Advanced Surface Treatment

Who is suitable for laser eye surgery?

You need to be at least 20 years of age and have had no change in your glasses or contact lens prescription for at least a year. Laser eye surgery can correct short sightedness, long sightedness and astigmatism. Dr Kent can correct focusing errors in the range of -10 to +5 with laser eye surgery. If you are beyond this level of short sightedness or long sightedness you may still be able to have a procedure to correct your focusing error other than a corrective laser procedure. You might be better suited to a Lifestyle lens procedure or Implantable contact lens procedure depending on your glasses prescription, age and lifestyle demands. Astigmatism is treated with the laser at the same time as your shortsightedness or long sightedness is corrected. Your eyes must be in good ocular health, with no pre-existing untreated eye disease. Laser vision correction is not recommended if you are pregnant or breast feeding. If you suffer from an auto-immune disorder you will need to discuss your suitability further with Dr Kent.

Why I should choose Fendalton Eye Clinic?

The expertise and experience of Dr David Kent combined with the quality of the technology we have at Fendalton Eye Clinic.
  • Our staff care about giving you the best result for you as an individual, finding the most appropriate procedure for you based on your unique focusing error and lifestyle requirements.
  • Dr. Kent is one of the most experienced surgeons for laser vision correction in Australasia having performed over 28,000 laser eye surgery procedures. Dr Kent has performed more LASIK procedures than any other New Zealand eye surgeon. For optimal results surgeon experience counts.
  • We are the only clinic in the South Island to offer you the safety, accuracy and superior results of the Schwind Amaris 1050RS excimer laser, the most advanced excimer laser with it's smart pulse technology and the unparalleled accuracy of a seven dimensional active eye tracker.
  • Every laser eye treatment is tailor-made to each individual eye.
  • We do everything we can to give you the best result possible. Follow up after laser eye surgery at Fendalton Eye Clinic is for six months. Within New Zealand the cost of follow up appointments is met by Fendalton Eye Clinic.
  • At Fendalton Eye Clinic we have a state-of-the-art purpose-built laser eye surgery theatre.

Has Dr Kent performed laser eye surgery on other Doctors … ?

Since 1997 Dr Kent has performed corrective laser eye surgery on more than four hundred medical doctors and optometrists combined. Dr Kent has performed laser vision correction procedures on five of his staff members and several of his relatives. Dr Kent has also treated many national sporting representatives.

What type of anaesthetic is used for laser eye surgery?

All laser eye surgery vision correction procedures are performed with anaesthetic drops placed in the eye which are extremely effective at completely numbing your eyes. A mild sedative is also offered 30 minutes before your procedure, it does not put you to sleep but helps to relax you before your procedure.

Why have PRK?

For some patients particularly those with very thin corneas PRK may be the safest laser vision procedure. With PRK good results can be expected for low corrections. PRK has been shown to have no significant long-term complications. However even in very low corrections there is a longer time before clear vision is obtained after PRK compared to the rapid vision recovery after LASIK or SMILE eye laser. The time delay to obtain clear vision following PRK is due to the fact that PRK is a laser procedure performed on the front surface of the eye, good vision is achieved once the corneal surface has healed generally within 5 to 7 days.

Pros and cons of having Photorefractive Keratectomy (PRK)?

PRK is a good option for people who are not suitable for HD LASIK® due to having a thin cornea; a cornea that does not have a symmetrical shape; or anyone at high risk of eye injury. Advantages of Photorefractive Keratectomy (PRK)
  • Leaves more corneal tissue untouched, making it safer if the cornea is thin.
  • Almost no long-term risk of developing keratectasia (bulging cornea).
  • Proven to have no visually significant complications after 10 years of follow up.
  • None of the possible flap-related complications of LASIK.
  • The structural strength of the cornea is not significantly altered.
Disadvantages of Photorefractive Keratectomy (PRK)
  • Can be painful for 2-3 days afterwards (although this is much less of a problem that it was in the past)
  • May take 7-10 days to achieve clear vision, requiring up to a week off work.
  • Some people develop a pronounced healing response in the cornea leading to deposition of new tissue. This causes corneal haze.
  • Not very predictable results in higher myopia or high astigmatism.

Will it hurt?

Anaesthetic eye drops are placed into your eye prior to laser eye surgery treatment to numb the eye so there is usually no pain experienced during the procedure. You will be aware of some pressure against your eye. For several hours after your laser eye procedure you may experience a grittiness or irritation. This irritation lasts about 4 or 5 hours. Some people do experience mild pain after laser vision correction that can be relieved with pain relief tablets (Panadol).

What is the success rate?

Our results show that 98% of people with moderate myopia can expect to achieve 20/20 vision or better after an initial treatment. About 2 % will require an enhancement Globally millions of people have had LASIK to correct their vision and are happy with the result.

What are the different types of laser eye surgery advertised?

PRK: (also referred as ASLA) Photorefractive Keratectomy or Advanced Surface Laser Ablation •    The use of one laser (excimer) without the creation of a corneal flap. The surface epithelium is exfoliated to allow the laser (excimer) to be applied to the corneal bed. •    The epithelium then regenerates naturally. LASIK: Laser In-situ Keratomileusis, in use since 1991. •    A microkeratome (a bladed mechanical surgical cutting instrument) is used to form a thin flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. Lasik (laser-initiated LASIK) •    A Femotosecond laser is used to form a thin Flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. SMILE (Smile LASER) •    The use of just a Femtosecond laser to create a “micro incision” rather than a flap. The laser also creates a lenticular shaped piece of tissue that is then removed with forceps via the “micro incision”. Note: SMILE is a new technology unable to treat low myopia, hyperopia and astigmatism.  The accuracy of HD LASIK and PRK remain the standard choice for these correction.

What happens if I move my eye?

Active 7D eye tracking The 7D active eye tracker impresses through a number of benefits: Apart from the linear movements (1st and 2nd dimensions) it compensates rolling movements of the eye (3rd and 4th dimensions). Compensation of the eye’s rotation around its optical axis is achieved with the static and dynamic Advanced Cyclotorsion Control (5th dimension). Movements along the z-axis (sixth dimension) are actively compensated by means of the z-tracking. Automatic pupil size control and pupil centroid shift compensation ensure additional safety. Latency-Free Tracking in the 7th dimension The new, ground-breaking Latency-Free Tracking considers the time factor, i.e. the 7th dimension. Latency-Free Tracking compensates for eye movements that occur in the period between acquisition of the eyetracker image and triggering of the subsequent laser pulses

Can I have both eyes done with at the same time?

