Laser eye surgery

Your eye is very similar to a camera. Inside the eye there is a lens which sits behind the pupil. The eye’s ability to focus depends on three main factors, the cornea (which is known as the “window of the eye”, the lens inside the eye and the length of the eye. The cornea and the lens should work together to focus an image on the retina at the back of the eye. However, when these three elements don’t work together this can lead to eyesight problems.

These include:

• Myopia (short-sightedness) where objects in the distance appear blurred or out of focus
• Hyperopia (long-sightedness) which affects the ability to see objects close to them. Long-sightedness often becomes more noticeable after the age of 40 and this is known as presbyopia
• Astigmatism (irregular shaped eye surface) - a condition where the eye surface is shaped more like a rugby ball than a football so light entering the eye isn’t focused properly causing vision problems
• Experience flashes and floaters

You are a good candidate for laser eye surgery if you:

• Are aged 18-50 (you will need to check your specific surgeon’s criteria)
• Have had a stable focusing error for at least a year
• Have otherwise healthy eyes
• Enjoy general good health

Our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals. They have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. And many consultants have international reputations for their research in their specialised field.

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

Your decision to have laser eye surgery should be a positive and informed decision based on an accurate assessment of the potential risks and benefits specific to your case. You should fully inform yourself of the clinical reasons behind your treatment, the predictability of the procedure’s results and the timescales involved.

Laser surgery is the most widely publicised type of vision correction surgery. There are two different types of laser eye surgery:

• Blade free LASIK; and
• Laser epithelial keratomileusis (LASEK)

Ask your chosen hospital about which laser they use.

Your consultant will give you tailored advice to follow in the run up to your procedure. An expert ophthalmic surgeon trained in the diagnosis of corneal disorders will carry out a comprehensive eye examination and discuss the best laser treatment option for you.

The examination should include:

• Refraction – a check on the focus of the eye
• Scanning Slit Corneal Topography – a map of the corneal shape and power
• Corneal Pachymetry – a measurement of corneal thickness
• Pupillometry – a measurement of the size of your pupil in the dark
• Keratometry – a measurement of corneal power; this data is useful if you end up needing a cataract operation in the future
• Dilated examinations of the retina – eye drops are used to dilate your pupil to help examine the back of the eye
• Wavefront scan – a measurement of the focusing error of the eye based on how light waves travel through it. This test is more objective than conventional measurements of focusing error which rely on your own assessment of how well you think you see during an eye examination

We've tried to make your experience with us as easy and relaxed as possible. For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages. Our dedicated team will also give you tailored advice to follow in the run up to your visit.

Blade Free (Femtosecond) Wavefront LASIK

The surgery usually takes about ten minutes per eye. On arrival at the hospital a nurse will assess you, you will have a wavefront scan and there will be a final discussion of the best treatment option. This is your opportunity to ask us any questions you have prior to giving your formal consent to the procedure. In the operating theatre you’ll lie down on a reclining chair and anaesthetic drops will be placed in your eyes. A clip is used to stop your eyelids from blinking.

The femtosecond laser hand-piece is then gently placed on your eye, and a vacuum is allowed to build so that the eye remains still. Your sight may blur and you may experience mild pressure. The femtosecond laser is then focused and scanned to create the LASIK flap. The hand-piece is removed and the corneal flap is gently lifted and turned on its side. You’ll be asked to concentrate on a flashing target light (fixation light) within the laser and the laser sculpting commences. A series of clicking or clapping noises are heard as the excimer laser removes corneal tissue to a pattern pre-determined by your wavefront prescription.

You may be aware of a gentle tapping sensation and a faint smell similar to singed hair. The laser isn’t thermal and no tissue is heated or burned during the process. The laser component of the treatment usually takes a few seconds and varies with your prescription. Once the laser sculpting is completed, the flap is repositioned and its alignment checked. It takes a couple of minutes for the flap to stick to the cornea. A protective eye shield is applied after applying antibiotic drops.

