Laser eye surgery

What is laser eye surgery?

Laser eye surgery is an eye refractive surgery that involves using lasers to reshape the front surface (cornea) of the eyes to improve vision as an alternative for anyone who uses glasses or contact lenses. It can correct short-sightedness, long-sightedness and astigmatism. Use the links to find out more about these eye conditions.

Laser eye treatment is suitable for most adults. Ideally the eye prescription will have stayed the same for about 2 years for laser eye surgery to be suitable.

The Royal College of Ophthalmologists has produced recommendations and guidance to improve standards for the provision of refractive surgery for the benefit of patients. See 'Further Reading' below.

See the leaflet on The Anatomy of the Eye for further information.

Prices are advertised from £500 to as much as £3,000 per eye. The cost will vary with different clinics and different methods of eye laser surgery. However, it is also very important to see what the price includes.

The price may include everything needed but there may be additional fees such as the initial consultation fees, after-care, and it is equally important to know how long after surgery the clinic will continue to provide support. About 1 in 10 people who have laser eye surgery need more surgery to get the best possible results so it's important to know whether this is included in the initial price.

Laser vision correction is permanent with a definite reduction in dependency on glasses and contact lenses. Laser eye surgery produces a change in the power of the cornea, similar in effect to wearing contact lenses. When performed correctly, the change will be stable for the long term. However, there may occasionally be small changes in vision after laser eye surgery.

There are 3 main types of laser eye surgery that can be performed by an eye surgeon:

• Laser-assisted in-situ keratomileusis (LASIK) uses 2 lasers, one to open up a thin flap in the surface of the cornea, and another to reshape the cornea underneath. The protective flap is then smoothed back over and stays in place without stitches.

• Small incision lenticule extraction (SMILE) reshapes the cornea through a small hole that then heals.

• Surface laser treatments (photorefractive keratectomy (PRK), laser-assisted subepithelial keratectomy (LASEK) and TransPRK) involve removing the clear skin covering the cornea so the cornea can be reshaped with a laser. The clear skin then grows back naturally.

All types of laser eye surgery use lasers to change the shape of the clear layer that covers the front of your eye (your cornea). This corrects short- or long-sight by enabling your eye to focus correctly. Laser eye surgery may also help with age-related sight changes.

Laser eye surgery doesn't usually hurt but may cause mild, gritty discomfort. This can be helped with artificial tears and the eyes will usually feel comfortable again in about 3 to 6 months.

Laser eye surgery is generally very safe. However, apart from causing mild, gritty discomfort, laser eye surgery may also cause:

• Visual disturbances (such as glare from oncoming headlights when driving at night). This usually resolves or can be treated. Severe loss of vision is very rare.

• Red marks on the white of your eye. These usually disappear within about a month.

Laser eye surgery is a very quick procedure, lasting anything from a few seconds to a couple of minutes.

The length of time needed for complete recovery will vary from person to person, and will mainly depend on how quickly your brain adapts to your new way of seeing.

Monovision essentially means that each eye is doing a different job: one focusing on distance, and the other on nearby items. This can be difficult to get used to and some people will never be able to adapt to it.

In comparison, blended vision means a ‘blend zone’ that is smoother and offers a greater depth of vision. In this case, many people can adjust to the new vision within a few weeks.

Most people recover and are able to resume normal activities and return to work 24 hours after laser eye surgery, and most people notice the improvement in their vision straight away.