Yes. It is safe to do both eyes one after the other, especially with the greater safety offered by eliminating the microkeratome blade by providing "all-laser"  LASIK instead. Dr. Kent has offered same day both eye LASIK since September 1997, the first New Zealand eye surgeon to do so.

What are the risks?

With over 20,000 laser procedures done at FEC, we have not had anyone go blind. As far as we know no clinic in New Zealand has had anyone go blind following LASIK. With all medical procedures, there is a possibility of complications. However, complications that could threaten your vision are extremely rare these need to be discussed with your surgeon.

What if I wear contact lenses?

How long do I have to be out of my contact lenses prior to my laser eye surgery? Contact lenses can affect the natural curvature of the cornea. You will be required to cease wearing contact lenses for a period of time leading up to your laser eye treatment. This period without contact lenses allows the cornea to return to its natural state, which will optimise the treatment outcome. The period without contact lenses depends on the type of contact lens that you are wearing.  
  • Soft daily wear or disposable contact lenses should not be worn for 12 days before laser eye surgery.
  • Soft toric (astigmatism correcting) contact lenses. This type of contact lens "moulds" the cornea more than a standard soft contact lens. Therefore we advise you to cease wearing soft toric contact lenses for three weeks prior to your laser vision correction.
  • Hard or rigid gas permeable (RGP) contact lenses. This type of lens maintains its own shape while on your eye. They therefore have a greater moulding effect on the cornea. You will need to cease wearing hard or RGP lenses for 6-8 weeks prior to your laser eye surgery.
If you do not have spectacles we may be able to supply you with a loaner pair that will be close to your prescription to assist you during the period that you are required to be out of contact lenses.

Can I go blind?

The risk of blindness from LASIK surgery is almost zero. Laser eye surgery is safer than wearing contact lenses. An eye could become legally blind if there was a very bad eye infection after the surgery, which was unable to be controlled with antibiotic drugs. If such a serious complication did occur, then it would normally be possible to perform a corneal transplant and restore sight to that eye. This has never occurred in New Zealand.

When can I get back to work?

Normally we ask that you have a quiet day the day after the surgery. If you have LASIK or SMILE, most people have their surgery on a Thursday, and are back at work on Monday. You should relax completely immediately after the surgery. If you have PRK treatment the recovery time is longer. You are best to plan to be off work for seven days.

What is an ‘enhancement’?

Enhancement surgery is additional treatment to "fine tune" the result. It takes one to three months from the initial surgery for the vision to be stable. During this time there may be some minor fluctuations in your vision. There is a lot of individual variation in the rate and amount that people heal. If after three months there is some under or over correction Dr Kent can offer you some additional lasering to optimise the outcome, providing it is safe to do so. Enhancement surgery involves lifting the existing flap using fine surgical instruments to identify the edge of the flap and lift it to perform additional lasering. Generally enhancement surgery is more likely in higher or more complicated corrections. Enhancements are only needed in about 1% of cases of low short-sightedness. For higher corrections (over -8.0) there is a greater chance that an enhancement may be required. The overall rate of enhancement surgery following LASIK is about 4%. Enhancements are done free of charge within twelve months of the initial procedure as we want you to be happy with the final outcome.

Why do we use Mitomycin-C (MMC)?

The use of Mitomycin-C (MMC) has also improved PRK results by reducing the chance of over aggressive healing responses. It has been in use for 20-25 years now with no reports of any adverse consequences. It has to be made up fresh by a compounding pharmacist. A round sponge is soaked in the MMC solution and placed onto the cornea for 12 to 60 seconds immediately after the excimer laser treatment. It works by both inhibiting cell activity and reducing the number of activated cells in the healing cornea. With all PRK procedures we irrigate the cornea with chilled balance salt both to wash away the MMC but also give the corneal nerves a “cold shock” and hence give pain relief for up to 48 hours

Possible PRK complications

While modern PRK surgery is very effective, it is still possible to be under or over corrected. Other possible complications include corneal haze, dry eye and problems with healing of the front cell layer of the cornea.

Cataract Surgery

When were intraocular lenses (IOL) invented?

The Intraocular Lens (IOL) was invented in 1949 by Sir Harold Ridley who pioneered IOL surgery for cataract patients. Ridley pioneered this treatment in the face of prolonged strong opposition from the medical community. His process has been refined over time and is routinely used in modern cataract surgery.

What options are there for intraocular lens (IOL) surgery?

There are four main options for IOL surgery today.
  • Monofocal IOLs for emmetropia
  • Monofocal IOL monovision
  • Extended-depth-focus IOLs (e.g. Oculentis Comfort)
  • Zeiss trifocal IOL

What are the symptoms of a cataract?

Symptoms of a cataract can be quite variable. The most common symptom is cloudy, blurry or dimmed vision. With a cataract you may also experience sensitivity to light and glare. As a cataract advances you may notice difficulty with night vision. It is not uncommon to notice that colours are dull in particular a fading or yellowing of bright colours. The formation of a cataract can cause your spectacle prescription to change, with advanced cataracts updating your glasses does not provide clear vision.

Where does Dr Kent perform cataract surgery?

Dr Kent performs cataract and refractive lens exchange procedures at the Christchurch Eye Surgery.  Opened in 2014, their state-of-the art facility has been purpose-built to give you the very best eye surgery experience possible.  They have an exceptionally-skilled professional team of experts including anaesthetists, nurses and technicians to put you first and ensure that you receive the best possible treatment and quality care.

Laser Eye Surgery

Who is suitable for laser eye surgery?

