Laser refractive surgery helps people overcome eyesight problems

Maria Endah Hulupi, The Jakarta Post, Jakarta

Hilda, who had just graduated from university, had experienced a sight problem starting at junior high school. Since then, she had to rely on her glasses but the spectacles only helped her to see better instead of genuinely improving her vision.

One day, she decided to undergo Laser-Assisted in-Situ Keratomileusis (lasik) refractive surgery at a clinic in South Jakarta and after treatment, plus a three-hour sleep, she woke up with clear vision, without feeling any pain. On that particular day, she kissed her glasses goodbye.

With lasik surgery, people with various eyesight problems -- be it myopia (short-sightedness), hypermetropia (long- sightedness), astigmatism and presbyopia (middle-aged people's need for reading glasses) -- can eliminate their problems instead of relying on visual aids.

There is no official data on the number of people with eyesight problems in Indonesia but Sidharta Ilyas, a senior ophthalmologist with the Gatot Soebroto Army Hospital, estimated the number at around 20 percent of the country's population.

"Those who can afford laser refractive surgery go overseas to improve their vision," he said during the launching of Laser Sight Centers Indonesia, located on Jl. Wolter Monginsidi, Kebayoran Baru, Central Jakarta.

The center is the second in Indonesia that can perform lasik refractive surgery -- after the Jakarta Eye Center in Menteng, Central Jakarta -- and it is a (franchised) branch of Australia- based Laser Sight Centres.

The normal eye operates on the same principle as a conventional camera, with the iris acting as the shutter to regulate the amount of light admitted to the eye, while the cornea and the lens focus the light rays from the object onto the retina at the back of the eye.

Eyesight problems can occur when the cornea and the lens are too strong, causing the light rays to focus in front of the retina (short-sightedness) or too weak, leading to failure to focus light rays onto the retina (far-sightedness).

It can also be triggered by refractive error, as the cornea is not perfectly spherical. As a result the light is focused at different locations, causing asymmetric blur (astigmatism).

People aged 40 and above are prone to presbyopia, a condition that occurs due to the aging eye, which naturally loses its flexibility. That person will find it increasingly difficult to focus on close objects.

All these visual problems can be corrected by Lasik refractive surgery, a painless procedure that combines conventional ocular surgery with state-of-the-art excimer laser surgical technology.

First, the patient is given anesthetic eye drops and ophthalmologists prepare the area around the eyes with antiseptic solution to minimize the risk of infection.

The procedure is performed by making a partial cut through the front surface of the cornea to create a 160-micron-thick flap, then a cool beam excimer laser is used to reshape the cornea, including removing microscopic layers of corneal tissue to meet the person's specific refractive requirement.

After the laser treatment, the flap is carefully repositioned over the newly contoured corneal tissue where it adheres immediately with the underlying tissue -- like an own body band- aid -- thus eliminating the need for sutures, which helps speed up the healing process.

People suitable for the treatment are those aged 20 or above, with stable vision for the last 12 months, not pregnant and enjoying good health in general.

The procedure takes about 10 minutes for each eye, with an average of six seconds to cut the flap and about one minute to reshape the corneal layer using the laser, said Aloysius Joseph Low, a consultant ophthalmic surgeon from Malaysia.

The quick treatment is done on an outpatient basis and offers fast recovery without the usual post-operative discomforts, including mild scratchy or gritty sensations and watery eyes.

It is also safe, as 99 percent of patients can see much better, while the remainder can enjoy obtain significantly improved vision, although they might still need another visual enhancement treatment, said Raman R. Saman, an ophthalmologist from the University of Indonesia.

People with eyesight problems can undergo Lasik refractive surgery which cost from Rp 6 million (US$652) to Rp 12 million depending on the eyes condition.

Saman and two other local ophthalmologists, Bondan Harmani and Bambang Triwiyono, have recently completed their intensive training in Queensland, Australia, led by a pioneer of lasik refractive surgery and cofounder of the Australia-based Laser Sight Centres, Peter Stewart.