FAQs

Below you can read the answers to the most frequently asked questions about laser eye surgery we receive at LaserVision.
Patients will need to consider the majority of the below before going ahead with vision correction treatment to make sure it is the right course for them.

 

What is laser eye surgery?

Laser eye surgery is an operation, which aims to reduce dependence on glasses or contact lenses by correcting vision using an excimer laser. During the ten minute surgery the laser reshapes the cornea of the eye in a predetermined manner to improve unaided vision. The two most common types of laser eye surgery are LASIK and LASEK, although there are several other types of refractive surgery that can improve your vision when laser surgery is not the most appropriate option.

What is refractive error?

The eye acts like a camera focusing light through the cornea and lens, onto the retina. If the shape and power of the cornea or lens do not match the length of the eye, then the light will focus either in front or behind the retina, meaning the image will be out of focus. This is termed refractive error and glasses or contact lenses are traditionally used to correct this blur.

What is short sightedness?

Someone who is short-sighted sees better up close without their glasses than they do in the distance. This is called 'myopia'.

What is long sightedness?

Someone who is long-sighted sees better in the distance than up close without their glasses. This is often called 'hyperopia'.

What is astigmatism?

The simplest way to understand astigmatism is to imagine the cornea (front surface of the eye) to be shaped like a rugby ball instead of a football. As this acts like a lens, the light is bent and focused differently depending on which part of the cornea it hits. This results in a blurred image which requires a more complex shaped lens to correct to focus.

What is presbyopia?

Presbyopia is an age related condition in which the eye has a reduced ability to focus on near objects. This is due to the natural lens within the eye losing its ability to flex. People initially find that the hold objects further away from their eyes to see clearly, and soon after reading glasses are required for routine day to day tasks. At LaserVision, we have several solutions to treat presbyopia and at your consultation, your surgeon will discuss the best solution for you.

Do I need a consultation?

Yes, a consultation is a must. It’s a very important part of the decision making process to find if you are suitable. You will discuss with your surgeon what treatment options are suitable for your eyes. It also allows you to find out more about the benefits, affordability and facts before making your decision.

Is there a waiting list for consultations?

No, but eye treatments are increasingly popular. Our Consultant Ophthalmic Surgeon is always in demand but we aim to accommodate you as soon as possible usually within 1-2 weeks. However, sometimes we are busier than usual and you may have to wait a while longer.

How long should I leave out my contact lenses for?

Prior to your initial assessment, it is essential to leave out your contact lenses for a period of 1 week if they are soft contact lenses and for 4 weeks if they are rigid contact lenses. This is imperative for accurate assessment of the cornea prior to treatment and for correct planning of your surgery.

Can I wear make up?

Consultation
We would advise that you do not wear eye make up to your consultation.

Treatment
On the day of treatment you should not wear any make up at all, as this may affect the accuracy of the laser. The eye area will be cleaned by nursing staff prior to treatment to ensure the area is cleaned effectively.

After treatment
We recommend that you do not wear eye make up for up to 4 weeks after surgery.

LASIK, LASEK or ReLEx?

The decision about which technique of laser vision correction is right for you is made after assessment and discussion with your surgeon.  It depends on factors such as your prescription and many aspects of your ocular examination but also your personal choice.

LASIK gives fast visual recovery with little discomfort: for these reasons it is the commonest choice for many people.  It involves creation of a very thin and precise LASIK flap: it may not be appropriate if you participate in contact-sports or if your cornea is thinner than normal. On the other hand for some refractive errors LASIK is the only choice.

ReLEx FLEx and SMILE are exciting new techniques that share many of the advantages as LASIK but have less of an impact on corneal strength so the contact-sport and corneal thickness issues are less relevant.  ReLEx can at the moment only be used for treatment of short-sight.

LASEK does not require flap or lenticule creation so in many ways is the simplest treatment. However, visual recovery is slower and your eye will be uncomfortable during the early post-operative period.  LASEK may be the treatment of choice for thin corneas.  LASEK is best suited to correction of low to moderate degrees of short-sight.

A final decision about which treatment to have can only be made after full ophthalmic examination and discussion with your consultant.

How old do I have to be for refractive surgery?

Refractive surgery can be performed at any age above 18 years old, but the treatment of choice may vary depending on different factors. Beyond the age of 50 the refractive procedure of choice may be a lens exchange as opposed to laser correction.

What are the exclusion criteria for refractive surgery?

To be considered one must be over the age of 18, not pregnant and have a stable prescription for 18 months.

I have been refused laser eye surgery in the past owing to the strength of my prescription. Have techniques moved on?

Yes they have. Our consultation includes a number of tests which will determine both your suitability for treatment and help you decide on which is best suited to your personal needs and expectations.

How soon after the consultation can treatment start?

Treatment can start no earlier than five days after consultation as it allows you to consider your decision to proceed as we feel it should not be rushed into.

Are there any hidden costs?

The fee which we detail in all of our publications for Laser Eye Surgery is totally comprehensive. All follow ups, post-operative care and necessary enhancements are included (follow-up visits for 12 months post-op).