You need to be at least 20 years of age and have had no change in your glasses or contact lens prescription for at least a year. Laser eye surgery can correct short sightedness, long sightedness and astigmatism. Dr Kent can correct focusing errors in the range of -10 to +5 with laser eye surgery. If you are beyond this level of short sightedness or long sightedness you may still be able to have a procedure to correct your focusing error other than a corrective laser procedure. You might be better suited to a Lifestyle lens procedure or Implantable contact lens procedure depending on your glasses prescription, age and lifestyle demands. Astigmatism is treated with the laser at the same time as your shortsightedness or long sightedness is corrected. Your eyes must be in good ocular health, with no pre-existing untreated eye disease. Laser vision correction is not recommended if you are pregnant or breast feeding. If you suffer from an auto-immune disorder you will need to discuss your suitability further with Dr Kent.

Why I should choose Fendalton Eye Clinic?

The expertise and experience of Dr David Kent combined with the quality of the technology we have at Fendalton Eye Clinic.
  • Our staff care about giving you the best result for you as an individual, finding the most appropriate procedure for you based on your unique focusing error and lifestyle requirements.
  • Dr. Kent is one of the most experienced surgeons for laser vision correction in Australasia having performed over 28,000 laser eye surgery procedures. Dr Kent has performed more LASIK procedures than any other New Zealand eye surgeon. For optimal results surgeon experience counts.
  • We are the only clinic in the South Island to offer you the safety, accuracy and superior results of the Schwind Amaris 1050RS excimer laser, the most advanced excimer laser with it's smart pulse technology and the unparalleled accuracy of a seven dimensional active eye tracker.
  • Every laser eye treatment is tailor-made to each individual eye.
  • We do everything we can to give you the best result possible. Follow up after laser eye surgery at Fendalton Eye Clinic is for six months. Within New Zealand the cost of follow up appointments is met by Fendalton Eye Clinic.
  • At Fendalton Eye Clinic we have a state-of-the-art purpose-built laser eye surgery theatre.

Is there an upper age limit for corrective laser eye surgery?

Generally beyond the sixth decade of life there is a high likelihood that you will have early or mild cataracts. If there is any sign of early cataracts it is more appropriate to perform surgery to remove the deteriorating lens, lifestyle lens replacement or cataract extraction, replacing the natural lens of the eye with an intraocular implant. In most cases we would use a multifocal intraocular lens to give the best chance of seeing clearly for both distance and near vision without spectacles following extraction of the lens.  

Has Dr Kent performed laser eye surgery on other Doctors … ?

Since 1997 Dr Kent has performed corrective laser eye surgery on more than four hundred medical doctors and optometrists combined. Dr Kent has performed laser vision correction procedures on five of his staff members and several of his relatives. Dr Kent has also treated many national sporting representatives.

What type of anaesthetic is used for laser eye surgery?

All laser eye surgery vision correction procedures are performed with anaesthetic drops placed in the eye which are extremely effective at completely numbing your eyes. A mild sedative is also offered 30 minutes before your procedure, it does not put you to sleep but helps to relax you before your procedure.

Why have PRK?

For some patients particularly those with very thin corneas PRK may be the safest laser vision procedure. With PRK good results can be expected for low corrections. PRK has been shown to have no significant long-term complications. However even in very low corrections there is a longer time before clear vision is obtained after PRK compared to the rapid vision recovery after LASIK or SMILE eye laser. The time delay to obtain clear vision following PRK is due to the fact that PRK is a laser procedure performed on the front surface of the eye, good vision is achieved once the corneal surface has healed generally within 5 to 7 days.

What is a femtosecond laser?

A femtosecond laser generates light pulses as short as one quadrillionth of a second. Femtosecond technology has opened up a whole new area of scientific study, femtochemistry, which won the 1999 Nobel Prize in Chemistry. The application of the femtosecond laser in ophthalmology was developed by physicists, biomedical engineers and ophthalmologists at the Center for Ultrafast Optical Sciences and the Kellogg Eye Center, University of Michigan, USA. The femtosecond laser has become the most accurate and safest technology for the creation of the corneal flap the first step in the LASIK procedure. The Zeiss Visumax femtosecond laser has enabled the latest laser eye surgery technique to be achieved SMILE eye laser.

Will it hurt?

Anaesthetic eye drops are placed into your eye prior to laser eye surgery treatment to numb the eye so there is usually no pain experienced during the procedure. You will be aware of some pressure against your eye. For several hours after your laser eye procedure you may experience a grittiness or irritation. This irritation lasts about 4 or 5 hours. Some people do experience mild pain after laser vision correction that can be relieved with pain relief tablets (Panadol).

What is the success rate?

Our results show that 98% of people with moderate myopia can expect to achieve 20/20 vision or better after an initial treatment. About 2 % will require an enhancement Globally millions of people have had LASIK to correct their vision and are happy with the result.

What are the different types of laser eye surgery advertised?

PRK: (also referred as ASLA) Photorefractive Keratectomy or Advanced Surface Laser Ablation •    The use of one laser (excimer) without the creation of a corneal flap. The surface epithelium is exfoliated to allow the laser (excimer) to be applied to the corneal bed. •    The epithelium then regenerates naturally. LASIK: Laser In-situ Keratomileusis, in use since 1991. •    A microkeratome (a bladed mechanical surgical cutting instrument) is used to form a thin flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. Lasik (laser-initiated LASIK) •    A Femotosecond laser is used to form a thin Flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. SMILE (Smile LASER) •    The use of just a Femtosecond laser to create a “micro incision” rather than a flap. The laser also creates a lenticular shaped piece of tissue that is then removed with forceps via the “micro incision”. Note: SMILE is a new technology unable to treat low myopia, hyperopia and astigmatism.  The accuracy of HD LASIK and PRK remain the standard choice for these correction.

What happens if I move my eye?

Active 7D eye tracking The 7D active eye tracker impresses through a number of benefits: Apart from the linear movements (1st and 2nd dimensions) it compensates rolling movements of the eye (3rd and 4th dimensions). Compensation of the eye’s rotation around its optical axis is achieved with the static and dynamic Advanced Cyclotorsion Control (5th dimension). Movements along the z-axis (sixth dimension) are actively compensated by means of the z-tracking. Automatic pupil size control and pupil centroid shift compensation ensure additional safety. Latency-Free Tracking in the 7th dimension The new, ground-breaking Latency-Free Tracking considers the time factor, i.e. the 7th dimension. Latency-Free Tracking compensates for eye movements that occur in the period between acquisition of the eyetracker image and triggering of the subsequent laser pulses

Can I have both eyes done with at the same time?

