ARE REFRACTIVE SURGERIES THE SOLUTION?

Indeed, refractive surgery, particularly Lasik, has become a popular option for correcting poor eyesight and eliminating the inconvenience of wearing glasses. 

Lasik involves reshaping the cornea with a laser so that light is focused correctly on the retina, reducing the need for glasses or contact lenses.

Other than Lasik, ophthalmologists observed that alternatives such as keratorefractive lenticule extraction (commonly known as SMILE) and implantable collamer lenses (ICL) are steadily gaining ground, though there are no recent public figures on how many Singaporeans are opting for each.

Smile is a newer form of laser vision correction that treats short-sightedness and astigmatism by removing a small piece of corneal tissue through a tiny keyhole incision, avoiding the need for a flap as in Lasik. 

ICL is a procedure where a thin, artificial lens is placed inside the eye to correct high degrees of short- or long-sightedness, often for patients whose corneas are unsuitable for laser surgery.

Since 1992, SNEC has performed more than 75,000 refractive surgeries, with Lasik introduced in 1998 and newer techniques added in recent years to cater to a wider range of patients. 

Surgery numbers dipped during the COVID-19 pandemic but rebounded sharply once restrictions eased, and have continued to rise since 2023, but SNEC did not provide recent annual figures.

But ophthalmologists CNA TODAY spoke to cautioned that none of these procedures is the silver bullet many assume them to be. 

Dr David Chen, ophthalmology consultant at National University Hospital (NUH), said that while these procedures correct the degree of myopia and improve one’s vision without glasses, they do not address the root cause of myopia.

“Myopia is due to an abnormally increased eyeball length, which increases risks like retinal detachment or glaucoma. Lasik doesn’t reduce those risks. It only corrects vision for daily functioning without glasses,” he said.

He added that Lasik generally does not increase the likelihood of age-related eye conditions, such as cataracts, glaucoma, or macular degeneration, although it can complicate their management.

For example, intraocular pressure readings in glaucoma patients may be less precise, and lens calculations for cataract surgery are more complex after Lasik, because the surgery alters the corneal anatomy, he said.

The risks also vary with the severity of myopia, said Dr Chen. 

“Low myopes – those with 200 to 300 degrees – have a much lower risk profile than patients with very high myopia, such as 1,000 degrees or more.

“Surgery corrects the vision without glasses, but the underlying anatomical risks remain. ICL offers an alternative for patients unsuitable for Lasik, but similarly does not change the long-term risks tied to myopia.”