LASER EYE SURGERY
CHOOSE THE RIGHT LASER EYE SURGERY FOR YOU
What is laser eye surgery?
Laser eye surgery is the variety of surgical procedures that involve an eye surgeon (ophthalmologist) using a laser to reshape the front surface of the eye (cornea) to correct a refractive error.
Laser eye surgery has a long and successful track record
Scientists developed the excimer laser in the early 1970s and modified it for ophthalmic (eye surgery) use in the early 1980s. Since medical device companies introduced the excimer laser into commercial use, eye surgeons have performed over 40 million procedures worldwide.
Laser eye surgery is a safe and effective treatment
Studies, governmental bodies like NICE, and millions of happy patients have demonstrated that laser eye surgery is both safe and effective. The aim of laser eye surgery is to reduce your dependency on spectacles and/or contact lenses.
There are different types of laser eye surgery
Laser eye surgery is a fast moving field with new developments arising frequently. Over the past few decades we’ve seen laser eye surgery move through three generations.
Laser eye surgery stages of development
- 1st generation
- 2nd generation
- Femtosecond laser eye surgery (also known as all-laser LASIK and by trade names such as VisuMax ™ or IntraLase ™)
- 3rd generation
- ReLEx SMILE ™ laser eye surgery (also known as keyhole laser eye surgery)
Now, laser eye surgery can correct the need for reading glasses
Laser eye surgery to correct presbyopia (ageing eyes) has been commercially available in the UK since 2004. Since then, laser eye surgeons have successfully treated thousands of patients with a technique called laser blended vision. The German medical device company, Zeiss, has commercialised this technique as PRESBYOND ™.
The Custom Vision Clinic and laser eye surgery
James Ball has been at the forefront of laser eye surgery over the last decade. He was one of the first laser eye surgeons to use the femtosecond laser (at St. James’ Laser Vision) north of London.
What conditions does laser eye surgery treat?
Laser eye surgery treats refractive errors. Refractive errors are abnormalities in the anatomy of the eye that results in what we call
- Presbyopia (the need for reading glasses)
Who is suitable for laser eye surgery?
Nearly everyone (98%) is now suitable for laser eye surgery. Ideal candidates are in good general health and specifically have healthy eyes (apart from having a refractive error).
Laser eye surgery myths
There is plenty of misinformation out there, and laser eye surgery is no exception. Here are the top 5 things that many people don’t know about laser eye surgery:
- Laser eye surgery can treat astigmatism
- Laser eye surgery can treat very high prescriptions
- Laser eye surgery can treat ageing eyes
- Laser eye surgery is relatively painless
- Laser eye surgery is permanent
Laser eye surgery requirements
There are some laser eye surgery requirements that might make laser eye surgery unsuitable for you. If you have specific questions about suitability, we can share general laser eye surgery requirements with you over the phone. For a more specific recommendation, we can examine your eyes and give you a medical recommendation at your first visit.
How does laser eye surgery work?
You don’t need to understand how laser eye surgery works to benefit from it. However, many people are fascinated by a technology that sometimes feels like magic.
First of all, it’s important to think about the eye as a camera. When light enters the eye, your front lens (your cornea) bends the light so that it focuses on your retina. The light travels through an internal lens and then onto the retina. The retina (the film at the back of the eye) then interprets the light as an image and sends the signal to your brain so that you can see.
Just like some people are tall or short, some people have longer eyes and some people have shorter eyes. While many people’s eyes are round, some are more oblong, like a rugby ball. In normal eyes, the light passes through the cornea to a point on the retina.
In a Short-sighted, Long-sighted or astigmatic eye, the cornea bends the light and it incorrectly meets your retina so that the image you see is blurry and/or distorted.
In a nutshell, a laser eye surgery can fix this blurriness and distortion by applying a laser to the surface of your eye (the cornea) to change its shape and alter the curvature that causes the incorrect bending of light.
As a result, the reshaped cornea can then bend the light in such a way that it meets the retina in a correct way, which enables you to see as if your eye was a normal shape and length.
What are some advantages and disadvantages of laser eye surgery over glasses and contact lenses?
The main alternative to laser eye surgery is spectacles and contact lenses.