Yes. It is safe to do both eyes one after the other, especially with the greater safety offered by eliminating the microkeratome blade by providing "all-laser"  LASIK instead. Dr. Kent has offered same day both eye LASIK since September 1997, the first New Zealand eye surgeon to do so.

What are the risks?

With over 20,000 laser procedures done at FEC, we have not had anyone go blind. As far as we know no clinic in New Zealand has had anyone go blind following LASIK. With all medical procedures, there is a possibility of complications. However, complications that could threaten your vision are extremely rare these need to be discussed with your surgeon.

What if I wear contact lenses?

How long do I have to be out of my contact lenses prior to my laser eye surgery? Contact lenses can affect the natural curvature of the cornea. You will be required to cease wearing contact lenses for a period of time leading up to your laser eye treatment. This period without contact lenses allows the cornea to return to its natural state, which will optimise the treatment outcome. The period without contact lenses depends on the type of contact lens that you are wearing.  
  • Soft daily wear or disposable contact lenses should not be worn for 12 days before laser eye surgery.
  • Soft toric (astigmatism correcting) contact lenses. This type of contact lens "moulds" the cornea more than a standard soft contact lens. Therefore we advise you to cease wearing soft toric contact lenses for three weeks prior to your laser vision correction.
  • Hard or rigid gas permeable (RGP) contact lenses. This type of lens maintains its own shape while on your eye. They therefore have a greater moulding effect on the cornea. You will need to cease wearing hard or RGP lenses for 6-8 weeks prior to your laser eye surgery.
If you do not have spectacles we may be able to supply you with a loaner pair that will be close to your prescription to assist you during the period that you are required to be out of contact lenses.

Can I go blind?

The risk of blindness from LASIK surgery is almost zero. Laser eye surgery is safer than wearing contact lenses. An eye could become legally blind if there was a very bad eye infection after the surgery, which was unable to be controlled with antibiotic drugs. If such a serious complication did occur, then it would normally be possible to perform a corneal transplant and restore sight to that eye. This has never occurred in New Zealand.

What are the complications of LASIK?

Every procedure has the possibility of complications, with the majority of these resolving over time or being able to be managed with further treatment by Dr Kent:
  • Mild dry eye - Some people experience mild to moderate dry eye symptoms after laser eye treatment. Use of lubricating eyedrops may be required. By 3-6 months the eyes are usually back to normal. We have found that dry eye problems are less common with HD LASIK than with the older micokeratome bladed LASIK.
  • Undercorrection - If the refraction is not fully corrected and it causes a problem then an enhancement procedure can usually correct it.
  • Overcorrection - An initial overcorrection is expected for high corrections and in hyperopia.
  • Induced astigmatism - Can usually be corrected with enhancement procedure. Now very rare with IntraLase all-laser HD LASIK.
  • Regression – This is the normal healing of the eye and results in undercorrection. It is corrected with enhancement procedure.
  • Infection -We have had only one case in over 13,000 LASIK procedures which quickly responded to antibiotic eyedrops and resolved without complication.
 

When can I get back to work?

Normally we ask that you have a quiet day the day after the surgery. If you have LASIK or SMILE, most people have their surgery on a Thursday, and are back at work on Monday. You should relax completely immediately after the surgery. If you have PRK treatment the recovery time is longer. You are best to plan to be off work for seven days.

What is an ‘enhancement’?

Enhancement surgery is additional treatment to "fine tune" the result. It takes one to three months from the initial surgery for the vision to be stable. During this time there may be some minor fluctuations in your vision. There is a lot of individual variation in the rate and amount that people heal. If after three months there is some under or over correction Dr Kent can offer you some additional lasering to optimise the outcome, providing it is safe to do so. Enhancement surgery involves lifting the existing flap using fine surgical instruments to identify the edge of the flap and lift it to perform additional lasering. Generally enhancement surgery is more likely in higher or more complicated corrections. Enhancements are only needed in about 1% of cases of low short-sightedness. For higher corrections (over -8.0) there is a greater chance that an enhancement may be required. The overall rate of enhancement surgery following LASIK is about 4%. Enhancements are done free of charge within twelve months of the initial procedure as we want you to be happy with the final outcome.

Will laser eye surgery mean I will never need spectacles again?

In rare cases a full correction may not be achievable, if you have a high correction and a thin cornea. We will discuss this with you at your initial assessment. This may mean that you will need to wear spectacles occasionally eg driving at night time. Laser vision correction will not prevent your eyes from the normal ageing process. There are some people who will have a change in their eyes with time. This can be either progression of myopia or hyperopia. There is no way of predicting if changes will occur with your eyes after your treatment prior to laser vision correction. As with all people who have normal distance vision in both eyes you will require spectacles for reading at around age 45+. This aging of the eyes necessitating reading glasses at around 45+ in people with normal distance vision is called Presbyopia. The only way to minimise your dependence for near vision spectacles once you become presbyopic is to have monovision. Monovision is where one eye is treated so that it is fully corrected for the distance while the other eye is focused for near vision. If you are considering monovision as an option we would give you some disposable contact lenses to simulate what the treatment would achieve and get you to trial this for a week or two to determine for yourself whether or not monovision will suit your lifestyle. We would be happy to discuss monovision with you further. Please contact us directly.

How long has LASIK been done for?

LASIK using a microkeratome was first performed in Europe in 1991 and in New Zealand in 1995. IntraLase, femtosecond "all laser LASIK" was first performed in the USA in 2001 and in New Zealand in 2006.

What about side effects such as …?

What about side effects such as transient light sensitivity and inflammation? On rare occasions, some patients have reported transient light sensitivity (photophobia) at 2-6 weeks following IntraLase-initiated LASIK. This is due to an inflammatory response within the cornea. These side effects, while a nuisance, do not affect visual acuity and resolve with steroid eye drops. Almost all of these cases occurred with the older 15 and 30 kiloHeriz IntraLase models.

What is LASEK and Epi-LASIK?

