Every type of surgical procedure carries with it a number of risks. Fortunately for laser eye surgery patients, the procedure has become safer and more effective over the years, and the technology behind it is constantly improving.
What is laser eye surgery?
Laser eye surgery involves the use of a laser to vaporise parts of the cornea in order to reshape it and correct visual impairments. It’s an effective permanent solution for a range of refractive disorders, including myopia (shortsightedness), hyperopia (longsightedness) and astigmatism.
Introduced in the UK in 1990, laser eye surgery is now the most popular and the safest elective surgery in the country. Over 30 million procedures have been carried out worldwide so far, and here in the UK, more than 120,000 patients choose to undergo laser eye surgery every year.
Typical laser eye surgery procedure
Photorefractive keratectomy (PRK) was the first procedure used when laser eye surgery was introduced. It has since been replaced by LASEK (laser epithelial keratomileusis) and LASIK (laser-assisted in-situ keratomileusis). In PRK, the surgeon scrapes off the epithelium, the thin outermost layer of the cornea, in order to expose the cornea. In LASEK, the epithelium isn’t removed; instead, a flap is created in the epithelial layer and pushed to the side. In LASIK, the flap is created to expose a deeper part of the cornea.
A typical LASIK or LASEK procedure has the following 5 steps.
- The surgeon will prepare the patient by putting anaesthetic eyedrops in the eye to be treated. Once the eye is numb, a plastic instrument called speculum is used to hold the eyelids back and keep the eye open.
- The surgeon will now create the flap over the cornea using a high-precision blade. The flap is peeled back to expose the cornea.
- A computer-controlled laser will now vaporise bits of tissue from the cornea in order to reshape it. For shortsighted people, the cornea is flattened out a bit. For longsighted people, the cornea is made a bit steeper. For those suffering from astigmatism, the cornea is shaped to make it rounder. After the cornea has been reshaped, the surgeon will put the flap back in its place.
- Once the procedure is done, the surgeon will place a soft contact lens that will serve as a bandage for a LASEK patient. A LASIK patient won’t need a contact lens, but will most likely be given goggles to protect the treated eye on their way home.
- The patient will be given eyedrops and medicine to help them manage their discomfort during their recovery period.
You can see a more detailed explanation and video of how laser eye surgery works here.
How effective is laser eye treatment?
Laser eye surgery has progressed dramatically in the last ten years or so. It is a very effective permanent solution to a wide range of refractive errors. It is also generally painless and the recovery period is short.
Most laser eye surgery patients attain 20/20 vision or even better. The results do vary, though, among patients with higher prescriptions.
The average cost of laser eye surgery
The cost of laser eye surgery is determined by a certain number of factors—the type of procedure, the patient’s prescription, the surgeon and the reputation and size of the clinic.
Here are the average prices of standard laser eye procedures:
- PRK – £800 per eye
- LASIK- £2,800 per eye
- LASEK – £2,500 per eye
Wavefront technology is used in both LASIK and LASEK and is especially useful for patients with high prescriptions. This involves creating a 3D map of the contours of the eye in order to make accurate changes on the cornea. Wavefront is more expensive than standard LASIK and LASEK.
What are the risks of each laser eye surgery treatment?
Every surgical procedure carries a certain number of risks, and laser eye surgery is no exception. While the chances of most of the problems listed below occurring are very low (less than 0.5% for most), it’s still important to be aware of them so you’ll know what to expect and discuss whatever worries you may have with your surgeon.
The following is a list of the risks that come with laser eye surgery, along with the type of procedure where they normally occur:
- Your vision may be over- or under-corrected. This occurs mostly in PRK and LASEK patients. This is when the surgery doesn’t result in 20/20 vision or the patient’s condition actually gets reversed, e.g., a longsighted patient turns nearsighted. This can be corrected by another round of surgery, if the patient’s cornea is thick enough to withstand it.
- You might end up with visual aberrations. This is predominant among LASIK patients, although the probability is lower than 1%. These aberrations include halos (the patient sees a glowing ring around light sources), starbursts (the patient sees light radiating from light sources) and double vision. These defects are apparent at night or in dim light and are more likely to happen to patients with larger pupils
- You might develop chronic dry, red eyes. This occurs among patients of all types of laser eye surgery. For most patients, dryness and redness of the eyes disappear over time, but for a very few, this becomes permanent and the patients will have to use artificial tears for the rest of their life.
- Your eye may get infected. This complication is very rare, and the patient can be treated with steroid eyedrops or antibiotics.
- You might suffer from corneal estasia. This occurs in less than 0.2% of all laser eye surgery patients. Corneal estasia results from the cornea bulging and thinning out, most often because too much tissue had been removed. This condition can lead to blindness. As a solution, the patient will be given rigid contact lenses. Those with extreme estasia might need to undergo corneal transplant.
The importance of knowing success rates
Generally speaking, LASIK and LASEK have very high success rates among patients with mild to moderate prescriptions with around 80% attaining perfect vision. Those with more severe visual impairments might get varied results, although at least 40% have reported attaining 20/20 vision.
The success of your own procedure will be determined by your prescription and the competence of the surgeon who will perform the surgery. Before you decide which laser eye surgery clinic to go to, you’ll need to know the success rate of each clinic you’re looking into. Remember that more experienced surgeons will have higher success rates. When you do your comparison, make sure that you’re looking at the statistics pertaining to patients who had undergone the procedure that you’re about to have.