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This is what you need to know before you have laser eye surgery.

Image: Carla having her eyes tested, and looking pretty damn hot in the process.

“Enough is enough.”

That’s what I said to my glasses, which I’ve worn since kindergarten.

I’m in my early thirties, and all of a sudden it feels like everything is just wrong with my glasses. They seem constantly smudgy, no matter how often I clean them. The weather is never right: raindrops splatter on the lenses, and when it’s sunny, I’m playing the on-off juggling game between my prescription sunglasses and usual specs.

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When you wear glasses for almost your entire life, you reach a certain age when you’re just… over it. Laser eye surgery became enticing, and I wanted to know everything about it. I booked myself in to see Dr Con Moshegov, a Sydney-based ophthalmologist and clinical lecturer at Sydney University who’s also a laser eye surgeon.

"So, my eyes are f***ed..." Carla GS in conversation with Dr Con Moshegov, ophthalmologist. (Image: supplied)

I want to get laser eye surgery, but I’m really scared. Can you give me some advice?

“First of all, I understand and empathise. Vision is the most important of senses, and the eyes are so delicate,” Dr Moshegov says. He's spent time on the other side of the laser, having his own vision corrected, so he knows from experience what it feels like.

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“Laser eye surgery is not new. It’s been performed since the late '80s. We have many, many, many years of experience, and we know that it’s an incredibly safe procedure. No-one has lost their sight from iLasik [the newest form of laser eye surgery], certainly not in Australia. I always give the patient time to think about it, and never push.”

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Who is eligible for laser eye surgery?

Think of the laser eye surgery as a pub, because you need to be 18 years or over to have the procedure. And forget those beer goggles — you need a stable glasses prescription prior to having your eyes zapped. Make sure your eyes are healthy and in tip-top shape, with adequate corneal thickness and a regular corneal shape. Pregnant and breastfeeding women are discouraged from having laser eye surgery.

I have astigmatism. Can I still have laser eye surgery?

Like a lot of people, I’d heard that those with astigmatism - that is, a football-shaped eyeball, rather than a globe shape - couldn't have laser eye surgery. Thankfully, this is a myth.

“It’s a popular misconception. We can treat astigmatism, and we’re very good at it," says Dr Moshegov.

“However, there are some sub-sets of astigmatism where the astigmatism is what we’d call irregular, due to a disease. In that case, laser treatment isn’t possible.”

Glasses or not, here's a winged eyeliner hack to enhance every eye, thanks to makeup artist Eve Gunson. (Post continues after gallery)

What happens during iLasik?

Dr Moshegov conducts laser eye surgery at his practices. Before the procedure, patients are given an oral sedative, to help them relax without falling asleep. The patients are given anaesthetic drops in their eyes, and antiseptic is used around their face, to remove bacteria from their brows and eyelashes.

“Patients have two laser procedures. The first laser procedure creates a little, thin flap in the cornea. This was once done using a blade, and now it’s done with a laser. That flap is reflected (folded back)," Dr Moshegov explains. A second laser is then used to gently re-shape the cornea, which works to correct their vision. The flap is then re-positioned.

Look out, lasers about! Carla GS with an iLasik machine. (Image: supplied)
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The lasering itself takes less than a minute. Overall, the patient is in the laser room for 15 to 20 minutes.

“When the patient comes out, their vision is a little misty. We check their eyes after the procedure, to make sure everything’s okay, and then they go home. From when they walk into the centre, to when they leave, is an hour,” explains Dr Moshegov.

Is it safe?

“The only reason why we do this elective surgery is because we know that it is very, very safe. The risk of blindness is virtually nil. With laser, it is nil. If care is exercised, and the patient is chosen well, the results can be quite marvellous," Dr Moshegov says.

How long will it take to recover?

Laser eye surgery has a very quick recovery rate, usually 48 hours. So, you could have iLasik on a Friday, and be back at work on Monday. Dr Moshegov said that the day after surgery, patients can return to their regular life: "They can go to the gym, they can go for a jog, they can stand on their heads and do yoga.”