Laser epithelial keratomileusis (LASEK) and Epi-LASIK are outdated techniques for surface eye treatments. We recommend the latest in photorefractive keratectomy (PRK) as an alternative to HD LASIK® because of a thin or unsymmetrical cornea. LASEK involves using 20% ethanol on the central 8-9 mm of the cornea, then lifting the epithelial layer as a flap, doing the excimer laser treatment to the front of the cornea and repositioning the epithelial layer. Visual results, post-operative course, advantages and disadvantages are much the same as PRK. However, due to the lack of significant advantages over photorefractive keratectomy (PRK), most eye surgeons have stopped performing the LASEK technique. Epi-LASIK involves using a microkeratome with a steel blade to cleave off the epithelial cell layer beneath its basal layer. The epithelium is lifted as a flap and the excimer laser treatment done to the front surface of the cornea. The epithelial flap is repositioned and a soft contact lens fitted. The ideal behind the Epi-LASIK technique is to make visual recovery faster than photorefractive keratectomy (PRK) . However to date the visual results, post-operative course, advantages and disadvantages are much the same as PRK. At Fendalton Eye Clinic we have chosen the latest photorefractive keratectomy (PRK)  technique for our patients providing our patients with the safest, most accurate and precise treatment in advanced surface eye surgery.

Can the flap be dislodged?

During the first few weeks after the surgery you do need to be careful of your eyes, as a sharp object in your eye could possibly dislodge the flap. If the flap did get dislodged, then it can be repositioned. After six weeks the flap is well healed. The chance of the flap being dislodged at this point is remote. It would take an event that would otherwise cause a severe injury to your eye to cause a problem with the flap after six weeks.

What does ‘seven dimensions’ eye tracking system mean?

What does 'seven dimensions' mean in Fendalton Eye Clinic's eye tracking system? Our excimer laser (the one that performs the actual correction during LASIK), the Schwind Amaris 1050RS, registers all movements with an eye tracking system that compensates every movement of the eye up to the seventh dimension. An analogy to explain the advanced seven dimensional eye tracker is to imagine your eyeball being a buoy in the sea: When the sea is calm, the buoy shifts from the left to the right or forward and backward. In a swell, however, the buoy tilts to the side. Furthermore, a buoy also turns around its anchorage or moves up and down. In the same manner, your eyeball can make linear movements (1st and 2nd dimensions), rolling movements (3rd and 4th dimensions), rotate around its own axis (5th dimension) or move up and down along the z-axis (6th dimension). The 7th dimension considers the time factor and compensates for eye movements that occur during the reaction time of the laser system. That means our laser treatment is delivered without latency.

LASIK Surgery

Who is suitable for laser eye surgery?

You need to be at least 20 years of age and have had no change in your glasses or contact lens prescription for at least a year. Laser eye surgery can correct short sightedness, long sightedness and astigmatism. Dr Kent can correct focusing errors in the range of -10 to +5 with laser eye surgery. If you are beyond this level of short sightedness or long sightedness you may still be able to have a procedure to correct your focusing error other than a corrective laser procedure. You might be better suited to a Lifestyle lens procedure or Implantable contact lens procedure depending on your glasses prescription, age and lifestyle demands. Astigmatism is treated with the laser at the same time as your shortsightedness or long sightedness is corrected. Your eyes must be in good ocular health, with no pre-existing untreated eye disease. Laser vision correction is not recommended if you are pregnant or breast feeding. If you suffer from an auto-immune disorder you will need to discuss your suitability further with Dr Kent.

Why I should choose Fendalton Eye Clinic?

The expertise and experience of Dr David Kent combined with the quality of the technology we have at Fendalton Eye Clinic.
  • Our staff care about giving you the best result for you as an individual, finding the most appropriate procedure for you based on your unique focusing error and lifestyle requirements.
  • Dr. Kent is one of the most experienced surgeons for laser vision correction in Australasia having performed over 28,000 laser eye surgery procedures. Dr Kent has performed more LASIK procedures than any other New Zealand eye surgeon. For optimal results surgeon experience counts.
  • We are the only clinic in the South Island to offer you the safety, accuracy and superior results of the Schwind Amaris 1050RS excimer laser, the most advanced excimer laser with it's smart pulse technology and the unparalleled accuracy of a seven dimensional active eye tracker.
  • Every laser eye treatment is tailor-made to each individual eye.
  • We do everything we can to give you the best result possible. Follow up after laser eye surgery at Fendalton Eye Clinic is for six months. Within New Zealand the cost of follow up appointments is met by Fendalton Eye Clinic.
  • At Fendalton Eye Clinic we have a state-of-the-art purpose-built laser eye surgery theatre.

Is there an upper age limit for corrective laser eye surgery?

Generally beyond the sixth decade of life there is a high likelihood that you will have early or mild cataracts. If there is any sign of early cataracts it is more appropriate to perform surgery to remove the deteriorating lens, lifestyle lens replacement or cataract extraction, replacing the natural lens of the eye with an intraocular implant. In most cases we would use a multifocal intraocular lens to give the best chance of seeing clearly for both distance and near vision without spectacles following extraction of the lens.  

Has Dr Kent performed laser eye surgery on other Doctors … ?

Since 1997 Dr Kent has performed corrective laser eye surgery on more than four hundred medical doctors and optometrists combined. Dr Kent has performed laser vision correction procedures on five of his staff members and several of his relatives. Dr Kent has also treated many national sporting representatives.

What type of anaesthetic is used for laser eye surgery?

All laser eye surgery vision correction procedures are performed with anaesthetic drops placed in the eye which are extremely effective at completely numbing your eyes. A mild sedative is also offered 30 minutes before your procedure, it does not put you to sleep but helps to relax you before your procedure.

What is a femtosecond laser?

A femtosecond laser generates light pulses as short as one quadrillionth of a second. Femtosecond technology has opened up a whole new area of scientific study, femtochemistry, which won the 1999 Nobel Prize in Chemistry. The application of the femtosecond laser in ophthalmology was developed by physicists, biomedical engineers and ophthalmologists at the Center for Ultrafast Optical Sciences and the Kellogg Eye Center, University of Michigan, USA. The femtosecond laser has become the most accurate and safest technology for the creation of the corneal flap the first step in the LASIK procedure. The Zeiss Visumax femtosecond laser has enabled the latest laser eye surgery technique to be achieved SMILE eye laser.