Will there be pressure to proceed with treatment?

No. We just  use our expertise to give an honest opinion of what is best for you and your eyes. We will never pressurise anyone into treatment or phone you with offers trying to persuade you into treatment. This is a lifestyle operation to improve quality of life and it is not essential. We welcome anyone who has been seen elsewhere and wishes to come for a second opinion.

Is laser eye surgery risky?

This is often the main concern for people. The simple answer is “it depends”. Let us explain. The first thing to remember is that all surgery has risks and complications. The risks of having a complication from heart or orthopaedic surgery vary from surgeon to surgeon and hospital to hospital.

How do the risks compare with alternatives?

When laser eye surgery is performed in clinics like Laser Vision, the risks of developing a sight threatening complication is 8 times lower than wearing daily disposable contact lenses. To date, we have never had a sight threatening complication.

What are the complications of laser eye surgery?

There are always some potential risks and complications and it is imperative that these are well understood.

Minor Complications

Mild dry eye - Some people experience mild to moderate dry eye symptoms after LASIK. Occasional use of lubricating eye drops may be required. Some people need to use these regularly. By 3-6 months the eyes are usually back to normal. Under correction - If the refraction is not fully corrected and it causes a problem then an enhancement procedure can usually correct it, if there is enough corneal thickness to safely do more treatment. Enhancement treatments are generally done 3-6 months after the initial procedure, once vision has stabilised. Over correction - An initial overcorrection is expected for high corrections and in hyperopia. It usually regresses in the first 3 months. If overcorrection persists then enhancement surgery can be done, if it is safe to do so. Induced astigmatism - Can usually be corrected with enhancement surgery. Regression – As time goes on, a small proportion of eyes may slowly heal in a way that moves the prescription towards an under correction. This can usually be corrected with enhancement surgery. Light sensitivity - In the first few days some people will be sensitive to light. Pain - About 5% of patients say they have some mild pain after LASIK that can be relieved with pain relief tablets and usually resolves by 4-5 hours. Night vision problems - In the first few weeks following surgery about 10% may experience halos around lights at night time. This effect should fade. By twelve months this should only effect around 3%, generally those who started with a high correction. Haze - Some eyes develop faint haze in the interface between the flap and corneal bed that is maximal at 3-6 months and fades away by 12 months. It is very rare for this to affect vision. Interface debris - Minor debris in the interface is not uncommon. It very rarely affects vision and if it does can usually be removed. Corneal abrasion during the procedure - In some people the surface layer of cells on the cornea are looser than average and can be dislodged resulting in a surface abrasion. Over the following 2-3 days the abrasion will heal.

Important Complications

Loss of best-corrected vision - Following surgery if the vision in an eye cannot be corrected with lenses to the same line on the eye chart as before the surgery then this is called loss of best-corrected vision. Anything that affects the optical quality of the cornea can cause it. The chance of this happening is currently about 1 in 500. Corneal ectasia (bulging) - If there is too much tissue removed from the cornea it may lose its structural strength and start to bulge outwards. It can be eliminated by careful measurement of the thickness of the cornea. This is extremely rare, probably less than 1 in several thousand. Good screening and accurate assessment with a Pentacam will help avoid this. Progression from sub-clinical to true keratoconus (conical cornea) - This may occur if the most subtle signs of keratoconus are not detected with the corneal mapping (topography). With the use of the gold standard Pentacam topography this is very rare, probably less than 1 in several thousand. Severe dry eye – It is not uncommon for the eye to be slightly dry after laser surgery and most recover very quickly. If there is a predisposition to dryness, the eye may take longer to recover. Dry eye is more common with LASIK than LASEK. Epithelial ingrowth - Significant growth of the front cell layer (epithelial cells) between the flap and the bed. This occurs in less than 1 in 2000 eyes. This can only potentially occur in LASIK and not in LASEK. Diffuse lamellar keratitis - In rare cases there is movement of inflammatory cells into the interface between the flap and the bed. This can rarely result in the cornea becoming an irregular shape. Severe cases that affect vision occur in about 1 in 2000 cases. Most resolve with time. Again, this can only occur in LASIK and not in LASEK. Infection - Infection in the cornea following LASIK is extremely rare, about 1 in 10,000 cases. We are yet to have an infection in any of our cases to date. Problems cutting the flap - "Partial flaps", "Irregular flaps" or "Buttonholes" are all cases where a perfect flap is not achieved. The chance of this occurring with a microkeratome is about 1 in 500. With LASEK, there is no flap to create, so this problem is eliminated.

Why is the success rate not 100%?

At Laser Vision, we treat many complex patients, including those who require laser surgery for other reasons than vision correction. Some of these patients will never see 20/20 so when including these patients in our data, they will skew the results.

How long do the procedures take?

The procedures take approximately ten minutes per eye.

Are both eyes treated at the same time?

LASIK and LASEK is performed bilaterally simultaneously in approximately 95% of the patients we treat (i.e. both eyes same day). The decision always rests with the patient however after considering the pros and cons.