Is laser eye surgery better than spectacles?
Many patients agree that being spectacle-free
- Enhances their lifestyle
- Improves their appearance
- Increases their convenience
- Costs less than long-term spectacle use
- Increases their personal safety
- Improves their performance in sports and at work
Is laser eye surgery better than contact lenses?
Some patients choose to wear contact lenses as an alternative to spectacles. Many of these patients agree that being contact-lens free
- Increases their lifestyle flexibility
- Saves time and ongoing costs
- Reduces the incidence of sight-threatening contact lens infections
- Eliminates discomfort associated with contact lenses
Does laser eye surgery have any disadvantages?
Laser eye surgery risks
Laser eye surgery is surgery and all surgery carries an element of risk. With that said, the risk associated with laser eye surgery is minimal (and lower than the risk associated with prolonged contact lens use).
Laser eye surgery costs
Some people worry about the fees associated with laser eye surgery. While it’s true that laser eye surgery costs more in the short-term, when compared the prolonged spectacle and/or contact lens use, laser eye surgery can be less expensive in the long run.
Laser eye surgery fears
Finally, many people fear the prospect of laser eye surgery. Certainly, there is little one can do about the fear apart from join the millions of others that have faced their fears and lived through the experience to enjoy a life free of spectacles and contact lenses. Fear isn’t new to us, and we’ll do what we can to help dispel your fear with objective facts and information, so you can make an informed choice.
What are some laser eye surgery options and alternatives?
Laser eye surgery has advanced greatly over the last couple of decades. In the past there was a choice between surface laser eye surgery and LASIK. Patients tended to prefer LASIK because it was more comfortable than surface laser eye surgery and because the recovery time was so much faster.
Today, very few advanced laser eye surgeons perform surface laser eye surgery, because newer procedures offer similar benefits (like being able to treat those with thinner corneas or those who engage in contact sports and work). Keyhole laser eye surgery, where the laser reshapes the cornea without the need to make a flap, is called ReLEx SMILE ™ .
This procedure has all the great benefits of LASIK (fast visual improvement and short recovery time) with the associated benefits of not cutting a flap in the cornea (no flap complications, less dry eye, improved comfort during the operation) and none of the downsides of surface laser eye surgery (more discomfort and shorter recovery time).
Another procedure that is supposedly new is PRESBYOND ™ blended vision laser eye surgery. We say supposedly new because many people aren’t aware of it, despite it being available commercially in the UK for over 10 years.
The research is in: You can safely reduce your dependency on reading spectacles or varifocals with laser eye surgery.
Further information about laser eye surgery at Custom Vision Clinic
MORE USEFUL INFORMATION
Read more about laser eye surgery
New refractive surgery guidelines from The Royal College of Ophthalmologists, together with patient information on Laser Vision Correction, Phakic Intraocular Lens Implantation, Refractive Lens Exchange and a Checklist for patients will be published in April 2017. Click here for more information
Take this checklist to your consultation with your refractive surgeon performing the procedure. Discuss each item with your surgeon to help you make the decision that is right for you before having
refractive surgery. Click here for more information
The Royal College of Ophthalmologists’ Laser Vision Correction Patient Information booklet (PDF). Click here for more information
SMILE corrects myopia and astigmatism, or a combination of both refractive errors with only a very small incision at the corneal surface. This high-precision procedure is the latest development in the refractive laser treatments. Includes videos, treatment steps, and questions and answers.
Click here for more information
LASIK treats refractive errors by folding away the top layer of the eye and re-shaping tissue underneath. If a femtosecond laser is used, this type of procedure is called Femto-LASIK. Includes videos, treatment steps and questions and answers. Click here for more information
PRK/LASEK procedures remove a thin cell layer from the top of the eye so the laser can reshape the underlying cornea. This surgery may be an option for those who are not eligible for LASIK or those who look for the most economic option for refractive laser surgery. Includes videos, treatment steps, and questions and answers. Click here for more information
About the author
Mr James Ball | Consultant Ophthalmic Surgeon
MA (Cantab) MB BChir FRCOphth CertLRS
I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic, St James’s University Hospital, and Nuffield Hospital. My major interest is in refractive surgery and finding the best treatment suitable for each patient.