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Laser Eye Surgery Sydney
If you are considering looking for an alternative to glasses and contact lenses, laser eye surgery may be an excellent option. At Eye and Retina Specialists, laser vision correction is performed by Dr Linda Zheng, an experienced ophthalmic surgeon offering modern treatments including SMILE Pro, LASIK, PRK and PRESBYOND. Every patient receives an individual assessment to determine the safest and most effective option for their eyes and lifestyle.
Dr Linda Zheng performing SMILE surgery
Laser Vision Correction Techniques
SMILE and SMILE Pro Laser Eye Surgery
SMILE (Small Incision Lenticule Extraction) is one of the newest forms of laser eye surgery in common usage worldwide. The procedure was designed as a minimally invasive alternative to LASIK.
Unlike LASIK, SMILE does not involve creation of a large corneal flap or the use of a separate excimer laser to reshape the corneal surface. Instead, a femtosecond laser creates a thin disc-shaped lenticule of tissue within the cornea, which is then removed through a small peripheral incision measuring only a few millimetres.
Removing this lenticule changes the shape and focusing power of the cornea, thereby correcting the refractive error.
One of the major conceptual differences between SMILE and LASIK is that SMILE is a flapless procedure. Because the anterior corneal layers remain more intact, SMILE has attracted significant interest internationally as a potentially more biomechanically conservative approach to refractive surgery.
Several studies have suggested reduced early postoperative dry eye symptoms and less disruption of corneal nerves. SMILE is particularly attractive for many younger myopic patients, especially those seeking a flapless procedure or those involved in contact sports and physically demanding occupations where flap-related considerations may be relevant.
SMILE Pro Surgery
SMILE Pro represents the latest evolution of SMILE technology and is performed using the ZEISS VISUMAX 800 platform. While the fundamental surgical principle remains the same, the newer system introduces several technological refinements compared with earlier-generations.
One of the most noticeable differences is speed. The VISUMAX 800 platform allows significantly faster lenticule creation, often in less than 10 seconds per eye, reducing treatment time and potentially improving patient comfort during docking and laser delivery.
SMILE Pro also incorporates improved centration assistance and cyclotorsion alignment technology, helping optimise treatment precision, particularly in patients with astigmatism.
In 2024, it was announced there had been over 10 million SMILE and SMILE Pro laser eye surgery procedures performed globally with high rates of patient satisfaction.
Laser creating the lenticule in SMILE surgery
LASIK Eye Surgery
LASIK (Laser-Assisted In Situ Keratomileusis) was first developed in the 1990s and rapidly became one of the most widely performed refractive procedures in the world. Modern LASIK combines femtosecond laser technology with sophisticated excimer laser treatment algorithms to correct myopia, hyperopia and astigmatism with excellent accuracy and predictability in suitable patients.
During LASIK, a thin corneal flap is first created using a femtosecond laser. The flap is gently lifted to expose the underlying stromal tissue, after which an excimer laser reshapes the cornea according to the patient’s refractive error and customised treatment plan. The flap is then repositioned without the need for sutures.
The excimer laser used in LASIK does not cut tissue mechanically. Instead, it precisely removes microscopic amounts of corneal tissue using ultraviolet laser energy, allowing highly controlled reshaping of the corneal curvature.
One of the major reasons LASIK became so popular internationally was the combination of rapid visual recovery and relatively mild early postoperative discomfort. Many patients notice functional vision within the first day or two after surgery, although visual stabilisation continues over subsequent weeks.
Modern LASIK platforms can also incorporate wavefront-guided or topography-guided treatment planning, allowing increasingly customised correction strategies in selected patients.
Despite its long track record and excellent outcomes, LASIK does involve creation of a corneal flap, which distinguishes it fundamentally from SMILE and SMILE Pro. Although flap complications are uncommon with modern femtosecond technology, some patients prefer a flapless approach where appropriate.
Dry eye symptoms can also occur after LASIK because corneal nerves are disrupted during flap creation and stromal treatment. While symptoms are often temporary, careful preoperative dry eye assessment remains important.
For many patients, however, LASIK remains an outstanding refractive procedure with excellent safety, efficacy and long-term clinical data.
The decision between LASIK, SMILE Pro, SMILE or PRK depends not only on the prescription itself, but also on corneal measurements, ocular surface health, occupation, sporting activities, age and visual priorities.
LASIK laser eye surgery uses advanced laser technology to reshape the cornea and reduce dependence on glasses or contact lenses
SMILE Pro vs LASIK Eye Surgery
Patients are often interested in understanding the practical differences between SMILE Pro and LASIK, including flap creation, recovery, dry eye considerations, visual outcomes and suitability for different lifestyles and occupations.
In this video, Dr Linda Zheng discusses some of the key similarities and differences between modern SMILE Pro and LASIK procedures.
