Laser eye surgery

In the UK, there are three different types of laser treatment - Lasik, PRK and, less common, Lasek. They all use an excimer laser to reshape the front covering layer of the eye (cornea) and correct focusing problems.

The correction of short sight (myopia) is the most common use for laser surgery. The images above show cross sections of a shortsighted eye before and after treatment. Long sight can also be treated, as well as mild astigmatism, though the success rates are lower than with short or long sight. It is not recommended for correcting reading prescriptions (presbyopia), as these change as you get older, or for strong prescriptions.

Many people are happy with the results of their surgery. But as with all operations there is a risk of serious complications (between 0.1% and 1%) or milder problems (about 5%).

Is laser eye surgery for you?

Many people who choose laser surgery do so because they have experienced problems with their glasses or contact lenses. Yet most of these problems could be overcome without resorting to surgery. Your optician can give you advice about the alternatives.

You should also be aware that your prescription may mean laser surgery is not right for you. All laser treatments remove part of the surface of the cornea as illustrated in the images above, so the stronger your prescription, the more tissue needs to be removed. There is a limit to the amount of tissue which can be safely removed.

Another factor to consider is the short and long term effects of surgery on your lifestyle. Some treatments, such as Lasik, require just a few days recovery time, while others take weeks or even months. If you play sport, you may be out of action for some time, while your job could also be affected.

Before you proceed

If you can, before proceeding you should talk to patients who've had laser surgery and ask them about their experiences. You should also bear in mind that some occupations do not admit refractive surgery patients.

When assessing the cost of treatment, remember that some clinics may charge extra if you require re-treatment or further procedures, such as check-ups.

What are the practicalities?

If you wear contact lenses, you will have to remove them a number of days before your assessment and then again before the surgery itself. Before undergoing surgery, you will have to sign a consent form confirming that you understand the treatment and the risks associated with it.

The procedure itself takes just a few minutes, though you will probably be at the clinic for a couple of hours in total. Anaesthetic drops are put into your eyes and your eyelids are held open using a special instrument. The laser itself is invisible and painless, though patients sometimes notice a burning smell.

After PRK surgery, pain relieving eye drops and oral painkillers will be needed. Pain is less marked after Lasek, while Lasik patients will notice an improvement in a couple of days.

Finding a surgeon

To minimise the risks of problems you are advised to find a skilled and experienced surgeon. Ask them how many procedures they've performed and what their success rate is. You may also want to check who would treat any problems - some people prefer the same doctor to provide both surgery and any later treatment.

Not all ophthalmologists are specialists in refractive surgery. You should try to find a surgeon who is a consultant corneal surgeon with an interest in refractive surgery. A consultant will be more able to deal with any complications which may arise than a more junior surgeon.

After the treatment

The healing process is very rapid with Lasik and the vast majority of patients experience no pain. You can probably return to work after two or three days, but you will have to be careful when showering and performing other everyday activities. Patients cannot play sports for up to a month. With Lasek and PRK, vision takes longer to stabilise.

If you are unhappy with the results, contact the surgeon who performed your surgery as repeat treatment may rectify the problem. If you are still not satisfied, you should complain in writing to the clinic or hospital. Many problems are resolved without the need for legal action.