Lasik eye Surgery

[eyz]

check out the shinagawa link i posted. Under epi-lasik, it has a short para on how no touch epi lasik done.

do u have any info abt the no touch epi lasik ?
how is it done?

 

[yosemi]

check out the shinagawa link i posted. Under epi-lasik, it has a short para on how no touch epi lasik done.

ok, i also found those info on eec webby.
look like lsc only offer the 1 with the alcohol doesnt have no touch

i will go for forum with the shinagawa to ask some question regarding no touch epi-lasik and den do a final decision .

 

[eyz]

cool. i also found out clearvision at nutmeg road provide only no-touch epi lasik. their machine Amaris 1050 is similar to Shinagawa 1. EyeSurgeon also has no touch epi lasik, and their machine is Amaris 750. the model no. defines the no. of laser pulse per second.

EEC excimer machine Allegretto is supposedly to be the cheaper option at Shinagawa. Nonetheless, I think all these lasik technology had far exceeded US FDA requirement.

Another pros for Shinagawa is that the enhancement procedure at the discounted price is for a period of 3 years, whereas for LSC is only 2 years.

if you are going for no touch epi lasik, you can try the forum at clearvision as well. i missed mine last saturday, will probably going for the next one.

I'll go to eyesurgeon to check out the price tomorrow.

ok, i also found those info on eec webby.
look like lsc only offer the 1 with the alcohol doesnt have no touch

i will go for forum with the shinagawa to ask some question regarding no touch epi-lasik and den do a final decision .

 

[sibei_disappointed]

Been leeching here for awhile and would like to contribute my findings/thoughts

I'm looking at epi as I wanna keep an active lifestyle. My findings/thoughts

- SNEC does not do epi
- Eye surgeons use EEC's Amaris machine at Gleneagles Novena and do surgery on Tue or Thur. Dunno what model but shd be the 750 as mentioned by eyz.
- The CSO EEC said that the pre-surgery and surgery can be arranged for the same day, ie, assessment in the morning, go for lunch, do surgery in the afternoon.
- The CSO at Eye Surgeons said surgery can only be done 4 days after the assessment as the pupil will be dilated after the assessment and they don't do surgery on dilated pupil.
- I wanted to do epi at SNEC in the first place but found out that they don't offer that. The reason for opting for government hospital is the I am worried that the private docs will try to go for surgery with lesser regards/concerns for other issues as they are more business hungry. Is EEC more business hungry?...
- The total cost for assessment, surgery + 3X follow-up should be around $4k ($200- $300 for assessment, $3,700 for surgery + 3X free follow-up). They will play around the numbers by having cheaper assessment or surgery but not giving free post surgery assessment or giving prices b4 GST etc. I stand to be corrected.

 

[yosemi]

Been leeching here for awhile and would like to contribute my findings/thoughts

I'm looking at epi as I wanna keep an active lifestyle. My findings/thoughts

- SNEC does not do epi
- Eye surgeons use EEC's Amaris machine at Gleneagles Novena and do surgery on Tue or Thur. Dunno what model but shd be the 750 as mentioned by eyz.
- The CSO EEC said that the pre-surgery and surgery can be arranged for the same day, ie, assessment in the morning, go for lunch, do surgery in the afternoon.
- The CSO at Eye Surgeons said surgery can only be done 4 days after the assessment as the pupil will be dilated after the assessment and they don't do surgery on dilated pupil.
- I wanted to do epi at SNEC in the first place but found out that they don't offer that. The reason for opting for government hospital is the I am worried that the private docs will try to go for surgery with lesser regards/concerns for other issues as they are more business hungry. Is EEC more business hungry?...
- The total cost for assessment, surgery + 3X follow-up should be around $4k ($200- $300 for assessment, $3,700 for surgery + 3X free follow-up). They will play around the numbers by having cheaper assessment or surgery but not giving free post surgery assessment or giving prices b4 GST etc. I stand to be corrected.

$3700 u quoted is eec?

 

[sibei_disappointed]

$3700 is from Eyesurgeon. EEC will deduct the assessment cost from the surgery. The CSO said the opt cost should be around $3.5K to $3.6K after deducting the assessment fees. But EEC does not give 3X free post opt follow-up.

If you are looking for Dr Julian Theng, he won't be the one doing the 3X follow-up but someone else. He will see you at a later follow-up if I rem correctly.

 

[eyz]

i spoke to Dr. Por of Eyesurgeon last Fri. He was kind enough to share with me his procedures and charges. He conduct his procedures at EEC. EEC Amaris is 750, which is just a tad slower than Shinagawa and Clearvision 1050. The difference is the duraction of the excimer lasering. He also has his own procedures, which differ from EEC.

