 months, 6 months, and 1 year after surgery.
How much will my eye doctor charge for these visits?
This is strictly between you and your eye doctor. Please establish this follow up fee with your doctor prior to your procedure.
How long have Dr. Lin and Dr. Holland been doing refractive surgery and how many have they done?
Dr. Lin assisted in the first human laser eye surgery performed at the Louisiana State University in 1988. Dr. Lin also was the first to perform LASIK in BC in 1996. The first Intralase was also performed by Dr. Lin in 2006.
Dr. Holland started laser refractive training in London England in 1987 with Dr. John Marshall, a pioneer and leader in laser refractive procedures. Dr. Holland later received the honour award for the American Academy of Ophthalmology in 1992
Together, Dr. Lin and Dr. Holland have performed over 100,000 procedures.
Can you guarantee 20/20 vision?
Not everyone has 20/20 vision to begin with. SLP can only correct your vision to its best potential. All refractive procedures carry risks and cannot be guaranteed.
We can provide you with our statistics that outline our success rate according to your pre-op refraction. Our clinic’s re-treatment rate is less than 0.4%.
What are the risks?
The greatest risk is the risk of infection during the first week. This is why we place a bandage contact in your eyes to protect them from dust or debris.
You will also need to avoid water in your eyes while the bandage contacts are in. This means showering and bathing with swimming goggles on for the first week.
Eye-rubbing should be avoided. We strongly emphasize the need to wash your hands before touching your face, eyes, or eye drops.
The other two main risks are under/ over correction. A complete consent form is given to SLP patients prior to their surgery date outlining potential risks.
Do I need reading glasses after the age of 40 (approx.)?
Yes. Presbyopia is an age-related change in the lens, unrelated to, and not correctable by refractive treatment. However, the need for reading glasses can be reduced or delayed by under-correcting one eye.
How much time do I need to take off work?
We typically recommend taking one week off of school or work to allow ample time to heal.
Can I drive?
You will not be able to drive during the first week after the procedure while the bandage contact lenses are in.
Can I use my phone/computer?
Yes, even immediately after the procedure, screen use is fine. During the first week, we recommend limiting usage to 30-minute intervals to avoid eye-strain, and frequent use of preservative-free lubricant eye drops to help clear up vision.
What will my vision be like after the procedure?
You will have functional vision immediately after the procedure that is generally better than your pre-operative vision without glasses or contact lenses. However, during the first week, expect fluctuating vision and periods of blurriness. This can be significantly improved with the use of lubricating drops before using any screen time.
For SLP patients, vision may take 1-2 weeks to improve.
How long is the healing period?
While you can go back to school or work one week after the procedure, it may take up to 2-3 months for vision to stabilize.
Is there any pain?
Most patients do not experience significant pain, however during the initial healing there may be slight discomfort similar to an eyelash in the eye. We do recommend taking over-the-counter pain medications to alleviate any discomfort.
Are there concerns with dry eyes after surgery?
During the healing process, you may find that your eyes feel drier than normal. This is alleviated with frequent use of preservative-free lubricant eye drops, and the dryness typically improves as the eyes heal.
What about halos, glares, and night vision problems?
If these are not issues you already have, the procedure generally does not create them. During healing, you may notice vision changes, but they improve with time.
Post-Operative FAQs
When do I have to wear the sunglasses?
The larger sunglasses given on day of procedure should be worn all day, including to bed, until the
following day’s appointment. Afterwards, it is recommended that the smaller pair,
or your own sun-protective glasses be worn for 3 months while outdoors.
Can I look at a screen/phone/etc?
Yes. We recommend keeping screen time to 30 minutes at a time to avoid eyestrain. Make sure to use
preservative-free lubricant eye drops BEFORE reading/ screen-time. It may also be helpful to increase font size.
My vision is very blurry/itchy/eye(s) are irritated right now. Is that normal?
Yes. Your vision will be blurry and fluctuating for the first week. If your eyes are feeling scratchy or
irritated, it is recommended to lubricate more frequently (with the preservative-free lubricant eye drops).
Do I need to keep my eyes closed all day?
Eyes can be kept open or closed as this does not affect healing, just lubricate as often as needed.
Do I need to wear swimming goggles?
