Laser eye surgery

What was once laser eye surgery is now considered vision correction. In fact, I don’t see myself to be a laser eye surgeon. I consider myself to be in the profession of vision correction.

Technically, there are several forms of vision correction. How I decide which laser eye surgery procedure is correct is as follows: I work out the anatomy of the patient’s eye, their optical error, then take into account their age and expectations. Then, I work out which laser eye surgery procedure is best for them. 

My introduction to laser eye surgery

My initial interest was in corneal transplantation, and I was fortunate enough to do a fellowship with Professor Richard Troutman in the USA. At the time, he was the leading transplant surgeon – people would come to him from all over the world. We would do our rounds after surgery, and it was my job to ensure that the patients were well enough to be discharged.

 Professor Troutman would say during these rounds – ‘great, the transplant was successful’. And it was beautiful work. However, I would come back and the patient would say – ‘But doctor, I can’t see clearly.’ The corneal grafts were clear and healthy but the optics were imperfect.. I’d think, ‘well, no one is taking notice of what the patients really need.

In 1986 while presenting a paper at the World Cornea Congress in Washington I met Professor Theo Seiler from Germany, who had just performed the first excimer laser treatments I thought – ‘this is the answer’. We can use an excimer laser to improve the optics of corneal grafts, and help them see. It was such a logical fit.

During the very early days of laser eye surgery, I started to learn and then publish and lecture on the topic, work with some of the early leaders. Here I was, at age 31, a world-authority in laser eye surgery. I was at ‘the eye of the storm’ of this intense research and development and I emerged as an expert of applying laser to the cornea.

Back in Australia

I returned at the end of 1987. There was still no laser eye surgery at that stage, so I set up as a corneal surgeon. I began a corneal clinic at Royal North Shore Hospital, both in a public and private practice. In a relatively short time I was one of the busiest corneal transplant surgeons in Australia.

I then met Dr Chris Rogers, which was the beginning of a long collaboration that is still strong today. In 1991, we brought in the very first excimer laser to Australia and the very first laser eye surgery procedure was performed in our clinic.

Chris and I worked well together. We had a vision of performing the best laser eye surgery combined with clinical research and by July 1997 we moved to Chatswood to the current site. Gradually we built up our practice – first, the laser suite, then, the day surgery. Dr Gerard Sutton joined us, and we called ourselves ‘The Eye Institute’.

Laser vision correction today

For procedures using only a laser, there are two main forms of laser eye surgery – LASIK and ASLA (also known as PRK).

Laser eye surgery – LASIK 

I was fortunate enough to have performed the first LASIK procedure in Sydney in October 1995. Laser technology was improving quickly in the early 90s, and LASIK – short for ‘Laser-assisted in situ keratomileusis’ – is now a common procedure. Although the technology has improved, the basic principle remains the same. 

Click here for more information about about the laser eye surgery procedure, LASIK.

Laser eye surgery – ASLA (PRK)

PRK was actually the first laser eye surgery procedure used. It began in 1986, and involves lasering the surface of the cornea only. LASIK began quite under the radar, when, in 1989 in Crete, Dr Ionnis Pallikaris created a flap and performed laser eye surgery on the corneal bed beneath

LASIK soon took over, and PRK was thought to have disappeared forever. But then, in the late 90s, it was seen that PRK still had a place, and so it returned.

At Vision Eye Institute, we perform ASLA, which is a more advanced version of PRK. It still involves laser technology applied onto the surface of the eye, and is generally used for those people who have particularly thin corneas.

For more information about the laser eye surgery procedure, ASLA/PRK, click here.

Laser eye surgery –
Dr Michael Lawless

Dr Lawless of Vision Eye Institute answers the most commonly asked questions about LASIK, as well as explaining the difference between laser eye surgery procedures (LASIK and ASLA)