great piece of information.
realised that you posted some info earlier, and you mentioned that you are gonna make an appt to see Dr.
Jerry Tan. So did you see him in the end?
i went for the assessment. I spent half a day there going through at least 20 machines and I got to see Dr Jerry Tan at the end. The consultation wasn't rushed and I had plenty of the time to ask him questions.
The reason why he does one eye at a time is because a very small minority of patients may not heal in a predictive manner. As such, he does on the non-dominant eye to observe the healing response. If the non-dominant eye does not heal in a predictive manner, he can tweak the treatment to achieve better results on the dominant eye.
He also share his success rate and complication rate which actually exceeded my expectations.
so Epi-LASIK and LASEK do keep the epithelium flap right?
whereas the PRK and TransPRK remove the epithelium completely.
Both Epi-LASIK and LASEK separates the epithelium from the cornea throught epi-keratome and alcohol but I can't remember whether both removes the epithelium or the epithelium flap will be covered back. I do remember in journals, the results was that if the epithelium was removed, the recovery was faster by a day but patients will feel more uncomfortable.
PRK has many variants on how the epithelium is to be treated. For transpeithelial PRK, the epithelieum is ablated i.e. vaporized. So you can say that it removes it.
I thought the custom measurement of the cornea dimension is already available in the form of custom wavefront with LASIK surgery.
I think it should be available soon for TransPRK.
I believe custom wavefront refers to the shaping of the cornea using laser. Our corneas may not be entirely spherical and there may be bumps or humps depending on individual thus a custom wavefront can ablate the cornea to shape it into a perfect sphere.
The program for TransPRK assumes that epithelium is of a certain uniform thickness and shape based on the general population thus it does not ablate the epithelium exactly based on an individual.
Anyway, I'm not a surgeon so I can't comment on the accuracy on the above.
other than preference and protocol, I think the type of machines that is available to the doctor also plays an important part. cos if the clinic has only the older version of the amaris schwind 750, the doctor can't be marketing how good the 1050 is, likewise if their machine is unable to perform 2 procedure consecutively.
Yes. That is why SNEC does not offer the TransPRK because they do not have the Schwind Amaris machine. Their excimer machine is the WavelightEX500 which is used to ablate the cornea. As such, they may do LASEK i.e. use alcohol to separate the epithelium from the cornea and use the excimer laser to ablate the cornea.
but come to think of it, eye correction surgery has come a long way, does the difference in the laser pulse of 750 and 1050 per sec makes any huge difference. and in the operating theatre where it's sterile, how much risk is eye exposed to during the switching of the equipment.
Certainly, there are difference technically as the 1050 ablates the cornea faster and it has additional tracking of being able to predict your eyeball movement. However, we would have to look at published journals to see if there is any clinical difference in the treatment outcome of both machines.
the only difference i can see that with the more advance in the technology, there is just a lesser hands on by the doctor himself. everything is automated.
For TransPRK, the surgery itself is pretty automated.
For LASIK and ReLEX SMILE, the surgeon's skill is very important during the surgery itself. During the flap or lenticule creation, you can imagine the possibilities of things going wrong such as flap not properly created, flap dislodged, unable to pull out lenticule, loss of suction during surgery etc. No doubt, the risk is very low but when it happens to any individual, to that individual, that risk for him / her is 100%.
