The procedures are currently available in Adelaide, Brisbane, Melbourne, Perth and Sydney. Nearly 30% of adult Australians have myopia and most could potentially be considered for surgical correction. Laser correction may be a suitable alternative for people who would prefer to have their myopia surgically treated. People generally have the procedure performed for two reasons. It may be because they want to be involved in work or leisure activities where glasses or contact lenses are not appropriate or cannot be worn. The other reason is for cosmetic purposes, because they do not want to wear glasses and are not able to wear contact lenses. This type of procedure cannot correct either long-sightedness or presbyopia (age-related long-sightedness).

Laser Correction is done on an out-patient basis, by ophthalmologists using privately purchased laser machines. The procedure lasts 20 to 30 minutes with a laser time of usually less than a minute. The latest procedure uses an automated keratome to cut a hinged flap in the cornea. The flap is then folded back and the excimer laser is used to shape the corneal tissue. The flap is replaced without sutures. The eye is then patched for a few days and the patient is monitored over a period of several months while using eye drops.

Current guidelines suggest that one should wait at least three months before having the second eye treated. Before the second eye is treated, patients usually use modified glasses or a contact lens in the untreated eye.

The high cost of Laser Corneal correction and the lack of any cover from either private or public health insurance schemes, means the number of people likely to undergo the procedure will remain small. Currently, treatment for each eye costs about $2500. Only a small number of public patients have been treated at no cost.

While there are some signs that competition between providers in other countries may reduce the cost of the procedure, the high capital investment in the laser itself, makes competitive price reduction unlikely in the short-term.

After laser treatment, it is relatively common for patients to experience some pain, at times severe, for a few days after the procedure.

Unwanted effects, which have been recorded in a varying number of cases, include: a lack of permanency with reversion occurring ('regression'); over-correction ('hypermetropic shift'); erosion and scarring of the cornea; sensitivity to glare which may make night driving hazardous; halos; and corneal haze. While almost all people who have undergone the procedure have their myopia reduced, many may still need to wear glasses or contact lenses to achieve their best vision.

No long-term effects additional to those mentioned above have been identified up to five years after the procedure, but the very long-term questions remain unanswered. Therefore, potential patients need to have this situation carefully explained to them in discussions with their ophthalmologists and in their informed consent forms, as is currently widely practised.

The results of the procedure so far are encouraging, but further investigations are needed, especially on the questions of predictability and stability, as well as considerations of affordability, before the procedure can be routinely recommended as a treatment for myopia. Those considering Laser Correction should be aware that: the very long-term effects are not yet known and there are relatively few people who have had the procedure for more than five years; glasses and contact lenses are still the safest, most effective and affordable treatment for myopia; and even after the procedure, many people still need to wear glasses or contact lenses in some circumstances, such as for driving or reading.

Article #4515

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