ASLA, also known as "Advanced PRK" or "LASEK", uses a laser to reshape the cornea to correct short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism
What is ASLA eye surgery?
ASLA eye surgery (Advanced Surface Laser Ablation) was first introduced in Australia in 1991 to treat short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism.
The procedure was originally called PRK (Photo Refractive Keratectomy), however, as techniques improved, it became known as ASLA or Advanced PRK.
For Myopia (short-sightedness), the cornea is made flatter, in order for light to focus on the retina instead of in front of it.
For Hyperopia (long-sightedness), the cornea is made steeper, causing light to focus on the retina instead of a point behind it.
For Astigmatism, the cornea is made more spherical in order for the light to focus on a single point on the retina instead of many.
Who is suitable for ASLA eye surgery?
ASLA is used to correct:
- short-sightedness (myopia)
- long-sightedness (hyperopia)
- presbyopia (using the monovision method)
It is most commonly recommended to patients with thin corneas or those with high prescriptions where it might not be possible to perform LASIK.
If you are over 18 years of age and have healthy eyes you may be suitable for ASLA. At VISTAeyes, we will perform a comprehensive range of tests to evaluate the structure and health of your eyes to ensure you are an eligible candidate for ASLA.
How does the surgery work?
To perform ASLA, Dr Wolfe removes the surface cells from the cornea (epithelium) using a solution that softens this layer for easier removal.
The underlying cornea is then reshaped using the Wavelight ® EX500 excimer laser. The Wavelight® EX500 excimer laser applies a customised, computer-generated pattern to permanently reshape the cornea. During the application of the treatment, a high-speed eye tracker monitors the eye’s position to ensure precise and accurate placement of the treatment.
At the end of the procedure, a clear contact lens is placed over the eye to protect the cornea as the surface cells regrow.
Both eyes are usually treated on the one day and after 5 days the contact lenses are removed from the eyes. The vision continues to improve for some weeks after the surgery but most patients are able to resume normal activities one week after their procedure.
How do I prepare for the surgery?
In preparation for your ASLA procedure, there are few things to remember prior to surgery:
- Soft contact lenses must be left out 3 days (or as advised) prior to surgery
- Hard contact lenses must be left out 4 weeks (or as advised) prior to surgery
- Please do not wear any make-up, eyelash extensions, moisturiser, cologne, perfumes or after shave on the day of surgery
- Avoid wearing fibrous or fluffy clothing
- Take any prescribed medications as normal
- You should have breakfast or lunch as normal before arriving for your procedure
- Please bring non-prescription sunglasses with you to wear after surgery on your way home
What to expect on the day of ASLA eye surgery
When you arrive at VISTAeyes on the day of your procedure you will have an opportunity to meet with Dr Wolfe and discuss any questions or concerns you may have about your laser eye surgery.
Once any final testing has been performed, we will demonstrate how to use your post-operative eye drops and medications and explain any restrictions you may have following your procedure.
At this stage we will offer you a mild sedative to help you relax for your ASLA surgery. You will remain awake for the procedure.
Immediately before your ASLA surgery we will use anaesthetic eye drops to numb your eyes.
During the procedure, you may feel some stretching of your eyelids and a sensation of pressure, however, you should not experience pain.
You will be lying down on your back for the procedure, looking up into the microscope through which Dr Wolfe will operate. He will position a small instrument between your eyelids to hold them open and prevent you blinking. You will be asked to watch a small, green flashing light.
Dr Wolfe will place a solution on the cornea to loosen the surface cells (epithelium) of the cornea. Once this has been removed, the Wavelight® EX500 excimer laser will precisely reshape the cornea by applying a customised, computer-generated pattern to permanently reshape your cornea. The laser time is usually between 5 and 15 seconds per eye, depending on the degree of correction required.
A contact lens is then positioned over the treated area to protect the cornea as the surface cells regenerate. This contact lens will be removed after 5 days.
You will be given a pair of eye shields to wear for the following four nights to protect your eyes from accidental rubbing during sleep.
Your eyes will examined before you leave VISTAeyes and then we recommend you head home and have some time to relax. You will need to arrange for someone to drive you home.
What to expect after surgery
You will need someone to drive you home from your ASLA procedure and we recommend you plan to relax for the rest of the day. You may wish to have a sleep or simply keep your eyes closed.
Your vision will fluctuate, especially in the week following your ASLA eye surgery, as the surface cells regenerate. During this time the vision may be blurry. Once the contact lens is removed after 5 days, the vision will continue to improve for several weeks. Most patients are able to return to most visual activities a week after their ASLA eye surgery.
For the first one to three days following the ASLA procedure, many patients experience some discomfort or grittiness in the eyes. Dr Wolfe will provide you medication to assist you through this period. You will also be asked to use antibiotic and anti-inflammatory drops and will be given lubricating eye drops to assist with comfort.
A pair of eye shields will be provided for you to wear for the next 5 nights to protect your eyes from accidental rubbing during your sleep and so you don’t disturb the contact lens.
You will return to VISTAeyes five days after your procedure and the contact lens will be removed. We will typically also re-examine your eyes 1 month and 4 months following your surgery or until you are discharged.
ASLA eye surgery – recovery time
How soon before I can …?
- Wear make up? 1 week (eye make up only), next day (all other make up)
- Have a shower? Same day but avoid getting water or soap in your eyes
- Wash my face? Same day but avoid the eye area
- Go back to work? 5-7 days later
- Go swimming? 1 week
- Exercise? 1 week strenuous exercise but no contact sports for two weeks
- Drive? ASLA patients will be advised when they can drive, usually 5 – 7 days after surgery
- Rub my eyes? 1 week (gentle rubbing at first)
- Fly in a plane? Next day but we prefer you remain in the country for at least 2 weeks following your procedure
- Use a computer? Next day, however the quality of your vision may fluctuate
What are the risks with ASLA eye surgery?
The risks are rare and often only minor if they occur. Laser eye surgery is a very safe procedure, but like all surgical or medical procedures there is always a risk of complication. All known complications will be discussed at your consultation.
Need more information about ASLA eye surgery?
In this video, Dr Rick Wolfe explains the 3 steps of the VISTAeyes laser eye surgery journey