Are the results immediate?

Yes. Most people start noticing an improvement in vision almost immediately. After LASIK you will normally be able to see without glasses or contact lenses within twenty four hours. With LASEK the visual recovery is slower but by day 5 most patients are seeing well.

What happens if I move my eye?

The laser has an eye-tracker that will track each and every small movement that your eye makes. The laser only fires when the eye is perfectly in position so there is no chance of your looking around affecting the procedure. The good news is that most people find it very easy to keep the eye still by focusing on the target fixation light.

Are the procedures painful?

The procedure itself is painless. However, the eyes may feel a bit gritty after LASIK for a few hours, but there is no pain. Visual recovery from LASIK will normally be observed within 24hours.
There is more discomfort with LASEK but it is still possible to treat both eyes at the same time with LASEK and full recovery is expected within five days.

When will I be discharged?

Depending on your treatment, there are around 5-6 recommended aftercare appointments. On average this will take around four months. When you are discharged from our care you will be sent a discharge summary. You need to keep for in a safe place as it may be required in the future. When we have discharged you we will write to your doctor (GP).

What is ‘enhancement’ surgery?

Enhancement surgery is additional treatment to "fine tune" the result. It takes one to three months from the initial surgery for the vision to be stable. During this time there may be some minor fluctuations in your vision. There is a lot of individual variation in the rate and amount that people heal. If after three months there is some under or over correction, the surgeons at Laser Vision can offer you some additional laser to optimise the outcome, providing it is safe to do so. Generally enhancement surgery is more likely in higher or more complicated corrections. Enhancements are only needed in about 1% of cases of low short-sightedness. For higher corrections (over -8.0) there is a greater chance that an enhancement may be required. The overall rate of enhancement surgery following LASIK is about 4%. Enhancements are done free of charge within twelve months of the initial procedure as we want you to be happy with the final outcome

Will I need to take time off work?

Consultation
Your laser consultation can take up to two hours. You can return to work after this, but do not drive as we will have to use drops to dilate your pupils and this can make your vision blurry and light sensitive. We recommend you bring a pair of sunglasses.
Treatment
The laser treatment, including immediate post-treatment time, will be around 2 hours. We would not recommend you returning to work on the day of treatment. Many return to work two days later but this will depend on the type of treatment you have and type of work you do.
Aftercare
Each aftercare appointment can take up to one hour. If you have LASIK treatment we will see you the following day. Your next aftercare appointment will be one week following treatment. You will be then be seen at intervals determined by your Consultant Ophthalmologic Surgeon. If you have LASEK treatment we will see you 3-7 days following your treatment. Your next aftercare appointment will then be arranged for the following week, then at intervals determined by your consultant ophthalmologist.

How long before I can drive?

Consultation
We do not recommend you drive as we will use drops to dilate your pupils, and this can make your vision blurred and light sensitive.

Treatment
Everybody’s eyes are different. Usually, you can drive the following day after LASIK or intraLASIK and 7 days after LASEK or SupraLASE. However, you should not drive until your vision meets the driving standards. Our Consultant Ophthalmologists will test your vision and confirm this at your aftercare appointments.

How soon after treatment can I resume sporting activities?

Please discuss with your Consultant Ophthalmic Surgeon when you can resume sporting activities. Swimming is not recommended for 6 weeks after LASIK treatment and up to 4 weeks after LASEK treatment.

Can I fly after laser eye treatment?

We would recommend not flying for 2 to 3 days after laser eye surgery (this includes both long- haul and short-haul flights). This is due to the dry atmosphere inside an aeroplane. When you do fly please make sure you use plenty of artificial tears.

How soon can I use my PC?

This depends on your own recovery rate, but allow at least 24 to 48 hours, and it could be up to a week. If you must use your PC, then remember to blink frequently and use the drops provided.

Where do ophthalmic surgeons have LASIK?

They have LASIK with well-respected experienced colleagues with a proven track record and access to the most up-to-date effective technology. At Laservision, we have treated many doctors including our very own Mike Tappin.

I am a commercial pilot. Can I have laser vision correction?

We have treated pilots in the past and this has not been a problem. Often your employer may require a report after the treatment. You would need to clarify this with the Civil Aviation authority (CAA).

Do public services employers (fire, police, and armed forces) recognise laser eye treatment?

The police will generally accept applications from people who have undergone laser eye surgery after the elapse of 6-10 weeks, and provided there are no residual side-effects and other eyesight standards are met. Laser eye surgery treatments are generally acceptable for current employees, but check with your employer beforehand.

Some fire brigades will make allowances for those with laser vision correction. In most cases, you will have to wait 6 months after treatment before applying. Check with your local brigade. Laser eye surgery treatments are generally acceptable for current employees, but check with your superior beforehand.

Military police states that while laser eye procedures are not generally prohibited among serving recruits, there are rules covering its use. Please check with your superior.

In association with:
Sheffield Teaching Hospital NHS Foundation Trust, Greater Manchester University Hospitals NHS Foundation Trust