Wavefront LASEK

The surgery usually takes about 15 minutes per eye. You will be assessed by a nurse, have a wavefront scan and a final discussion of the best treatment option. You can ask us any questions you have prior to you giving your formal consent to the procedure. Anaesthetic drops will be placed in your eyes and a clip is used to stop your eyelids from blinking.

The surface of the epithelium (the surface layer of the cornea) is loosened from its underlying attachments using chemicals. The epithelium is gently rolled back to form a flap with a hinge under the top eyelid. You will be asked to concentrate on a target light (fixation light) within the laser and the laser sculpting commences.

A series of clicking or clapping noises are heard as the excimer laser removes corneal tissue to a pattern pre-determined by your own refraction. You may be aware of a gentle tapping sensation and a faint smell similar to singed hair. This isn’t an issue as tissue is not heated and burned during the process. The laser component of the treatment usually takes a few seconds. Antibiotic drops are applied and a bandage contact lens put into the eye at the end of the procedure.

Blade Free (Femtosecond) Wavefront LASIK

It is common for the eye to be red, watery, feel scratchy and be very light sensitive for 4-6 hours following treatment. You may experience mild discomfort for the first 24 hours after treatment. Recovery of vision to a reasonable level is almost immediate, and typically most patients notice a significant improvement in their vision the next day.

You should wait at least one week following surgery before beginning any non-contact sports. To help prevent infection, you will need to wait for up to four weeks after surgery before using lotions, creams or make up around the eye. You should also avoid swimming and using hot tubs or whirlpools for a month. Strenuous contact sports such as boxing, football, karate etc, should not be attempted for at least four weeks after surgery. It is important to protect your eyes from anything that might get in them and from being hit or bumped. It is also essential to protect your eyes from bright sunlight by using a good pair of sunglasses for at least three months after surgery.

During the first few months after treatment, your vision may fluctuate. It may take up to 3-6 months for your vision to stabilise after treatment. Most patients have a mild to moderate degree of dry eye up to six months after treatment and can require artificial tears or rarely, punctual occlusion during this period. Glare, haloes, difficulty driving at night and other visual symptoms may also persist during this stabilisation period.

Wavefront LASEK

It is common for the eye to be red, watery, feel scratchy and be very light sensitive for 24-48 hours following surgery. There is moderate discomfort to severe pain for the first 24-48 hours after surgery. After 3-4 days, the bandage contact lens is removed. Recovery of vision to a reasonable level typically takes 3-6 days, while stability of vision is achieved usually by two weeks, although in rare cases it could be 3-6 months. Most people are able to return to work after 3-6 days. Antibiotic drops are prescribed for a week after surgery while steroids and artificial teardrops are usually prescribed for a month. There is a complete regime of pain relief in place and most patients are able to cope reasonably well with any post-operative discomfort.

You should wait at least one week following surgery before beginning any non-contact sports. To help prevent infection, you will need to wait for up to four weeks after surgery before using lotions, creams or make-up around the eye. You should also avoid swimming and using hot tubs or whirlpools for a month. Strenuous contact sports such as boxing, football, karate etc, should not be attempted for at least four weeks after surgery. It is important to protect your eyes from anything that might get in them and from being hit or bumped, it is essential to protect your eyes from bright sunlight by using a good pair of sunglasses for at least three months after surgery.

During the first few months after surgery your vision may fluctuate. It may take up to 3-6 months for your vision to stabilise after surgery. Most LASEK patients have a mild degree of dry eye up to three months after surgery and can require artificial tears or rarely punctual occlusion during this period. You may experience glare, haloes, difficulty driving at night and other visual symptoms while your vision stabilises.

How your loved ones can help

Even after you’ve left hospital, we’re still looking after you every step of the way. After laser vision correction, we’ll want to see you the day after your procedure to see how you are doing. Follow up appointments with your consultant are included for six months after the procedure.

Complication from laser eye surgery is very rare but our consultants provide total continuity of care and if you have any concerns after surgery please call us straight away.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.