Laser Eye Surgery

LASER EYE SURGERY

The decision to have laser eye surgery is a major one. You manage with spectacles or contact lenses, so why take the risk of an operation? Well, if wearing spectacles or contact lenses is not an inconvenience you should not have laser vision correction.
However, if you are eager to have excellent vision without visual aids, then minimising the risk is essential. You can rest assured that your surgeon is fellowship trained in refractive surgery and that the laser being used for your treatment is a market leader. Prof Muhtaseb is one of very few ophthalmologists working in the UK who is a fellowship-trained specialist in cornea and refractive surgery. He will advise you on your suitability for laser vision correction, and use only state-of-the-art equipment to deliver the treatment that best suits your eyes.

What is the success rate of laser vision correction?

What can be achieved depends on whether the patient is near-sighted (myopia) or far-sighted (hyperopia), the strength of the prescription, and the presence of astigmatism. Generally, over 90% of patients will achieve “driving standard” vision without glasses. This means reading the 6/12 line of the vision chart. Over 70-80% will achieve 6/6 (or 20/20) vision without glasses, but this will depend on the initial prescription.

What does the laser do?

The laser is applied to the middle layer of the cornea (the clear window at the front of the eye). The shape of the cornea is altered to allow light to focus on the retina, so treating the spectacle prescription.

The distinction between the different types of laser treatment lies in how the surgeon gets past the front layer of corneal cells (the epithelium) in order to apply the laser to the middle layer (the stroma). All of these procedures are carried out under local anaesthetic and are pain free.

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Lasik

A flap is made and lifted (like a trap door), the laser is applied, and the flap is replaced (the trap door is closed) The epithelium remains viable and no new epithelium has to grow . Advantages: Fast recovery. Excellent visual results achieved quickly.

Lasek

The epithelium is softened with a solution and moved to one side, the laser is applied, and the epithelium is replaced. The epithelium is not functional and new cells have to grow as a replacement (requires a protective contact lens in the eye for 5 days after surgery to allow the epithelium to heal)
Advantages:
No flap is needed. Same visual results as LASIK, but takes a little longer to achieve.

PRK

As LASEK, but the epithelium is not replaced.New cells have to grow to replace the epithelium (requires a protective contact lens in the eye for 5 days after surgery to allow the epithelium to heal)
Advantages:
No flap is needed. Same visual results as LASIK, but takes a little longer to achieve.

So, why have LASEK or PRK?

First, it is important to note that all treatment modalities produce equally good results.
So, it would be reasonable to ask why not everybody has LASIK, especially given that the recovery is sooner, there is no need to use a contact lens for 5 days, and it avoids the feeling of grittiness that often follows LASEK and PRK in the first 2 – 3 days after treatment.

There may be several good reasons for not choosing LASIK:

  • There are many people who simply do not like the idea of a flap but would still like to have laser vision correction.
  • Others are unsuitable for LASIK because the cornea may not be sufficiently thick to allow the flap to be made.
  • The LASIK flap may be disrupted at any time by a direct trauma to the eye. So, whenever this risk is higher than normal it is sensible to consider LASEK / PRK. Examples may include participation in contact sports such as rugby.

As with any surgical procedure, there are risks of which you must be aware. Your doctor will explain these risks to you and ensure that you understand them completely. You will be given time to discuss all issues to your satisfaction.

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