Your Guide to Supracor LASIK

Distance vision in the treated non-dominant eye may be poor.

Each eye of the same patient may behave differently. The near vision correction is placed in the very centre of the cornea and the cornea becomes slightly steeper in the centre than usual. This results in a “Multifocal” cornea with different zones for distance and near. Near vision from the first day is usually excellent and remains the same.

Distance vision is highly variable from being fairly good to being quite poor soon after surgery. Distance vision is better with both eyes open. The first week is often the most difficult for distance vision and driving can be difficult. The majority of patients eventually cope well once they start to adapt and distance vision continues to improve gradually.

At 3 months vision is a lot better, however still might not be perfect at distance. By 6 months both distance and near vision is good with both eyes open.

There are a few reasons for this phenomenon.

1. The cornea is made to be multifocal and the eyes optical system changes. The brain is used to analysing optical information received from the centre of the cornea but now has to adjust to a multifocal cornea. The centre now has a very small zone for near correction and an outer zone for distance. Cortical (the location in the brain) adaptation is the process where the patient gradually gets used to deciphering information from the altered optical system and becomes able to analyse distance visual information.
2. A slight myopic correction is intended as the eyes do regress a little over time. This early myopia results in blurry distance vision.
3. Those who have been farsighted (hyperopic) have always had a tendency to “accommodate” or use the muscles inside the eye to change the shape of the lens in the eye to focus. The trigger for this mechanism is ‘blur’ – when the brain receives a slightly blurry image, its compensatory mechanism to correct the blur is for the eye muscles to go into action. This is the opposite of what is required and makes the eye more myopic making distance vision more blurry – a vicious cycle! This does eventually stop and vision at distance improves. Patients often find their vision is better at distance, late in the day when tired, or first thing in the morning on awakening when the eye is relaxed.
4. Temporary dry eye is not uncommon after LASIK surgery and in the case of Supracor the central slightly steep area is prone to drying more, with tears evaporating in this area faster. As this area is in the visual axis, blurry vision for both distance and near is a possibility. This is temporary and will in time, resolve. If this does occur, frequent use of lubricants is necessary and will improve vision. At your Centre for Sight preoperative evaluation, you will have dry eye testing and if dry eye is evident, treatment would not be recommended. In some cases of slight tear underproduction, temporary Punctual Plugs are inserted to prevent tears from draining away. By about 8 to 12 weeks the majority of dry eye problems resolve.

This phenomenon can sometimes occur although reported rarely. The cornea is multifocal and visual information is split between distance and near. At night, when the pupil is wide open, halos may initially occur. With cortical adaptation, the brain “tunes out” the poor information and the halos from the treated eye disappear.

These are results from the CE marking European Multicentric Study (courtesy Technolas) for Hyperopia (Farsightedness). Notice distance vision improves with time, however near vision is excellent right away and remains stable.

Distance vision
(96% see distance sc 0.8 or better (6M)

Near vision
(91% see near sc 0.8 or better)

The dominant eye should have excellent vision and with both eyes open vision should meet the DVLA standard for driving. If you feel that driving is not safe, then you are urged to get a pair of temporary spectacles to help, but only use them when distance vision is critical. Using the glasses all the time will delay the process of cortical adaptation.

Yes. Although unusual, this is possible and there is a software option for this. The typical patient will have good distance vision but near may not be as good. An enhancement will be considered at 3 months at the earliest.

A dramatic difference is noted immediately in terms of near vision and all patients are able to read a newspaper immediately after the procedure. As discussed above, to begin with the treatment does make patients a little short-sighted (-0.50D), in other words vision is slightly blurry at distance and this improves over the following weeks. Distance vision continues to improve month by month and 6/7.5 (20/25) vision is obtained in 74% at 3 months 96% at 6 months. (Multicentric CE marking study).

Suitability for treatment requires a thorough consultation with specific investigations including the degree of Presbyopia (requirement for reading glasses). Treatment is available for those who are farsighted, short-sighted and astigmatism. Find out if you are suitable for Supracor.

YES – patients who have previously had Laser eye surgery have had successful outcomes following Supracor LASIK. Understandably those who have experienced the benefit and visual freedom from previous laser eye surgery are really motivated to stay out of glasses including readers. Supracor Lasik is an excellent option for this group of patients.

Care following this type of procedure is identical to Lasik / Intralasik the details of which are found here.