Dr. Por's fee is $3200 (exclusive of medicine & GST), but inclusive of 3 follow up (1 day, 1 week and 1 month). For the follow up, the patient need to pay a facility fee of around $20+, and on the third visit for the topography test of $100+. A topo test would done during the assessment, which is around $200-$300.

I'm not sure the topo test is something similar to wavefront guided though.

For epi-lasik, the Dr. Por recommend alcohol for the removal of the epithelium, cheap and safe. For no touch, the excimer laser will remove the epithelium, and the machine doesn't know whether the cut is too deep or too thin, as all the configuration are dialed into the machine. however, this is recommended for uneven cornea, where the laser will help to smoothen the contour of thr cornea. the last method is using a non sharp blade to slice off the epithelium, which Dr. Por don't recommend as well.

 

[eyz]

is that fee for elizebeth or novena?

$3700 is from Eyesurgeon. EEC will deduct the assessment cost from the surgery. The CSO said the opt cost should be around $3.5K to $3.6K after deducting the assessment fees. But EEC does not give 3X free post opt follow-up.

If you are looking for Dr Julian Theng, he won't be the one doing the 3X follow-up but someone else. He will see you at a later follow-up if I rem correctly.

 

[sibei_disappointed]

The fee is for Novena. The CSO from EEC mentioned that the fees for Novena is higher due to the different machine used compared to say Mount A.

I am speculating here, I think the fee Dr Por mentioned ($3200) is the doctor's fees and not the total cost of surgery. The surgery will include cost of booking the machines etc. So in total, its around $3700. Hopefully, the cost of surgery is really $3.2k and not $3.7k...

I read that the main issue with using alcohol is that it can kill the epithelium cells.

 

[eyz]

if i am not wrong, it's $3200/-.

but the fee should be more of less the same as EEC.

i though the purpose of lasek is to remove the epithelium? and alcohol is to remove or kill it off?

The fee is for Novena. The CSO from EEC mentioned that the fees for Novena is higher due to the different machine used compared to say Mount A.

I am speculating here, I think the fee Dr Por mentioned ($3200) is the doctor's fees and not the total cost of surgery. The surgery will include cost of booking the machines etc. So in total, its around $3700. Hopefully, the cost of surgery is really $3.2k and not $3.7k...

I read that the main issue with using alcohol is that it can kill the epithelium cells.

 

[FuNKySoULyBrO]

The fee is for Novena. The CSO from EEC mentioned that the fees for Novena is higher due to the different machine used compared to say Mount A.

Ahhh... didn't know EEC uses different machine at different branches.... Damn...if I have known, I would have chosen the Novena branch ( which I assume it's using the Amaris 750S ) instead of the Mt Alvernia branch, using the older Wavelight?

Thought Mt A was it's main core branch which will have the best equipment available.

Done mine abt 3 weeks ago at Mt A branch. Left eye is perfect ( 6/6 ), right eye is still slightly blurry as compared to left, I think around 6/9.... Mine is originally -4.5/-5 myopia for L/R and -2.5 Astig each for both....

I guess for those with astig, it's better to use the Amaris machine. Coz even some studies show it has better results for astig

http://www.escrs.org/prague2012/programme/poster-details.asp?id=12686

PS, Mt A branch is more spacious as compared to Novena branch though ( coz I went to Novena for the 1st-day post-op followup )

 

[sibei_disappointed]

if i am not wrong, it's $3200/-.

but the fee should be more of less the same as EEC.

i though the purpose of lasek is to remove the epithelium? and alcohol is to remove or kill it off?

If its really $3.2K and is epi and is using the Amaris machine at Novena, then I think its really a competitive price. Dunno if the use of alcohol vs other methods of removing the epithelium plays a part in the pricing or not... I thought Lasek use alcohol and epi-lasik does not? No?

I cannot post link, so u guys just add www in front.
ncbi.nlm.nih.gov/pmc/articles/PMC3381083/

I read that the alcohol is toxic to the epithelium cells may cause more adverse reactions. The above article states that "Alcohol-assisted removal is easier and faster, and probably more comfortable for the patient and surgeon, but may entail toxic side effects. Common problems of epithelial debridement include moderate to severe pain, a relatively long period of visual recovery, and corneal haze. The application of alcohol makes epithelial removal simple, fast and complete, but entails certain problems. High concentrations of ethanol have been found to cause inflammation and damage to underlying stromal keratocytes. Ethanol may also affect stromal hydration."

medicalcityeye.com/epi-lasik.html
This article says that not using alcohol results in faster healing and less pain. There is also a lower chance of haze (with the use of alcohol) which another article says can be reduced with prudent use. Yet another site says the use of alcohol does not increase pain or haze.. Sibei confused...