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What’s on the no-go list? Swimming, medications in the eye, rubbing the eyes, and eye makeup. No eye makeup? Count me out! (I’m kidding.) Many patients experience dry eyes after laser eye surgery, so during the recovery period, frequent use of eyedrops is recommended.

How much will it cost?

Dr Moshegov assesses Carla's eyes. (Image: supplied)
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“In the vicinity of $3,000 per eye,” says Dr Moshegov, adding that this is on bar with his competition. He says that if the idea of laser eye surgery appeals to you, and if you want to experience the freedom of not wearing glasses, “then it’s worth it.”

Will my eyes be assessed before the procedure?

I had a two-hour consultation at Dr Moshegov’s clinic, which is the norm for anyone visiting for the first time. My eyes were given the most thorough examination of their lives. All of the examination procedures were non-invasive and easy, conducted by a friendly orthoptist named Sarah. It felt like a regular visit to the optometrist, except with a few more fancy machines.

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The purpose of this examination is to ensure you're a good candidate for laser eye surgery. The initial consultation costs $200, some of which is claimable from Medicare.

What if I need time to think it over?

If you are deemed a good candidate for laser eye surgery, you can take your time to make the decision. With the right surgeon, you won’t be pressured into a choice. Dr Moshegov told me he's happy to talk to potential patients on the phone or via email, if his patients need further information or reassurance. He confided that one patient even waited seven years before having the procedure.

I’ve heard laser eye surgery doesn’t last forever. A friend had their eyes lasered, but their eyesight became bad again after a few years, and they had to have surgery again. Is this true?

Mel B says she experienced regression 15 years after having laser eye surgery

“It’s true, but only in a small percentage of patients. It depends on the patient’s age, and the type of prescription they have," explains Dr Moshegov.

Regression – that is, having your eyesight return to a poor prescription – is dependent on how bad your eyes were in the first place.

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“If someone has a high prescription, of let’s say, minus 8 (i.e. very poor eyesight), and you operate on them in their 20s, giving them near-perfect vision. There’s a significant chance that, in their 30s, they’ll have regressed a little bit. Of course, they won’t regress to minus 8 or minus 9, but they may regress to minus 1,” says Dr Moshegov.

“On the other hand, if you’re operating on someone with a low prescription of minus 2, and they’re pushing 40, their chances of regression are so low.” If regression occurs very soon after surgery, Dr Moshegov is happy to “adjust” (i.e. perform laser eye surgery again) without charge.

My optometrist says even if I get laser eye surgery, I’ll still need reading glasses when I’m in my mid-40s, because it’s normal for near-vision to deteriorate with age. Should I bother?

Dr Moshegov thinks it’s still worth it, as patients will experience “the instant gratification of perfect distance vision”. Those who delay laser eye surgery could “miss out on that time of freedom”.

I’m seriously considering having laser eye surgery. Do you have any advice for me?

When an orthoptist tells me to open my eyes wide, I deliver. (Image: supplied)
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“Ensure that your eyes are examined thoroughly, and that you are a good candidate for the procedure. The best people are experienced, refractive surgeons – not optometrists, not GPs, not even general opthamologists, but someone who does it all the time,” suggests Dr Mosegov.

And finally, I had a question that was just for me.

Should I get laser eye surgery?

For me, it was a no… for now. Dr Moshegov described my eyes as “quite an unusual situation”, in that my left eye is short-sighted with astigmatism, and my right eye is long-sighted. He suggested I could have laser eye surgery on my left, short-sighted eye, as the vision in my right eye isn’t that bad.

Surprisingly, it wasn’t my mismatched eyes which stopped me from hopping into that chair for iLasik, but the dryness of my eyes. Dr Moshegov diagnosed me with keratoconjunctivitis sicca, which is a fancy phrase for ‘very dry eyes’. He gave me a set of instructions to follow which should help lubricate my eyes (using eyedrops and ingesting fish oil, linoleic acid and flaxseed oil). He also suggested that later on down the track, I could take medication to help further lubricate my eyes.

Apparently, if I followed the instructions, I may be a better candidate for laser eye surgery in six months. Watch this space. For now, I'll just go take some fish oil and polish my glasses.

What about you? Have you considered having laser eye surgery? Would you consider having it done?

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