Will it hurt?

Anaesthetic eye drops are placed into your eye prior to laser eye surgery treatment to numb the eye so there is usually no pain experienced during the procedure. You will be aware of some pressure against your eye. For several hours after your laser eye procedure you may experience a grittiness or irritation. This irritation lasts about 4 or 5 hours. Some people do experience mild pain after laser vision correction that can be relieved with pain relief tablets (Panadol).

What is the success rate?

Our results show that 98% of people with moderate myopia can expect to achieve 20/20 vision or better after an initial treatment. About 2 % will require an enhancement Globally millions of people have had LASIK to correct their vision and are happy with the result.

What are the different types of laser eye surgery advertised?

PRK: (also referred as ASLA) Photorefractive Keratectomy or Advanced Surface Laser Ablation •    The use of one laser (excimer) without the creation of a corneal flap. The surface epithelium is exfoliated to allow the laser (excimer) to be applied to the corneal bed. •    The epithelium then regenerates naturally. LASIK: Laser In-situ Keratomileusis, in use since 1991. •    A microkeratome (a bladed mechanical surgical cutting instrument) is used to form a thin flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. Lasik (laser-initiated LASIK) •    A Femotosecond laser is used to form a thin Flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. SMILE (Smile LASER) •    The use of just a Femtosecond laser to create a “micro incision” rather than a flap. The laser also creates a lenticular shaped piece of tissue that is then removed with forceps via the “micro incision”. Note: SMILE is a new technology unable to treat low myopia, hyperopia and astigmatism.  The accuracy of HD LASIK and PRK remain the standard choice for these correction.

What happens if I move my eye?

Active 7D eye tracking The 7D active eye tracker impresses through a number of benefits: Apart from the linear movements (1st and 2nd dimensions) it compensates rolling movements of the eye (3rd and 4th dimensions). Compensation of the eye’s rotation around its optical axis is achieved with the static and dynamic Advanced Cyclotorsion Control (5th dimension). Movements along the z-axis (sixth dimension) are actively compensated by means of the z-tracking. Automatic pupil size control and pupil centroid shift compensation ensure additional safety. Latency-Free Tracking in the 7th dimension The new, ground-breaking Latency-Free Tracking considers the time factor, i.e. the 7th dimension. Latency-Free Tracking compensates for eye movements that occur in the period between acquisition of the eyetracker image and triggering of the subsequent laser pulses

Can I have both eyes done with at the same time?

Yes. It is safe to do both eyes one after the other, especially with the greater safety offered by eliminating the microkeratome blade by providing "all-laser"  LASIK instead. Dr. Kent has offered same day both eye LASIK since September 1997, the first New Zealand eye surgeon to do so.

What are the risks?

With over 20,000 laser procedures done at FEC, we have not had anyone go blind. As far as we know no clinic in New Zealand has had anyone go blind following LASIK. With all medical procedures, there is a possibility of complications. However, complications that could threaten your vision are extremely rare these need to be discussed with your surgeon.

What if I wear contact lenses?

How long do I have to be out of my contact lenses prior to my laser eye surgery? Contact lenses can affect the natural curvature of the cornea. You will be required to cease wearing contact lenses for a period of time leading up to your laser eye treatment. This period without contact lenses allows the cornea to return to its natural state, which will optimise the treatment outcome. The period without contact lenses depends on the type of contact lens that you are wearing.  
  • Soft daily wear or disposable contact lenses should not be worn for 12 days before laser eye surgery.
  • Soft toric (astigmatism correcting) contact lenses. This type of contact lens "moulds" the cornea more than a standard soft contact lens. Therefore we advise you to cease wearing soft toric contact lenses for three weeks prior to your laser vision correction.
  • Hard or rigid gas permeable (RGP) contact lenses. This type of lens maintains its own shape while on your eye. They therefore have a greater moulding effect on the cornea. You will need to cease wearing hard or RGP lenses for 6-8 weeks prior to your laser eye surgery.
If you do not have spectacles we may be able to supply you with a loaner pair that will be close to your prescription to assist you during the period that you are required to be out of contact lenses.

Can I go blind?

The risk of blindness from LASIK surgery is almost zero. Laser eye surgery is safer than wearing contact lenses. An eye could become legally blind if there was a very bad eye infection after the surgery, which was unable to be controlled with antibiotic drugs. If such a serious complication did occur, then it would normally be possible to perform a corneal transplant and restore sight to that eye. This has never occurred in New Zealand.

What are the complications of LASIK?

Every procedure has the possibility of complications, with the majority of these resolving over time or being able to be managed with further treatment by Dr Kent:
  • Mild dry eye - Some people experience mild to moderate dry eye symptoms after laser eye treatment. Use of lubricating eyedrops may be required. By 3-6 months the eyes are usually back to normal. We have found that dry eye problems are less common with HD LASIK than with the older micokeratome bladed LASIK.
  • Undercorrection - If the refraction is not fully corrected and it causes a problem then an enhancement procedure can usually correct it.
  • Overcorrection - An initial overcorrection is expected for high corrections and in hyperopia.
  • Induced astigmatism - Can usually be corrected with enhancement procedure. Now very rare with IntraLase all-laser HD LASIK.
  • Regression – This is the normal healing of the eye and results in undercorrection. It is corrected with enhancement procedure.
  • Infection -We have had only one case in over 13,000 LASIK procedures which quickly responded to antibiotic eyedrops and resolved without complication.
 

When can I get back to work?

Normally we ask that you have a quiet day the day after the surgery. If you have LASIK or SMILE, most people have their surgery on a Thursday, and are back at work on Monday. You should relax completely immediately after the surgery. If you have PRK treatment the recovery time is longer. You are best to plan to be off work for seven days.

What is an ‘enhancement’?