I guess the difference between the using alcohol or not lies in that alcohol may cause more issues like haze and pain while the non-alcohol may increase the chance of cutting wrongly by using laser or blade.

 

[sibei_disappointed]

Ahhh... didn't know EEC uses different machine at different branches.... Damn...if I have known, I would have chosen the Novena branch ( which I assume it's using the Amaris 750S ) instead of the Mt Alvernia branch, using the older Wavelight?)

The CSO did not mention what machine is used at Mt A but he did mention that Novena uses Amaris. He did not mention which model though. The cost at Mt A is also lower than at Novena. How much is the surgery at Mt A? Done by Dr Julian Theng?

I would think that Novena uses the newer machines as it is a newer clinic.

So that is why I though the surgery cost should be around the same if using the same machine/technology. The bigger differences in prices is likely to be due to the use of different technology. Simply looking at the price may not tell the whole story... I could be wrong.

 

[eyz]

i think EyeSurgeon will provide whatever procedures EEC has, as EyeSurgeon uses EEC machines.

I think $3.2k should be LASEK, my apology. Now I remembered that he mentioned that all instruments used during the procedures are chargeable ie. epithelial separator, cones and stuffs for LASIK and Epi-Lasik, hence LASEK is cheaper.

Shinagawa and Clearvision provide no touch epi lasik with Amaris 1050 at $3388 (before GST).

My apology on the misinformation, as sometimes I am also confused with the procedures and the names.

If its really $3.2K and is epi and is using the Amaris machine at Novena, then I think its really a competitive price. Dunno if the use of alcohol vs other methods of removing the epithelium plays a part in the pricing or not... I thought Lasek use alcohol and epi-lasik does not? No?

I cannot post link, so u guys just add www in front.
ncbi.nlm.nih.gov/pmc/articles/PMC3381083/

I read that the alcohol is toxic to the epithelium cells may cause more adverse reactions. The above article states that "Alcohol-assisted removal is easier and faster, and probably more comfortable for the patient and surgeon, but may entail toxic side effects. Common problems of epithelial debridement include moderate to severe pain, a relatively long period of visual recovery, and corneal haze. The application of alcohol makes epithelial removal simple, fast and complete, but entails certain problems. High concentrations of ethanol have been found to cause inflammation and damage to underlying stromal keratocytes. Ethanol may also affect stromal hydration."

medicalcityeye.com/epi-lasik.html
This article says that not using alcohol results in faster healing and less pain. There is also a lower chance of haze (with the use of alcohol) which another article says can be reduced with prudent use. Yet another site says the use of alcohol does not increase pain or haze.. Sibei confused...

I guess the difference between the using alcohol or not lies in that alcohol may cause more issues like haze and pain while the non-alcohol may increase the chance of cutting wrongly by using laser or blade.

 

[yosemi]

The CSO did not mention what machine is used at Mt A but he did mention that Novena uses Amaris. He did not mention which model though. The cost at Mt A is also lower than at Novena. How much is the surgery at Mt A? Done by Dr Julian Theng?

I would think that Novena uses the newer machines as it is a newer clinic.

So that is why I though the surgery cost should be around the same if using the same machine/technology. The bigger differences in prices is likely to be due to the use of different technology. Simply looking at the price may not tell the whole story... I could be wrong.

the amount to cut is should be programmed according to each person right how can it cut wrongly or cut more than it should be?

 

[yosemi]

i spoke to Dr. Por of Eyesurgeon last Fri. He was kind enough to share with me his procedures and charges. He conduct his procedures at EEC. EEC Amaris is 750, which is just a tad slower than Shinagawa and Clearvision 1050. The difference is the duraction of the excimer lasering. He also has his own procedures, which differ from EEC.

Dr. Por's fee is $3200 (exclusive of medicine & GST), but inclusive of 3 follow up (1 day, 1 week and 1 month). For the follow up, the patient need to pay a facility fee of around $20+, and on the third visit for the topography test of $100+. A topo test would done during the assessment, which is around $200-$300.

I'm not sure the topo test is something similar to wavefront guided though.

For epi-lasik, the Dr. Por recommend alcohol for the removal of the epithelium, cheap and safe. For no touch, the excimer laser will remove the epithelium, and the machine doesn't know whether the cut is too deep or too thin, as all the configuration are dialed into the machine. however, this is recommended for uneven cornea, where the laser will help to smoothen the contour of thr cornea. the last method is using a non sharp blade to slice off the epithelium, which Dr. Por don't recommend as well.

I went for shinagawa forum they are using Amaris is 750S not 1050RS which The talk also didnt cover anything about epi-lasik. So I ask about it and was told that epi-lasik was not recommended unless the corneal is too thin and the recovery may varies as tissue will recover. Also was told that only 1 clinic market epi-lasik but she didnt say which clinic but I believe she meant 'clearvision'. Also was told that if perform epi lasik, alcohol to remove layer of epithelium is recommended.