PRESBYOND Laser Blended Vision Surgery
Many patients in their 40s and 50s become increasingly frustrated by the need for reading glasses despite previously having excellent distance vision. This natural age-related loss of near focusing ability is known as presbyopia and eventually affects almost everyone.
PRESBYOND Laser Blended Vision was developed by Professor Dan Reinstein at the London Vision Clinic in the early 2000s and was later incorporated into the ZEISS refractive laser platform around 2009. It was designed specifically to address one of the major limitations of conventional monovision approaches for presbyopia correction.
Traditional monovision works by correcting one eye primarily for distance vision and the other eye primarily for near vision. Although effective for some patients, standard monovision can reduce binocular visual quality and intermediate vision, and not all patients tolerate the imbalance comfortably.
PRESBYOND is more sophisticated than traditional monovision. Using ZEISS wavefront-guided planning software and controlled induction of spherical aberration, the treatment increases the depth of focus in each eye while creating only a subtle difference between the two eyes, often referred to as micro-monovision or micro-anisometropia.
Rather than one eye seeing only far and the other only near, PRESBYOND creates what is often described as a “blend zone”, where the visual ranges of the two eyes overlap. This allows the brain to combine information from both eyes more naturally across distance, intermediate and near tasks. Intermediate vision — such as computer use, dashboard viewing and restaurant menus — is often one of the major advantages of the PRESBYOND approach compared with older forms of monovision.
During surgery, the cornea is reshaped using a customised excimer laser profile planned specifically for the individual patient’s visual requirements, ocular dominance and tolerance to blended vision. The dominant eye is usually targeted slightly more towards distance vision, while the non-dominant eye is adjusted to provide greater near support. Because depth of focus is increased in both eyes, the visual transition between eyes is smoother than with conventional monovision techniques.
PRESBYOND aims to reduce dependence on reading glasses while maintaining good overall binocular visual quality for everyday life. Suitability depends on careful patient selection, ocular dominance testing, refractive measurements and visual expectations. Some patients adapt extremely well to blended vision strategies, while others may be more sensitive to imbalance between the eyes. Detailed preoperative counselling is therefore particularly important before proceeding.
Dr Linda Zheng places significant emphasis on understanding each patient’s occupational requirements, reading demands, night driving expectations and lifestyle priorities when assessing whether PRESBYOND is likely to provide an appropriate balance of distance and near vision for the individual patient.
PRESBYOND Laser Blended Vision uses customised excimer laser treatment to increase depth of focus and reduce dependence on reading glasses in selected patients with presbyopia.
Photo Refractive Keratectomy (PRK) Surgery
PRK laser surgery was one of the earliest forms of modern laser eye surgery and remains an important procedure in selected patients today.
Unlike LASIK, PRK does not involve creation of a corneal flap. Instead, the surface epithelial layer of the cornea is removed before the excimer laser reshapes the underlying corneal tissue.
Because the surface layer needs time to regenerate, visual recovery after PRK is generally slower and early postoperative discomfort greater than with LASIK or SMILE Pro. However, PRK may still be advantageous in selected patients with thinner corneas, certain corneal characteristics or occupational considerations where avoiding flap creation is desirable.
Careful assessment is important to determine whether PRK, LASIK, SMILE Pro or another refractive approach is most appropriate for the individual patient.
Importance of Corneal Imaging
Modern laser vision correction relies heavily on detailed corneal imaging and refractive analysis.
Investigations may include corneal topography, tomography, wavefront analysis, pupillometry, tear film assessment and detailed refraction. These measurements help identify subtle corneal abnormalities, irregular astigmatism and early keratoconus that may not otherwise be apparent during a routine eye examination.
Corneal assessment is particularly important because some patients with apparently normal vision and prescriptions may still have underlying corneal instability that increases the risk of postoperative ectasia if laser surgery is performed inappropriately.
Detailed preoperative imaging also assists in selecting the most appropriate procedure, whether that be SMILE Pro, LASIK, PRK or an alternative refractive approach
Dry Eye and Laser Eye Surgery
Dry eye assessment forms an important part of refractive surgery planning. Many patients seeking laser vision correction already have underlying dry eye symptoms related to prolonged screen use, contact lens wear or meibomian gland dysfunction. Laser vision correction surgery can temporarily worsen dryness during the healing phase.
Since SMILE and SMILE Pro avoid creation of a LASIK flap, some studies suggest it may result in less early postoperative dry eye symptoms and less disruption of corneal nerves in selected patients.
Dry eye outcomes vary between individuals, and careful ocular surface assessment remains important regardless of the procedure being considered. Patients with significant untreated ocular surface disease may require treatment before proceeding with refractive surgery.
