Laser eye surgery (PRK, SMILE and LASIK)

Laser eye surgery can be used to treat long or short sightedness and astigmatism. Each laser treatment is customised to treat your eye making it highly accurate. Dr Tom Cunneen is one of the few surgeons in Perth who have done an international fellowship in laser eye surgery. He will discuss which option is best for you based on your lifestyle and the precise nature of your eye.

SMILE laser surgery is the latest innovation in laser refractive surgery. SMILE involves removing a thin layer of tissue from within the cornea. This gives a rapid visual recovery, leaves the cornea stronger than with LASIK and reduces the incidence of dry eye.

LASIK involves using a femtosecond laser to create a wafer thin flap of corneal tissue (one tenth of a millimetre) which is carefully rolled back. An excimer laser then precisely shapes the cornea. The flap is placed back in position and the vision rapidly improves.  98% of people will see 6/6 (20/20) one week after surgery.

Trans – Phototherapeutic Keratectomy (Trans- PRK) is an alternate technique which involves directly changing the surface of the cornea with an excimer laser. The cornea heals rapidly leaving a smooth surface. Because there is no flap created, the eye maintains almost all its structural integrity. The rates of dry eye are less than LASIK. The cells of the eye need to cover the lasered area, and so the recovery is slower than with SMILE or LASIK; however after the healing phase, the results are equivalent.


Frequently Asked Questions

Am I suitable for laser eye surgery?

This is the first thing that most people want to know. There are now many safe and effective ways to treat short or long sightedness and Dr Cunneen will find a solution that is most suited to your lifestyle and your eyes. So while your eyes may not be ideal for LASIK, there may be another procedure to improve your vision.

Generally it is important that your cornea is thick enough, you do not have severe dry eye, severe allergic disease, or are pregnant.

What does the assessment entail?

On the day of your assessment a detailed history of your ocular and general health and will be taken.

You will be asked to bring details of your previous glasses prescriptions and an updated glasses prescription if you haven’t had this done in the past 6 months.

Scans of the front of your eye will be taken to precisely map the shape and thickness of your cornea. Your tear production will be measured and a full clinical eye exam performed. Eye drops will be used to open your pupil and allow the examination for the back of the eye. This will make your vision blurry for several hours. Please arrange to not drive home from the appointment. This examination ensures that your eyes are perfectly healthy before any surgery is discussed.

What happens on the day of LASIK surgery?

On the day of surgery you will need someone to come with you to escort you home. Your details will be checked and you will have anaesthetic and antiseptic drops instilled in the eye. In the operating theatre you will be asked to lie down on the bed and your eye will be positioned under the first laser. This laser creates the extremely thin corneal flap. You shouldn’t feel any pain however often people feel a pressure sensation. After the flap is created you will move to the second laser. At this stage you will see the bright lights of the second laser. The flap is then placed back in position and drops put in the eye. You will be checked after the procedure and seen the following day for a check up.

How soon will the vision improve?

With LASIK your vision will be foggy on the day of surgery however it will be much clearer the following day. By one week 98% of LASIK patients will see 6/6 (20/20). With surface ablation your vision will take some weeks to clear completely.

Can I go blind from the surgery?

With state of the art lasers, this is vanishingly rare. The complication rates from LASIK are very low. The most common problem after Laser surgery is residual refractive error. This occurs because everyone’s eyes heal slightly differently after surgery. Other rarely reported complications are infection, light sensitivity, inflammation and dryness. These conditions are treatable and are increasingly rare.

For a scientific discussion of the risks please follow this link.

How do I get to and from the appointment?

Dr Cunneen’s rooms are centrally located at 10 Churchill Ave, Subiaco. There is ample parking behind the premises which can be accessed via the laneway to the right of the building. Alternatively there is 2 hour parking in the street. Public transport from the CBD includes catching the Yellow CAT bus to Murray St Princess Margaret and walking 400m south to Churchill Ave. Alternatively, West Leederville train station is a 13 minute walk from the rooms.

What should I look for in choosing my laser eye surgeon?

It’s important that you ask your surgeon whether he or she has done a fellowship in laser eye surgery. This is advanced training, generally in a specialised, international centre.

Secondly, surgeons who also have appointments at tertiary teaching hospitals are the ones who look after the sickest of eyes and are generally leaders in their field. They are trusted to train the next generation of surgeons and you can expect expert care from them.

Finally, nothing can substitute the feeling you have when you meet your surgeon. Make sure you trust him or her and are comfortable with them.

Laser eye surgery

If you’re interested in improving your vision, please book a consultation with Dr Tom Cunneen.