Shinagawa - Amaris 750S (main IntraLase Wavefront Lasik)
LSC - STAR VISX S4(Lasik) ZEISS VisuMax® Femtosecond Laser (main ReLEx)
clearvision - Amaris 1050RS (main Epi Lasik)
EEC - Amaris 750S
EYESURGEONS - not sure(no technology stated on website cant google)

Amaris 1050RS

STAR S4 IR® Excimer Laser

I have done some reading online found out that some say epi lasik is better some say lasik is more stable. Anyway if my research is wrong do let me know. I want to make a final decision on which procedure to do next yr after Christmas trip

pricing may not be an issue , cos i think it will be a few hundreds diff from each clinics only.Main thing is the treatment and the aftercare provided.

 

[jovial-tan]

Hi, any referral for EEC?

 

[sibei_disappointed]

I went for shinagawa forum they are using Amaris is 750S not 1050RS which The talk also didnt cover anything about epi-lasik. So I ask about it and was told that epi-lasik was not recommended unless the corneal is too thin and the recovery may varies as tissue will recover. Also was told that only 1 clinic market epi-lasik but she didnt say which clinic but I believe she meant 'clearvision'. Also was told that if perform epi lasik, alcohol to remove layer of epithelium is recommended.

Lasek uses alcohol, epi-lasik uses a device to remove the epithelium. Dr Por from Eyesurgeons (as mentioned by eyz and from his articles on Quora) prefers alcohol (Lasek). Dr Natasha Lim also prefers alcohol. The reason is that the device that removes the epithelium can cut into the cornea and leave a permanent scar. That is the reason SNEC no longer does epi-lasik but do Lasek. So Shinagawa also prefers Lasek...

Shinagawa - Amaris 750S (main IntraLase Wavefront Lasik)
LSC - STAR VISX S4(Lasik) ZEISS VisuMax® Femtosecond Laser (main ReLEx)
clearvision - Amaris 1050RS (main Epi Lasik)
EEC - Amaris 750S
EYESURGEONS - not sure(no technology stated on website cant google)

Eyesurgeons uses EEC's facilities at Novena so uses the Amaris 750S.

I have done some reading online found out that some say epi lasik is better some say lasik is more stable. Anyway if my research is wrong do let me know. I want to make a final decision on which procedure to do next yr after Christmas trip

pricing may not be an issue , cos i think it will be a few hundreds diff from each clinics only.Main thing is the treatment and the aftercare provided.

Lasik is more common, cheaper, faster recovery, less pain. But downside is that the mechanical strength of the cornea is lower than Lasek/Epi. There may be more chances of complications. But some surgeons say that technology has reduced that.

Maybe you should consider if you want an active lifestyle? Although some say that Lasik is good enough if you do not do contact sports or is in the military. If you cornea is thin, Lasek/Epi may be the more probable option.

 

[sibei_disappointed]

the amount to cut is should be programmed according to each person right how can it cut wrongly or cut more than it should be?

As far as I know. there are 2 parts to the cutting:
1. the outer layer (creating the flap in Lasik or removal of epithelium in Lasek/Epi/PRK)
2. The actual cutting of the cornea to solve the myopia/astig by the excimer laser

Step 2 is quite standard and safe nowadays. The flap creation in part 1 for Lasik is also commonly done by laser nowadays and quite safe. But the removal of epithelium in Lasek/Epi is not done by laser and can create issues...

 

[yosemi]

Lasek uses alcohol, epi-lasik uses a device to remove the epithelium. Dr Por from Eyesurgeons (as mentioned by eyz and from his articles on Quora) prefers alcohol (Lasek). Dr Natasha Lim also prefers alcohol. The reason is that the device that removes the epithelium can cut into the cornea and leave a permanent scar. That is the reason SNEC no longer does epi-lasik but do Lasek. So Shinagawa also prefers Lasek...




Eyesurgeons uses EEC's facilities at Novena so uses the Amaris 750S.




Lasik is more common, cheaper, faster recovery, less pain. But downside is that the mechanical strength of the cornea is lower than Lasek/Epi. There may be more chances of complications. But some surgeons say that technology has reduced that.

Maybe you should consider if you want an active lifestyle? Although some say that Lasik is good enough if you do not do contact sports or is in the military. If you cornea is thin, Lasek/Epi may be the more probable option.

I just do normal sport n swimming, as for military part I still have to under go reservist chiongsua unit with out field.

also i fogot to ask doctor , if do lasik, forever cannot rub the eyes anymore?