Risks and Limitations of Laser Eye Surgery
Although modern laser eye surgery is generally very safe when patients, all procedures carry risks and limitations.
Potential risks may include dry eye symptoms, glare, halos, fluctuating vision, residual refractive error, undercorrection, overcorrection, infection, inflammation, delayed healing, regression, need for enhancement surgery or, rarely, reduced quality of vision.
Laser eye surgery aims to reduce dependence on glasses and contact lenses. Long-term visual quality depends not only on the procedure itself, but also on careful screening, accurate treatment planning, postoperative healing and the natural ageing process of the eye. Realistic expectations and informed consent are therefore extremely important before proceeding with any refractive procedure.
It is important that patients feel comfortable discussing with their surgeon their goals, visual needs and realistic expectations, and that the surgeon listens and factors these into account for each patient. Dr Linda Zheng places significant emphasis on understanding each patient’s visual priorities, occupational requirements and lifestyle considerations before recommending whether or not laser eye surgery is suitable, and to discuss the most appropriate options.
Why Patients Choose Eye and Retina Specialists
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Caring specialist care
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Comprehensive suitability assessment
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Modern laser treatment options with personalised recommendations
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Convenient Sydney location
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Mandarin-speaking consultations available
Laser vision correction is ultimately eye surgery and should be approached with the same degree of careful medical assessment as any other ophthalmic procedure.
Assessment by a trained ophthalmologist who spends the time to listen to your needs and personal situation is important not only for refractive planning, but also for identifying underlying ocular disease that may affect long-term visual health or influence treatment suitability.
This may include early cataract, keratoconus, retinal pathology, glaucoma, dry eye disease or corneal abnormalities that may not previously have been diagnosed.
A medically focused assessment helps ensure recommendations are based on the overall health of the eye.
As a specialised practice managing serious eye and retinal diseases on a regular basis, our clinic is well equipped to undertake a thorough assessment of the overall health of your eye prior to considering laser surgery.
Meet Dr Linda Zheng
Dr Linda Zheng is a Sydney ophthalmic surgeon with advanced training in refractive laser eye surgery. Linda studied medicine at UNSW and completed her advanced training in ophthalmology at Sydney Eye Hospital. She then gained further subspeciality fellowship experience at Fudan University Eye & ENT Hospital in Shanghai, one of the world’s major refractive centres. She offers SMILE Pro, LASIK, PRK and PRESBYOND, as well as cataract surgery and general ophthalmic care.
Dr Linda Zheng provides laser vision correction consultations and suitability assessments at Eye and Retina Specialists. She speaks fluent English and Mandarin, helping many patients feel comfortable throughout the consultation process.
Laser Eye Surgery FAQs
Q1. Am I suitable for laser eye surgery?
Suitability for laser eye surgery depends on several factors, including your age, glasses prescription, prescription stability, corneal thickness, corneal shape, dry eye status, pupil size, occupation, visual goals and general eye health.
A person may have a prescription that appears suitable on paper but still not be an ideal candidate if there are subtle corneal irregularities, early keratoconus, significant dry eye disease, unstable refraction or early lens changes. This is why a proper assessment is essential before deciding whether treatment is appropriate.
At your consultation, Dr Linda Zheng will assess your prescription, examine your eyes and arrange the relevant measurements required to determine whether laser vision correction is safe and appropriate. The goal is not simply to confirm that you can have surgery, but to determine which procedure, if any, best suits your eyes and lifestyle.
Q2. Is laser eye surgery painful?
Most patients do not describe laser eye surgery itself as painful. Anaesthetic drops are used to numb the eye before treatment. During the procedure, patients may feel pressure, awareness of light, or a brief sensation of the eye being held in position, but the laser component is usually very quick.
Recovery discomfort varies depending on the procedure. SMILE Pro and LASIK are often associated with relatively rapid early recovery and mild discomfort for many patients. PRK usually involves more discomfort in the first few days because it is a surface laser procedure and the corneal surface needs time to heal.
Q3. How long does recovery take?
Recovery depends on the procedure performed and on the individual eye. Many patients having SMILE Pro or LASIK notice useful vision within the first few days. Clarity and quality of vision can continue to improve over the following weeks. With PRK, visual recovery is generally slower, and fluctuating vision is expected during the early healing period.
SMILE Pro is performed using the ZEISS VISUMAX 800 platform, which allows very rapid lenticule creation and shorter laser treatment times compared with earlier-generation systems. The shorter treatment duration may improve patient comfort and reduce the time the eye is docked during treatment.
Q4. Do you offer Mandarin consultations?
Yes. Mandarin-speaking consultations are available with Dr Linda Zheng
Book a Laser Eye Surgery Consultation
Find out whether SMILE Pro, LASIK, PRK or PRESBYOND is right for you. Contact our team at Eye and Retina Specialists to arrange your assessment.