This is to meet the demands of patients who are constantly in search of cheaper, faster, safer and more reliable medical treatments for their diseases and other health complications.

Among the latest developments in laser refractive surgery is the possibility to perform ‘no touch’ laser eye surgery.

Transepithelial Photorefractive Keratectomy (TransPRK) is the only surface laser treatment that doesn’t require physical contact with any suction or sharp surgical instrument on the eye.

Evolution of laser surgery

Laser eye surgery, or laser vision correction has been growing in popularity over the years. More and more people are opting for such surgeries as they are considered effective and safe solutions to:

• hyperopia (difficulty seeing objects up close)
• myopia (difficulty seeing objects at a distance)
• astigmatism (distorted and blurry vision at all distances)

The possibility of not having to wear prescription glasses or contact lenses anymore is also an attractive factor for patients. As people approach adulthood, myopia or short-sightedness, progresses until it usually stabilises in the late teens or early 20s.

To achieve independence from spectacles, laser eye surgeries are carried out to treat refractive errors, commonly known as ‘eye power’.

There are three common types of laser eye surgery available to patients:

• TransPRK
• LASIK: laser-assisted in situ keratomileusis
• SMILE: small incision lenticule extraction

LASIK is among the most common performed. A laser is first used to create a thin flap on the surface of the cornea, with a second laser used to reshape the cornea. The protective flap is then placed back in position without stitches.

In SMILE, a femtosecond laser is used to reshape the cornea by removing a small lens-shaped segment (called lenticule) of corneal stroma. The same femtosecond laser is then used to create an incision on the surface of the cornea. The lenticule is then extracted from the opening with a surgical instrument and discarded.

How TransPRK is performed

In TransPRK, a single laser machine is used to quickly and accurately remove the cornea epithelium (skin) and reshape the cornea in a single step.

Immediately after, a bandage contact lens is placed on the eye for protection and will be removed five days after the procedure.

The skin grows back naturally but requires the patient to be compliant with post-operative care, so that recovery goes smoothly.

Opting for TransPRK

In a TransPRK procedure, no incision is necessary. Instead, a laser is used to remove (ablate) the layer of cells that sit on the outermost surface of the eye, known as the epithelium.

The cool ultraviolet light beam produces high-energy pulses that vaporises the stromal tissue on the cornea.

This contouring of the cornea using TransPRK usually takes under one minute, and patients do not feel any pain.

What makes TransPRK different from other laser surgeries is its ability to perform the procedure with just one laser, without creating a flap or incision, and without touching the eye physically.

Another reason some patients opt for TransPRK surgery is that it gives them a second chance to be free of spectacles.

While laser eye surgeries have become safer, more precise and quicker, there are limitations and setbacks.

Some individuals may be deemed unsuitable candidates for LASIK due to thin or irregular corneas.

In these instances, TransPRK can be that second chance as it is a tissue-saving procedure which preserves most of the cornea tissue. TransPRK also has more biomechanical strength compared to other procedures.

SMILE, for example, is unable to treat hyperopia. TransPRK meanwhile, is able to treat patients with complications from previous refractive surgeries.

Following a TransPRK procedure, the epithelium will heal in approximately three to five days. While the epithelium is healing, a bandage contact lens protects the cornea and minimises discomfort. Ophthalmologists prescribe eye drops to aid the healing process.

It is important to bear in mind however, that like all medical procedures and surgeries, there are risks involved.

Patients are advised to view all forms of surgery seriously and consult a registered eye specialist so they are better able to understand the risks of each treatment, the preparation required and the steps to recovery.

Dr Wong Hon Seng, Consultant Ophthalmic Surgeon at OasisEye Specialists.

*pictures are for illustration purposes only