Enhancement surgery is additional treatment to "fine tune" the result. It takes one to three months from the initial surgery for the vision to be stable. During this time there may be some minor fluctuations in your vision. There is a lot of individual variation in the rate and amount that people heal. If after three months there is some under or over correction Dr Kent can offer you some additional lasering to optimise the outcome, providing it is safe to do so. Enhancement surgery involves lifting the existing flap using fine surgical instruments to identify the edge of the flap and lift it to perform additional lasering. Generally enhancement surgery is more likely in higher or more complicated corrections. Enhancements are only needed in about 1% of cases of low short-sightedness. For higher corrections (over -8.0) there is a greater chance that an enhancement may be required. The overall rate of enhancement surgery following LASIK is about 4%. Enhancements are done free of charge within twelve months of the initial procedure as we want you to be happy with the final outcome.

How long has LASIK been done for?

LASIK using a microkeratome was first performed in Europe in 1991 and in New Zealand in 1995. IntraLase, femtosecond "all laser LASIK" was first performed in the USA in 2001 and in New Zealand in 2006.

What about side effects such as …?

What about side effects such as transient light sensitivity and inflammation? On rare occasions, some patients have reported transient light sensitivity (photophobia) at 2-6 weeks following IntraLase-initiated LASIK. This is due to an inflammatory response within the cornea. These side effects, while a nuisance, do not affect visual acuity and resolve with steroid eye drops. Almost all of these cases occurred with the older 15 and 30 kiloHeriz IntraLase models.

Can the flap be dislodged?

During the first few weeks after the surgery you do need to be careful of your eyes, as a sharp object in your eye could possibly dislodge the flap. If the flap did get dislodged, then it can be repositioned. After six weeks the flap is well healed. The chance of the flap being dislodged at this point is remote. It would take an event that would otherwise cause a severe injury to your eye to cause a problem with the flap after six weeks.

How does the flap stick down?

The flap adheres back to the eye without the need for stitches. It is held in place until it heals by the natural stickiness of the inner layers of the cornea in combination with the "suction" effect of the back layer of cells (endothelium) of the cornea. Within four hours the front layer of cells (epithelium) heal over. We ask you to wear clear eye-shields after the surgery and overnight so that your eyes are not accidentally rubbed or bumped in the initial healing period.

What does ‘seven dimensions’ eye tracking system mean?

What does 'seven dimensions' mean in Fendalton Eye Clinic's eye tracking system? Our excimer laser (the one that performs the actual correction during LASIK), the Schwind Amaris 1050RS, registers all movements with an eye tracking system that compensates every movement of the eye up to the seventh dimension. An analogy to explain the advanced seven dimensional eye tracker is to imagine your eyeball being a buoy in the sea: When the sea is calm, the buoy shifts from the left to the right or forward and backward. In a swell, however, the buoy tilts to the side. Furthermore, a buoy also turns around its anchorage or moves up and down. In the same manner, your eyeball can make linear movements (1st and 2nd dimensions), rolling movements (3rd and 4th dimensions), rotate around its own axis (5th dimension) or move up and down along the z-axis (6th dimension). The 7th dimension considers the time factor and compensates for eye movements that occur during the reaction time of the laser system. That means our laser treatment is delivered without latency.

SMILE Eye Laser

Who is suitable for laser eye surgery?

You need to be at least 20 years of age and have had no change in your glasses or contact lens prescription for at least a year. Laser eye surgery can correct short sightedness, long sightedness and astigmatism. Dr Kent can correct focusing errors in the range of -10 to +5 with laser eye surgery. If you are beyond this level of short sightedness or long sightedness you may still be able to have a procedure to correct your focusing error other than a corrective laser procedure. You might be better suited to a Lifestyle lens procedure or Implantable contact lens procedure depending on your glasses prescription, age and lifestyle demands. Astigmatism is treated with the laser at the same time as your shortsightedness or long sightedness is corrected. Your eyes must be in good ocular health, with no pre-existing untreated eye disease. Laser vision correction is not recommended if you are pregnant or breast feeding. If you suffer from an auto-immune disorder you will need to discuss your suitability further with Dr Kent.

Why I should choose Fendalton Eye Clinic?

The expertise and experience of Dr David Kent combined with the quality of the technology we have at Fendalton Eye Clinic.
  • Our staff care about giving you the best result for you as an individual, finding the most appropriate procedure for you based on your unique focusing error and lifestyle requirements.
  • Dr. Kent is one of the most experienced surgeons for laser vision correction in Australasia having performed over 28,000 laser eye surgery procedures. Dr Kent has performed more LASIK procedures than any other New Zealand eye surgeon. For optimal results surgeon experience counts.
  • We are the only clinic in the South Island to offer you the safety, accuracy and superior results of the Schwind Amaris 1050RS excimer laser, the most advanced excimer laser with it's smart pulse technology and the unparalleled accuracy of a seven dimensional active eye tracker.
  • Every laser eye treatment is tailor-made to each individual eye.
  • We do everything we can to give you the best result possible. Follow up after laser eye surgery at Fendalton Eye Clinic is for six months. Within New Zealand the cost of follow up appointments is met by Fendalton Eye Clinic.
  • At Fendalton Eye Clinic we have a state-of-the-art purpose-built laser eye surgery theatre.

Is there an upper age limit for corrective laser eye surgery?

Generally beyond the sixth decade of life there is a high likelihood that you will have early or mild cataracts. If there is any sign of early cataracts it is more appropriate to perform surgery to remove the deteriorating lens, lifestyle lens replacement or cataract extraction, replacing the natural lens of the eye with an intraocular implant. In most cases we would use a multifocal intraocular lens to give the best chance of seeing clearly for both distance and near vision without spectacles following extraction of the lens.  

Has Dr Kent performed laser eye surgery on other Doctors … ?

Since 1997 Dr Kent has performed corrective laser eye surgery on more than four hundred medical doctors and optometrists combined. Dr Kent has performed laser vision correction procedures on five of his staff members and several of his relatives. Dr Kent has also treated many national sporting representatives.

What type of anaesthetic is used for laser eye surgery?

All laser eye surgery vision correction procedures are performed with anaesthetic drops placed in the eye which are extremely effective at completely numbing your eyes. A mild sedative is also offered 30 minutes before your procedure, it does not put you to sleep but helps to relax you before your procedure.

What is a femtosecond laser?