You MUST wear the swimming goggles when you shower this week as it is important to not to get tap
water in your eyes while the bandage contact lens is in. Getting water in
your eyes increases the risk of infection.
When can I rub my eyes?
You should NOT rub your eyes at all after the procedure. In the short-term, rubbing increases risk of
infection. In the long-term, habitual/vigorous eye rubbing can be associated with changes in vision and
corneal thinning after the procedure. If your eyes are consistently itchy, please talk to your eye care
professional about eye drops that they can prescribe to help.
When can I start swimming/exercise/sports/etc?
For general physical activity like going to the gym or running, it is okay to resume the same day after the procedure as long as you don’t get
sweat in your eyes (use a sweatband). Most other sports and activities are okay after 1 week (please call us if you are unsure about a
specific activity you would like to resume). Avoid all water related sports until the bandage contact lenses are removed, and there is no pain, redness, or decreased vision.
However, if any discomfort is present, please contact your eye care professional.
I don’t have any pain. Do I have to take the pain medication (Advil and Tylenol Extra Strength)?
We recommend taking both Advil (400 mg) and Tylenol Extra Strength (500 mg) for the first day after the
procedure regardless of pain. After the first day, you may stop the Tylenol Extra Strength, but continue the Advil
for the full 3 days to help with inflammation.
What if I run out of the eye drops prescribed for the proceedure?
Your original prescription has three refills on it — you may go back to your pharmacy to pick up more.
If you run out of prescription drops, please give us or your eye care professional a call.
How can I clean my eyes after the procedure?
With SLP – with the Balanced Saline Solution (BSS) provided for you, drop a few drops on a Q-tip. Carefully pull your lower eyelid down and gently clean the corners of your eye, and the lower eyelid. The upper lashes are okay to clean with BSS on a Q-tip as well, just be very careful not to poke yourself in the eye.
After Bandage Contact Lens Removal FAQs
Can I drive now?
To legally drive in Canada the vision requirement is 20/40. After the bandage contact lens removal the
technician will check your vision and notify you if it is safe to resume driving.
Can I increase screen usage?
You are able slowly increase your screen time however please apply as much preservative free eye drops as
possible and take frequent breaks.
Can I shower without swimming goggles now?
Yes, you may shower/bathe without swimming goggles now. Please keep eyes closed in the shower for 1 additional week.
Do I need to continue wearing sunglasses?
Sunglasses are to be worn outdoors at all times for the next 3 months. These serve the purpose of UV protection, and act as a physical protection layer and prevent from dust/debris getting into the eyes. They do not need to be dark, they can also be clear.
Can I go swimming?
Please wear goggles for an additional 3 days, then after 1.5 weeks post-procedure it is ok to swim without goggles.
Is it normal that my vision is blurrier after the bandage contact lens removal?
Please note vision will be blurry for couple days post-bandage contact lens removal, as eyes are adjusting to being without the bandage contact lens.
Vision will slowly improve during the next 1-2 months.
How long does it take for my vision to stabilize?
It may take up to 2-3 months for vision to fully stabilize. During this time period the epithelium is still growing back and smoothing out.
Can I rub my eyes?
You should NOT rub your eyes at all post-procedure. In the short-term, rubbing increases risk of infection.
In the long-term, habitual/vigorous eye rubbing can be associated with changes in the vision and corneal thinning post-procedure.
If your eyes are constantly itchy, please talk to you optometrist about prescribing eye drops that may help.
Can I wear eye makeup now?
Yes, you may resume wearing eye makeup now however please refrain from using waterproof eye makeup for 1 additional
week as it may be hard to take off without rubbing the eyes. Please be gentle around the eye area, and remember NO rubbing.
When can I resume exercising/sports?
You are able to resume most sports and activities after the bandage contact lens are removed (please call us if you are unsure about a specific activity you would like to resume).
Do I need to finish the rest of the drops from the “Day 1: With Bandage Contact Lens In” instructions (yellow set)?
No. If you have not completed all of the eye drops from the yellow set prior to the bandage contact lens removal, please move onto the green set of instructions “After Bandage Contact Lens Are Removed”.
Do I come back to Pacific Laser Eye Centre anymore?
No. The rest of your follow up visits will now be with your own optometrist at the 1,2,3,6, and 12 month.
These appointments should be booked from the procedure date.
