What Is Laser Eye Surgery?
Laser eye surgery refers to any procedure in which a cool beam of light from a laser is used to correct various refractive errors which affect the eye’s ability to focus. The beam of light changes the curvature of your cornea (the window at the front of your eye) to modify the focus of your eye, improving the sharpness of your vision. Laser eye surgery is the most commonly performed surgical procedure in the world, and is statistically the safest. It has already restored the vision of over 35 million people worldwide, with approximately 120,000 people in the UK undergoing the surgery every year.
Types Of Laser Eye Surgery
There are six main types of laser eye surgery. Although all correct refractive errors, their procedures differ from each other slightly. Your ophthalmologist will be able to advise you on which type of surgery is most appropriate for you after carrying out an assessment of your eyesight.
- LASIK: this is the most commonly used type of laser eye surgery. During a LASIK procedure, a surgeon uses a specialist instrument called a microkeratome to make a small flap in your cornea. This flap is then peeled back and using a laser, the shape of your corneal tissue is modified. After this, the flap is carefully put back into place and the surgery is complete.
- LASEK: this surgery is typically used on patients who have thinner corneas. Unlike LASIK eye surgery, a corneal flap is not created during LASEK eye surgery. Instead, the thin layer covering the cornea (the epithelium) is shifted to one side using an instrument called a trephine, your cornea is reshaped with a laser. Once this is completed, the epithelium is moved back in place to allow the eye to heal.
- PRK: this is the most longstanding type of laser eye surgery. Unlike LASEK eye surgery where the epithelium is simply moved to one side during the operation, during PRK the epithelium is removed completely before a laser is used to change the curvature of your cornea. Following surgery, the epithelium will then take a few days to grow back. PRK eye surgery is often used on patients with thin corneas or those who and who have previously had laser eye surgery.
- IntraLASIK: the intraLASIK procedure is comparable to LASIK eye surgery, except during this operation a flap on the cornea is made using a laser rather than a hand-held instrument (microkeratome).
- EpiLASEK: this type of laser eye surgery is similar to LASEK surgery. During the epiLASEK procedure, the epithelium is held with a flat, blunt blade whilst changes are made to the curvature of your cornea using a laser. This operation is much less invasive than the LASEK treatment, and so causes less pain to the patient.
- Wavefront Technology: this is a state-of-the-art version of LASEK surgery in which the changes made to the shape of your cornea can be precisely customized to your individual eye. Using a computer software to generate a 3D image of your eye, wavefront technology enables your surgeon to accurately evaluate how much your eye allows you to see (i.e. your visual acuity) and how well you see.
Each of the procedures are extremely quick with the operation usually taking less than sixty seconds. The entire process will take a little longer at around thirty minutes per eye.
What Does Laser Eye Surgery Treat?
Laser eye surgery can be used to treat a number of refractive errors:
- Myopia: also known as nearsightedness, myopia causes you to see near distance objects clearly, but far distance objects blurry.
- Hyperopia: also known as farsightedness, people with hyperopia can see far distance objects clearly, but struggle to focus on near distance objects causing them to be fuzzy.
- Astigmatism: this is a condition that can cause both myopia and hyperopia as a result of an irregularly shaped cornea. Many people have a certain degree of astigmatism, but after a certain point it can affect your clarity of vision.
- Presbyopia: this is a type of age-related farsightedness which typically affects those aged 40 and over. Presbyopia is caused by a loss of elasticity of the lens inside your eye.
This table shows which types of laser eye surgery treat which types of refractive error:
|Type Of Laser Eye Surgery||Refractive Error It Corrects|
|LASIK||Myopia, Hyperopia, Astigmatism|
|LASEK||Myopia, Hyperopia, Astigmatism|
|PRK||Myopia, Hyperopia, Astigmatism|
|IntraLASIK||Myopia, Hyperopia, Astigmatism, Presbyopia|
|EpiLASIK||Myopia, Hyperopia, Astigmatism|
|Wavefront Technology||Myopia, Hyperopia, Astigmatism|
Am I Eligible?
Before you decide to have laser eye surgery it is important that you explore your suitability for the procedure. There are a number of inclusion and exclusion criteria that will be need to be considered, including:
- You have a refractive error.