A femtosecond laser generates light pulses as short as one quadrillionth of a second. Femtosecond technology has opened up a whole new area of scientific study, femtochemistry, which won the 1999 Nobel Prize in Chemistry. The application of the femtosecond laser in ophthalmology was developed by physicists, biomedical engineers and ophthalmologists at the Center for Ultrafast Optical Sciences and the Kellogg Eye Center, University of Michigan, USA. The femtosecond laser has become the most accurate and safest technology for the creation of the corneal flap the first step in the LASIK procedure. The Zeiss Visumax femtosecond laser has enabled the latest laser eye surgery technique to be achieved SMILE eye laser.

Will it hurt?

Anaesthetic eye drops are placed into your eye prior to laser eye surgery treatment to numb the eye so there is usually no pain experienced during the procedure. You will be aware of some pressure against your eye. For several hours after your laser eye procedure you may experience a grittiness or irritation. This irritation lasts about 4 or 5 hours. Some people do experience mild pain after laser vision correction that can be relieved with pain relief tablets (Panadol).

What is the success rate?

Our results show that 98% of people with moderate myopia can expect to achieve 20/20 vision or better after an initial treatment. About 2 % will require an enhancement Globally millions of people have had LASIK to correct their vision and are happy with the result.

What are the different types of laser eye surgery advertised?

PRK: (also referred as ASLA) Photorefractive Keratectomy or Advanced Surface Laser Ablation •    The use of one laser (excimer) without the creation of a corneal flap. The surface epithelium is exfoliated to allow the laser (excimer) to be applied to the corneal bed. •    The epithelium then regenerates naturally. LASIK: Laser In-situ Keratomileusis, in use since 1991. •    A microkeratome (a bladed mechanical surgical cutting instrument) is used to form a thin flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. Lasik (laser-initiated LASIK) •    A Femotosecond laser is used to form a thin Flap on the front of the cornea. •    The flap is lifted and the laser is applied to the exposed deeper corneal bed. The flap is then replaced and correctly repositioned over the modified corneal bed, conforming to the new shape. SMILE (Smile LASER) •    The use of just a Femtosecond laser to create a “micro incision” rather than a flap. The laser also creates a lenticular shaped piece of tissue that is then removed with forceps via the “micro incision”. Note: SMILE is a new technology unable to treat low myopia, hyperopia and astigmatism.  The accuracy of HD LASIK and PRK remain the standard choice for these correction.

What happens if I move my eye?

Active 7D eye tracking The 7D active eye tracker impresses through a number of benefits: Apart from the linear movements (1st and 2nd dimensions) it compensates rolling movements of the eye (3rd and 4th dimensions). Compensation of the eye’s rotation around its optical axis is achieved with the static and dynamic Advanced Cyclotorsion Control (5th dimension). Movements along the z-axis (sixth dimension) are actively compensated by means of the z-tracking. Automatic pupil size control and pupil centroid shift compensation ensure additional safety. Latency-Free Tracking in the 7th dimension The new, ground-breaking Latency-Free Tracking considers the time factor, i.e. the 7th dimension. Latency-Free Tracking compensates for eye movements that occur in the period between acquisition of the eyetracker image and triggering of the subsequent laser pulses

Can I have both eyes done with at the same time?

Yes. It is safe to do both eyes one after the other, especially with the greater safety offered by eliminating the microkeratome blade by providing "all-laser"  LASIK instead. Dr. Kent has offered same day both eye LASIK since September 1997, the first New Zealand eye surgeon to do so.

What are the risks?

With over 20,000 laser procedures done at FEC, we have not had anyone go blind. As far as we know no clinic in New Zealand has had anyone go blind following LASIK. With all medical procedures, there is a possibility of complications. However, complications that could threaten your vision are extremely rare these need to be discussed with your surgeon.

What if I wear contact lenses?

How long do I have to be out of my contact lenses prior to my laser eye surgery? Contact lenses can affect the natural curvature of the cornea. You will be required to cease wearing contact lenses for a period of time leading up to your laser eye treatment. This period without contact lenses allows the cornea to return to its natural state, which will optimise the treatment outcome. The period without contact lenses depends on the type of contact lens that you are wearing.  
  • Soft daily wear or disposable contact lenses should not be worn for 12 days before laser eye surgery.
  • Soft toric (astigmatism correcting) contact lenses. This type of contact lens "moulds" the cornea more than a standard soft contact lens. Therefore we advise you to cease wearing soft toric contact lenses for three weeks prior to your laser vision correction.
  • Hard or rigid gas permeable (RGP) contact lenses. This type of lens maintains its own shape while on your eye. They therefore have a greater moulding effect on the cornea. You will need to cease wearing hard or RGP lenses for 6-8 weeks prior to your laser eye surgery.
If you do not have spectacles we may be able to supply you with a loaner pair that will be close to your prescription to assist you during the period that you are required to be out of contact lenses.

Can I go blind?

The risk of blindness from LASIK surgery is almost zero. Laser eye surgery is safer than wearing contact lenses. An eye could become legally blind if there was a very bad eye infection after the surgery, which was unable to be controlled with antibiotic drugs. If such a serious complication did occur, then it would normally be possible to perform a corneal transplant and restore sight to that eye. This has never occurred in New Zealand.

When can I get back to work?

Normally we ask that you have a quiet day the day after the surgery. If you have LASIK or SMILE, most people have their surgery on a Thursday, and are back at work on Monday. You should relax completely immediately after the surgery. If you have PRK treatment the recovery time is longer. You are best to plan to be off work for seven days.

What is an ‘enhancement’?

Enhancement surgery is additional treatment to "fine tune" the result. It takes one to three months from the initial surgery for the vision to be stable. During this time there may be some minor fluctuations in your vision. There is a lot of individual variation in the rate and amount that people heal. If after three months there is some under or over correction Dr Kent can offer you some additional lasering to optimise the outcome, providing it is safe to do so. Enhancement surgery involves lifting the existing flap using fine surgical instruments to identify the edge of the flap and lift it to perform additional lasering. Generally enhancement surgery is more likely in higher or more complicated corrections. Enhancements are only needed in about 1% of cases of low short-sightedness. For higher corrections (over -8.0) there is a greater chance that an enhancement may be required. The overall rate of enhancement surgery following LASIK is about 4%. Enhancements are done free of charge within twelve months of the initial procedure as we want you to be happy with the final outcome.