In the beginning, there were spectacles. Until then, if your eyesight failed you, your best bet was to squint. But now you can undergo Lasik and get your eyesight corrected in a fuss-free way.
How much would this actually cost though? We deep dive into the options you have at private clinics as well as the public health route with the Singapore National Eye Centre.
What is Lasik?
Lasik is short for Laser-Assisted In situ Keratomileusis. It’s a mouthful, so we appreciate the acronym. Lasik is a type of eye surgery where a laser is used to sculpt the cornea to improve short-sightedness (myopia), far-sightedness (hyperopia) and astigmatism.
The cornea is the transparent front part of the eye that lets light into the eyeball and retina so you can see. Think of it like the camera’s lens. When your cornea goes out of shape, the image on the retina becomes fuzzy.
Lasik helps to correct the misshapen cornea by using a laser to cut the surface of the cornea and create a thin flap. Another laser (an excimer laser) is then used to shape the middle section of the cornea. Once the cornea has been re-shaped, the flap is put back in place to cover the cornea. It then naturally adheres to the cornea, forming your eye’s own bandage.
It’s a 10 to 15-minute day surgery that requires only topical anaesthetic eyedrops. Improvements are usually immediate and within a day or two (a week at most), you can go back to life as normal (though you have to stay off water and contact sport for a month).
There is a premium Lasik treatment called iLASIK. It involves creating a 3D map of the eye using Wavefront technology. This allows for a more intricate representation of your vision needs. Then, a bladeless laser technique that promises greater precision and safety is used to create the flap in the cornea. Of course, greater accuracy also demands greater cost.
Apart from Lasik, there are other types of laser eye surgeries:
Advanced Surface Ablation (Epi-Lasik, LASEK, PRK, TransPRK)
A no-flap, no-incision, surfaced-based procedure, ASA involves the removal of a thin layer of cells on the surface of the cornea so the laser can shape the cornea. A protective contact lens is then placed over the eye till the cells grow back in a few days.
This is the best option for those with thin corneas but it requires a longer treatment and recovery time (three to five days).
ReLEx SMILE (Refractive Lenticule Extraction, Small Incision Lenticule Extraction)
Like ASA, it’s a flapless procedure but it’s recovery time is faster. A laser creates a disc-shaped piece of corneal tissue (lenticule) just beneath the surface of the cornea. The same laser then makes a small cut on the cornea to remove the lenticule. It’s the removal of the lenticule that changes the way light bends into the eye, clearing the vision.
This method doesn’t work for long-sightedness and isn’t as effective for high astigmatism or low myopia.
So, Lasik remains the most common and popular form of laser eye surgery in Singapore and around the world. Some estimates put the number between 28 and 40 million worldwide who have undergone Lasik.
Collagen Cross-Linking (CXL)
You might be offered CXL in addition to your laser eye surgery. This extra procedure aims at reducing both the risk of your degree returning and that of your cornea losing its shape which is known as corneal ectasia (though this is rare).
CXL is done during your laser surgery. Vitamin B12 drops are applied to the eye before UV light is shone on it for a minute. This activates the collagen fibres on your eye to cross-link and strengthen your cornea after Lasik.
Cost comparison of procedures
|Lasik||$2,980 to $4,500|
|iLASIK||Add 30per cent to 50per cent more to your Lasik bill|
|ASA||$3,599 to $4,000|
|ReLEx SMILE||$4,805 to $6,000|
|Post-procedure medication (if not included in package)||$50 to $100|
|CXL (add on)||$1,199 to $3,000|
Are there any side effects with Lasik?
The short answer is: Yes. The long answer is: Yes, but they are minimal, bearable and often temporary.
Dry eyes: This is caused by the creation of the corneal flap and the effect of the laser on the cornea which cuts the corneal nerves responsible for normal tear production. It should resolve itself in a few months.
Night vision issues: Seeing halos, glares and starbursts at night is especially common with people with high myopia or high astigmatism. This goes away gradually within nine months to a year.
Discomfort and itchiness: The discomfort is part of the healing and will go away a few hours after the procedure. Closing your eyes or sleeping should alleviate the sensation. The itch should disappear in a few days. Using preservative-free artificial tears eye drops will help.
Risks associated with Lasik
Thinning cornea: This is rare (globally only 0.04 per cent to 0.06 per cent) but it does happen. The cornea becomes irregular and unstable in a condition known as post-Lasik ectasia.
