All You Need to Know... Laser Eye Surgery

Created on 10th July 2009

Mr Pillai, medical director at Advance Vision Care, is regarded as one of the UK's most experienced refractive surgeons and answers all your questions on laser eye surgery

How successful is laser surgery?

With wave front laser surgery over 90 per cent of patients achieve unaided 20/20 vision or better (the gold standard of uncorrected vision). Over two-thirds of patients reach unaided 20/16 vision (even better than the gold standard).

Are the effects of treatment permanent?

It is a well-established technique (for the last 20 years) and there is no evidence to suggest that the treatment is anything other than permanent. However, it cannot prevent the eyes' natural ageing process. In the majority of cases only one treatment is required and it is permanent.

A small percentage (2-3%) may require re-treatment within the first year and this is dependent on prescription, healing and other ocular factors.

What about near vision?
At the age of 40+ all our eyes start to undergo a natural change in focusing ability, which means that we require glasses for reading. This is called presbyopia and is an independent change from hyperopia (long-sightedness) or myopia (short-sightedness). If you require spectacles for reading only then you are unlikely to be suitable for laser surgery.

What is the overall risk of something going wrong?

Laser eye treatment is a very safe and highly effective treatment. It is not unusual for patients to initially experience increased symptoms of dry eye and so called halos and starbursts around lights (these are eliminated by the latest Zyoptix wave front technology) but these side effects tend to resolve within just a few weeks of treatment and extremely rarely will they last into the long term.

The complications are minimal especially in the hands of an experienced surgeon and clinical team. However, no surgical procedure is risk free and there is an extremely small chance of complications most of which can be resolved within the first few months. The most common complication is dry eye (50 per cent), which in the vast majority of patients resolves after the first few months.

What is the difference between Wave front LASIK, Standard LASIK and LASEK?

Wavefront LASIK offers the very latest in laser technology, delivering treatment tailored to the individual defects of the eye, beyond spectacle prescription. We offer this as our first choice treatment, however not everyone is suited to this, and may benefit from standard LASIK. Alternatively, if your corneas are thin, you may be offered LASEK.

Are all lasers the same?

We use the most advanced, highly accurate Bausch and Lomb Z100 laser, which features Iris Recognition, wave front capability and rapid multi-dimensional eye tracking. It has been designed specifically for optimum safety and accuracy. You must ensure that the laser is FDA approved and also appropriate for that particular treatment.

How do I choose a surgeon?

The choice of surgeon is arguably the most important decision to make when deciding whether and where to have refractive surgery. Some questions that should be considered are:

• What is his/her track record?
• What are his/her qualifications? 
• What is his/her complication rate? 
• Will he/she be easily available after the procedure? 
• Will I meet him/her before the day of surgery? 
• Is he or she a certified laser surgeon as per the Royal College of Ophthalmologists?

You must always insist on seeing the surgeon beforehand as it is vital to ask him questions, as surgical skills and the knowledge to deal with any post operative problems are important.

Why is there a wide variation in laser eye surgery prices?

This is a question we are often asked when people see the prices quoted from other clinics. Please be aware that these prices are often a ‘From Price' and the final price quoted will usually be a lot higher.

Your eyes are invaluable and your decision should never be based on the price but on the quality of the service provided by the clinic. The price we quote at Advance Vision Care is for the surgical and clinical expertise of the surgeon, availability of the latest technology and one to one personalised clinical care that covers you for a year.

What if I am found not suitable?

Specialist eye clinics will offer you a comprehensive range of treatments such as implantable contact lenses or refractive lens exchange.

Is there an age limit for treatment?

Our lower age limit for laser eye treatment is usually 21 because the prescription needs to stabilise before treatment occurs otherwise your prescription may change after treatment.

The most important aspect is to have an eyesight prescription that has been stable for a minimum of two years. There is no upper age limit but medical conditions may affect the ability to be treated over the age of 70.

Will I need a general anaesthetic?

No. We only use local anaesthetic eye drops, which make the procedure painless, though you may feel a little discomfort.

After treatment...

Time off work: most patients are able to return to work within 48 hours of LASIK treatment for short sight but LASEK treatment (for long-sightedness) can mean a few more days off work for your vision to settle
Exercise: you will be able to perform gentle exercise a week after treatment followed by more strenuous exercise but we advise you to avoid swimming for 2-3 weeks after surgery (especially if it is in the sea)

Flying: flights less than two hours can be undertaken in a day or two and long haul flights after a week
CS&AM