- You are over the age of 21.
- You have no eye disease or infection, such as glaucoma or conjunctivitis.
- You have no corneal abnormalities, such as scarring.
- You have a good general health.
- You are not allergic to anaesthesia.
- You have very thin corneas.
- You have diabetes, hepatitis C or herpes virus.
- You have an autoimmune disease, such as rheumatoid arthritis or lupus.
- You are taking immunosuppressant drugs.
- You are pregnant or breastfeeding. It is recommended that you wait six months after you finish breastfeeding before undergoing laser eye surgery.
Your ophthalmologist will assess your optical and overall health, and will be able to deem you a suitable candidate (or not) for the surgery.
Here Dr Valerie Saw, Consultant Ophthalmic Surgeon, discusses who makes a good candidate for laser eye surgery.
How Much Is Laser Eye Surgery?
The cost of laser eye surgery can range anywhere from £595 per eye, up to £2175 per eye. The table below shows you how much you should expect to pay for the different types of laser eye surgery, based on quotes obtained from some of the best eye surgery clinics in the UK.
|Type Of Laser Eye Surgery||Price Per Eye|
|Wavefront Technology||From £1495|
As you can see, laser eye surgery is a significant investment. To make the surgery more affordable therefore, many clinics now offer finance packages to help you spread the cost of the procedure. These typically involve you paying an upfront deposit, followed by small financial instalments every month over a pre-agreed time period. To find out more about the cost of laser eye surgery and the financial agreements available, visit our eye surgery pricing page.
Laser Eye Surgery Risks
Statistically, laser eye surgery is the safest operation carried out in the world with complications occurring in less than 5% of cases, but as with any type of surgery there are risks involved that you should be aware of before undergoing the treatment. The risks include:
- Under- or over-correction of your vision: this occurs when the surgery does not achieve 20/20 vision meaning you may still need to wear glasses or contact lenses to see clearly. In some people, surgery can also reverse your refractive error making myopic patients hyperopic, for example. This can usually be corrected using a second round of laser eye surgery. Under- or over-correction typically occurs when your eyes do not respond to treatment as expected.
- Dry, red eyes: this can result from all types of laser eye surgery, but most commonly occurs in those who have undergone LASIK or PRK surgery. This typically clears up within a few weeks of undergoing the procedure. In a small number of patients however, dryness of the eyes can become permanent in which you will need to use artificial tears for the rest of your life.
- Visual disturbance: this includes symptoms such as blurred vision, light sensitivity double vision, halos and glare. It is common to experience these disturbances in the first few weeks following surgery, but they tend to resolve within 3 months once your vision has stabilised.
Less common risks:
- Eye infection: this can be easily treated with eye drops or antibiotics.
- Corneal ectasia: this occurs when too much corneal tissue is removed during surgery, causing the cornea to bulge over time, leading to a deterioration of vision. The chance of corneal ectasia happening is just 0.2%. It can be treated using rigid contact lenses, but patients with extreme ectasia may have to undergo corneal transplant surgery.
If following your surgery you experience any side effects, you should consult your ophthalmologist immediately and seek medical attention if necessary.
To minimize the possibility of you experiencing any side effects, you should choose an experienced and well-known laser eye surgeon from a respected clinic. You can visit our surgeon review page to find out more about the top rated surgeons in the UK.
Success Rates Of Laser Eye Surgery
Laser eye surgery is an extremely successful procedure, with approximately 80% of patients achieving perfect vision following surgery. The chances of patients developing sight-threatening conditions as a result of surgery are fortunately very low, with estimates of blindness occurring once in every 5 million patients who undergo the procedure.
In a very small percentage of cases, laser eye surgery may not bring about a significant improvement to vision as anticipated. In this situation, patients often undergo a secondary procedure known as laser eye surgery enhancement.
The success of your laser eye surgery will largely depend on your prescription and the skill of the laser eye surgeon who is performing the operation. Before undergoing laser eye surgery, we recommend that you carry out research into the success rates of different surgeons to ensure that you achieve the best outcome possible. In general, the more experienced a surgeon is the better their success rate will be. If possible you should opt for a surgeon with accreditation from the Royal College of Ophthalmologists, since they will have carried out over 300 procedures in a two year period.