Is it worth travelling to London for laser eye surgery if you live in Leeds?
In the 19th century, it was necessary to travel to London to access private healthcare and private surgery with the men (and at that time it was almost exclusively men) who were the top specialists. In the 21st century, there continues to be a perception amongst some people that it’s necessary to go to London to have the best care. They are, however, completely wrong.
In some respects, it’s similar to the fine dining landscape in Yorkshire and London. There are more Michelin-starred restaurants in London but you can only eat one meal at a time. If you want a fine dining experience then you don’t have to leave Yorkshire to enjoy the best food. (1)
Nevertheless, I wanted to see for myself what all the fuss was about, so in 2016 I took the opportunity to help to set up the laser eye surgery service of a flagship Harley Street hospital for one of the high street ophthalmic surgery chains.
While I was working there, I was able to see what all of the London eye clinics offered, what technology they had access to and indeed what their customer service was like. It was this experience that convinced me to establish my clinic in Yorkshire because I knew that I could do everything a little better.
Does London offer more choice than Yorkshire? No.
At Custom Vision Clinic we have access to the ZEISS MEL-90 excimer laser and VISUMAX femtosecond laser platform equipped with all of the latest software, which allows me to perform SMILE flapless laser eye surgery and PRESBYOND blended vision LASIK. We are the only clinic outside London to have an HD Analyser, which enables me to objectively assess the performance of the crystalline lens in a prospective patient’s eyes.
This means that I’m not pushing PRESBYOND LASIK on to people who would be better served by refractive lens exchange. Conversely, I’m not recommending RLE to people who would be better o having PRESBYOND LASIK. We have the latest Pentacam Tomographer and the lastest Lenstar biometry machine with all of the fourth-generation formulae to provide the most accurate possible outcomes for my RLE and cataract patients. The current UK benchmark for refractive outcomes after cataract surgery is 55% of eyes within half a diopter of the target. In our first six months, we achieved 92% of patients within half a diopter of the target and this percentage will increase as we continue to refine our nomograms.
Are costs in London lower than Yorkshire? No.
The clinics in London have to cover higher staffing costs and extraordinarily high rents and mortgage payments, and this has to be passed on to their customers. Our rental costs are lower (although anyone who has visited us at Bowcliffe Hall will know that we are in the most beautiful surroundings with access to a stunning members-only restaurant). As a result, we can offer the same technology locally at a lower price in surroundings that provide a superior customer experience. This is before you factor in the transport costs associated with travelling to London for all of your assessment, treatment and follow-up appointments.
Is London more convenient after surgery for patients in Yorkshire? No.
Every laser eye surgery clinic, however much they may laud themselves, has an enhancement rate. This is treatment required by patients after their primary surgery. Let’s say that we treat both eyes for clear distance vision and one eye comes out with a refraction of -0.75 diopters; the patient will correctly feel that the vision from that eye is slightly blurry.
It is essential that this patient is then offered enhancement surgery as part of their treatment package. This involves careful repeat measurement to ensure the stability of the refraction (requiring more visits).
Then comes the enhancement surgery itself, which, usually after LASIK, means a flap-lift combined with excimer laser treatment (requiring another visit). Further follow-up appointments are necessary to ensure a satisfactory outcome (which will mean more visits yet).
Even in the best hands, there can be complications after surgery. All of my patients have my mobile phone number. This isn’t some marketing gimmick; it’s my actual personal number for my mobile phone, which I have on me at all times. Therefore, if any of my patients have any concerns or problems after surgery they can call me directly. Even more importantly, I can be at my clinic or hospital in 25 minutes to sort out any eye problem they may have.
Last year, I had to help out a highly regarded London surgeon whose patient had developed a severe corneal infection. The patient lived in Yorkshire, and it was just impractical for the patient to access emergency care in London. The London surgeon was trying to manage the patient remotely, and it was utterly ineffective.
I look after patients who fly in to see me from the Channel Islands, France, Switzerland and some Arab states. I am comfortable providing consultations and giving my expert opinion, but I only undertake surgery if the patient can stay in Yorkshire for a safe length of time after their surgery so that I can provide them with the same level of care that I give to my Yorkshire patients. I have patients who travel up from London to see me but, where I think they can receive the same high standard of care that I provide, I recommend that they have treatment locally.
If you would like further information on the services I offer or advice about your eye condition, please call our friendly staff at Custom Vision Clinic on 0345 643 0466.
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.
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