Author: Dr Val Phua MBBS, MMed (Ophth), FRCOphth, FAMS
Photo by: Weston Eichner
Having played water polo for a good part of my life, the multiple intensive training sessions, both day and night, I look back now as an eye doctor and wonder at the grace i had been given. All those years relying on contact lenses to correct my vision with recurrent poor habits of contact lens care and maintenance, somehow i have managed to steer clear of any contact lens related infection until i went for laser vision correction myself. Through the years of caring for patient’s eyes, i’ve realised that contact lens related infection is not only more common than I thought, it is also much more aggressive than i had imagined with many needing very intense treatment regimes and on occasion even a corneal transplant. Is laser vision correction suitable for athletes?
Being an athlete does not disqualify anyone from undergoing laser vision correction. The risks associated with laser vision correction still applies to athletes including glare, halos, dry eyes and infection just to name a few. However, as you can imagine, different sports carry with it different risks. Athletes who do sprinting, cross-country running, swimming are at a lower risk of eye injury than those who do rugby, boxing, water-polo. This may affect the choice of procedure for laser vision correction.
With advanced surface ablation [PRK (Photorefractive Keratectomy), Transepithelial-PRK, Epi-LASIK, LASEK (Laser epithelial keratomileusis)], the eye is numbed with eye drops to ensure comfort during the procedure. The thin layer of “skin” of the cornea is removed by different means, be it a gentle scraping, applying some alcohol or even the use of a laser. A corrective excimer laser is then applied to the surface of the cornea to reshape it and allow the eye to focus better. A bandage contact lens is then applied to help the eye heal.
The procedure itself is painless but once the numbing eye drops wear off, patients do experience discomfort, glare and halos in the early recovery phase. This feeling of discomfort takes about 5-7 days and vision slowly stabilises over 3 months. During this period, eye drops are given to prevent infection and minimise scarring and also to keep the eye comfortable.
The results from advanced surface ablation is comparable with LASIK in terms of best corrected vision and it has the benefit of not having a LASIK flap hence athletes involved in higher risk sports may want to opt for this choice over LASIK. The down side is the longer and slightly more uncomfortable recovery period after the surgery which can eat into precious time from training
LASIK on the other hand, is a highly dependable, time-tested means of reshaping the cornea to help the eye focus images onto the retina. The procedure itself has 2 main steps.
The first step is creating a thin LASIK flap. This is done after numbing eye drops are given to make the process painless. Traditionally, a fine blade (microkeratome) was used for this step, however with advances in femto-second laser technology, flap creation with the microkeratome has largely been superceded by the femto-second laser. The flap is then lifted and the eye prepared for the application of corrective laser. Next, a corrective excimer laser is applied to reshape the cornea and allow the eye to focus better. This step is painless and typically takes seconds depending on the degree of correction needed. The flap is then replaced and a bandage contact lens applied.
Most patients who undergo LASIK will notice an improvement almost immediately and some with tight busy schedules can even return to work the next day. The recovery process for LASIK is quite different from advanced surface ablation with minimal discomfort and much faster stabilization of vision after the laser procedure. More than 98% of patients are satisfied with their vision after LASIK. For athletes involved not involved in high risk sports, LASIK may be a more acceptable option in view of the minimal down time and quick recovery. Care must of course still be exercised in the early days post surgery to ensure a successful outcome.
Which option should you go for? A personalised recommendation based on your specific needs should be made after taking a thorough ophthalmic history, examination and specialised tests which can highlight the suitability of each procedure for your eye. Journey along side your eye surgeon to discuss how best to achieve your vision goals.