Problems with cataract surgery in the future: During cataract surgery, the lens in your eye is replaced with an artificial one to clear your vision. Because Lasik permanently changes your cornea, the lens calculations become more difficult since it requires a normal cornea for correct reading. So, you might end up having to wear glasses after your cataract surgery, which you would not have otherwise had to do.
Inaccurate eye pressure readings: Glaucoma is a condition where there’s increased pressure on the eyeball. This causes damage to the optic nerve that can lead to poor eyesight or even blindness. Lasik makes reading your eye pressure more of a challenge, leading to a lower reading.
Regression: Your old degree could return, especially if your myopia is very high. But odds are, the improvements are permanent and require only minor adjustments because the shape of your cornea can still continue to alter Lasik.
Who can (or can’t) benefit from Lasik?
Like any procedure, there are ideal candidates and less than ideal ones for Lasik.
You can go for Lasik if:
- You are at least 18 years old (some say 21 years old)
- Your degrees have stabliisied for at least a year
- You are in good health
If you’re any younger, your eye-sight may not have stabilised yet. If you are in your 40s, you may need reading glasses as you age even with Lasik.
Lasik isn’t advisable if you:
- Have very high refractive error, for example myopia of more than 1000 degrees, hyperopia of more than 400 degrees, and astigmatism of more than 400 degrees. Results tend to be less predictable and satisfactory for patients with these conditions.
- Suffer from severe dry eye syndrome
- Have thin corneas relative to the degree of improvement you want
- Have irregularly-shaped or steep corneas
- Have existing eye injuries or diseases such as cataract, glaucoma, diabetic eyes or retina problems
- Are hoping to correct presbyopia (long-sightedness due to age)
- Are pregnant or nursing
Hormonal changes during pregnancy or nursing can cause vision to fluctuate. You may need to wait six months after pregnancy and nursing before undergoing Lasik.
Where can I get Lasik procedures done? Private vs public clinics
As with all medical procedures, you have your choice of public institutions and private clinics for your Lasik procedure. Public institutions are generally, though not always, the cheaper options.
There are a few of these that you can go to for Lasik:
- Singapore National Eye Centre (SNEC)
- National University Hospital
- Tan Tock Seng Hospital
|Tan Tock Seng Hospital (TTSH)||$2,000 to $3,590 (depending on whether Lasik is bladeless & seniority of consultant) + around $160 (consultation)|
|National University Hospital (NUH)||$1,766 to $2,354 (bladeless Lasik; depending on seniority of consultant) + $102 (consultation)|
|Singapore National Eye Centre (SNEC)||$2,364 to $3,531 (depending on whether Lasik is bladeless or not & seniority of consultant) + $109 to $123 (consultation)|
From our research, it would seem that SNEC is the most commonly chosen route for public clinics.
Private clinics / hospitals
Here are some examples of private clinics and their Lasik prices (for both eyes).
|Atlas Eye Specialist Centre||$2,959 to $3,659|
|Asia Pacific Eye Centre||From $2,980|
|LSE Eye Clinic||$3,198 to $4,375|
|Eagle Eye Centre||$3,250 to $3,450|
|Lee Hung Ming Eye Centre||From $3,724.67|
|Clearvision Eye Clinic||$3,888|
Note that there will be additional charges for your consultation before doing the actual procedure. This usually ranges from $100 to $135, depending on seniority of your consultant.
Can I use Medisave or insurance to pay for Lasik?
With a bill that can run into the thousands, financing your vision (couldn’t resist the pun) of better eye-sight is a real issue. So, here are answers to questions you may have about paying for your Lasik treatment.
Can I use my Medisave?
Usually not. Medisave is used for medical and surgical procedures. While Lasik is surgical, it isn’t always a medical procedure as much as it is a cosmetic one.
But, you can use Medisave to defray costs if:
- There is a difference of 300 degrees or more (3 diopters) between your two eyes
- Lasik is performed to correct errors from previous procedures such as a cataract surgery
- Your doctor certifies that you can’t tolerate contact lenses or spectacles.
Will my insurance cover Lasik?
No. Most insurance policies don’t cover Lasik because it’s an elective, cosmetic surgery. In other words, as far as they’re concerned, you don’t really need it, you just want it to look better. In addition, most in Singapore have worn glasses from young so your myopia is considered a pre-existing condition.
This article was first published in MoneySmart.