FREQUENTLY ASKED QUESTIONS ABOUT SILK SURGERY

The SILK refractive surgery procedure was introduced by Johnson & Johnson (USA), featuring significant advancements over traditional vision correction procedures. With up to 50% reduction in laser energy, a seamlessly connected laser spot pattern, and an exclusive biconvex lenticule design, SILK offers a gentle, comfortable surgical experience with rapid visual recovery. Let’s explore more about the SILK refractive procedure through the following frequently asked questions, provided by Japan International Eye Hospital.

1. How does SILK surgery work?

SILK (Smooth Incision Lenticule Keratomileusis) is a procedure that uses advanced Femtosecond Laser technology to create a lenticule - a small disc-shaped piece of stromal tissue - with a proprietary biconvex shape developed by Johnson & Johnson (USA). This lenticule is then removed through a tiny incision (approximately 2-3 mm) at the edge of the cornea, allowing for optimal vision correction.

2. Is SILK suitable for all patients with refractive errors?

Not exactly. SILK has a treatment range of up to -12D for myopia, -6D for astigmatism, with the total correctable refractive error falling between -1D and -12D. In addition, candidates must meet other ocular parameters, such as having sufficient corneal thickness, an adequate endothelial cell count within the safe range, and a normal corneal topography without abnormalities. These requirements help ensure both the safety and effectiveness of the procedure.

3. Is SILK surgery painful or uncomfortable?

Before the SILK surgery, patients are given topical anesthetic eye drops - a liquid anesthetic used to numb the surface of the eye. Additional anesthetic may be applied during the surgery to ensure full comfort throughout the procedure. As a result, patients typically experience little to no pain or discomfort during the surgery.

After the procedure, some patients - especially those with sensitive eyes - may feel mild discomfort or excessive tearing, which usually subsides within 4–6 hours. Moreover, since SILK does not involve creating a corneal flap, there is no sensation of grittiness or foreign body discomfort.

4. How long does SILK surgery take?

SILK surgery uses the Elita surgical machine laser system, which delivers high-frequency laser pulses to correct refractive errors. The laser application time is only 16 seconds per eye, and the total duration of the SILK procedure is approximately 10-15 minutes for both eyes.

5. How long is the recovery time after SILK surgery?

One of the key advantages of the SILK procedure is its fast recovery time. Most patients can return to work and normal activities within just 24 hours after the procedure. However, to ensure full healing, patients should strictly follow their doctor's post-operative instructions.

6. When can I use a phone or computer after SILK surgery?

Within 24 hours after surgery, patients can resume using electronic devices to help their eyes adjust to their new condition and daily routines. However, it's important to avoid eye strain. Follow the 20-20-20 rule to relax your eyes: every 20 minutes of screen time, rest your eyes for 20 seconds by closing them or looking at something 20 feet (approximately 6 meters) away.

8. Does SILK surgery help with bulging or dull-looking eyes?

In patients with refractive errors, removing glasses can cause blurred vision and difficulty focusing, often resulting in eyes that appear tired, unfocused, or less expressive. Common causes include wearing glasses with the wrong prescription - forcing the eyes to overwork - or glasses that don’t align properly with the visual axis, leading to constant eye strain. After SILK surgery, the eyes are corrected to emmetropia (normal vision), allowing for clear vision at different distances. As a result, the “dull eye” appearance often improves over time.

As for bulging eyes, there are various causes. In myopic patients, eye bulging may be due to an elongated eyeball (increased axial length). Since SILK refractive surgery only reshapes the corneal surface, it does not reduce the protrusion caused by axial elongation.

9. Are there any post-operative symptoms after SILK surgery, and should I be concerned?

As with other medical surgeries, after SILK myopia surgery, patients may experience some symptoms that, if not clearly understood, can cause anxiety for the patient. Some of the symptoms that may be encountered:

• Light sensitivity
• Hazy or foggy vision 
• Difficulty focusing on near objects
• Dry eyes
• Difficulty opening eyes

However, these symptoms are generally mild and not cause for concern. SILK incorporates several advanced features such as ultra-small laser spots, high-density and seamless laser patterns, low energy usage, rapid laser application, and Johnson & Johnson’s exclusive bi-convex lenticule design. These innovations promote faster corneal healing, significantly reduce haze compared to similar procedures, and help preserve corneal nerve fibers - thereby minimizing dryness.

These symptoms typically improve and stabilize over time. Serious complications are rare. Nevertheless, if patients notice any unusual or concerning changes in their eyes after surgery, they should promptly contact the hospital for evaluation and appropriate care.

10. Can myopia return after SILK surgery?

SILK surgery offers high stability. Therefore, if a patient's refractive condition is stable before surgery, the risk of regression (myopia returning) is very low. In rare cases, mild regression may occur over time, often due to improper eye care habits such as working in poor lighting conditions or not taking regular breaks. 

This risk can be minimized by undergoing a comprehensive pre-operative eye examination at a trusted ophthalmic facility. The procedure should only be performed when the eye meets all safety criteria and the refractive error has stabilized. Understanding your eye condition and the differences of different refractive surgery procedures also helps in choosing the most refractive surgery procedure option. Maintaining healthy eye habits post-surgery further supports long-term results.

If regression occurs and the cornea remains eligible, additional enhancement surgery is possible.

To learn more about SILK surgery and how to properly care for your eyes after refractive surgery, explore our comprehensive Japanese-standard refractive surgery consultation package, which includes:

• Conduct an in-depth examination to determine parameters of vision, corneal structure, anterior chamber ... to ensure that the patient meets all necessary conditions for refractive surgery.
• Provides detailed information on the advantages/disadvantages of the most modern refractive surgery procedures.
• The ophthalmologist advises the appropriate surgical procedure based on the examined parameters.

Answer questions and concerns about refractive surgery through a team of dedicated consultants.

📌 Register for a FREE refractive surgery screening (original price: 1,000,000 VND) every Wednesday, Saturday, and Sunday at:

 https://jieh.vn/dien-dan-lasik-and-phakic

👉 For consultation and personalized treatment planning, patients can contact the Japan International Eye Hospital at 0902 24 22 91 – 024 3715 3666 or via email at cskh@jieh.vn. We recommend booking an appointment at least one day in advance to receive scheduling priority and reduce waiting time.