Laser Eye Surgery

Written by Joy Watford

Medically reviewed by Dr Melody Huang, OD

Updated 14th Jan 2021

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What Is Laser Eye Surgery?

Also known as refractive surgery or vision correction, laser eye surgery is a short procedure that involves using an extremely precise laser to make tiny corrections to the surface of your eye (cornea) so that you can see with greater clarity and sharpness. Over 120,000 people receive laser eye surgery each year in the UK accounting for 75% of all surgical procedures carried out. When people refer to laser eye surgery they normally mean LASIK, SMILE or surface laser treatments (e.g. LASEK, PRK, TransPRK).

Am I Eligible For Laser Eye Surgery?

More people than ever are suitable to have laser eye surgery but there are still some restrictions on who can have refractive surgery. Below we’ve put together a guide to the criteria normally used by clinics to select who is eligible for vision correction surgery (we also have more information on suitability here):

You are suitable if:

You’re fit and healthy.
You aren’t allergic to anaesthesia.
You’ve had stable vision for around 2 years.
You’re over 21. There is no upper age limit for laser eye surgery patients, although some clinics that will not operate on those over 70.
You have a refractive error, which tends to be in the following range:
- Up to -10.00D of nearsightedness (myopia)
- Up to +4.00D of farsightedness (hyperopia)
- Up to +/-6.00D of astigmatism

You are not suitable if:

You have dry eyes.
You have cataracts or glaucoma.
You have thin corneas.
You’re pregnant or breastfeeding.
You’re taking immunosuppressant drugs.
You suffer from certain medical conditions, including rheumatoid arthritis, hepatitis C, diabetes, the herpes virus and lupus.
You have a job that’s dependent on your eyesight (although not an exclusion per se, professional athletes, pilots and so on are told to consider the implications if the procedure does go wrong).

What Type of Eye Surgery Is Right For Me?

The particular laser eye treatment that is right for you will depend on your budget and eye condition. The tabs below give an overview of the different laser eye surgery treatment types.

	What Is It?	Best for?
LASIK Laser-Assisted In Situ Keratomileusis	LASIK is the most common type of laser treatment and is relatively painless. It involves creating a flap in the cornea, peeling it back to expose the stromal layer. The cornea is then reshaped with a laser beam and the flap is replaced afterwards.	This procedure is best for those with common sight problems, such as nearsightedness, farsightedness and astigmatism.
LASEK Laser-Assisted Epithelial Keratomileusis	LASEK surgery involves peeling back the epithelium (the thin layer of cells that cover the cornea), exposing the Bowman’s layer. This is then reshaped with a laser beam and the epithelium is replaced.	This treatment is the most viable option for patients with thin corneas, and is a good alternative to LASIK surgery.
Wavefront	Wavefront is a type of technology utilised in LASIK and LASEK procedures. Software creates a map of the patient’s eye to give an accurate picture of the aberrations to be corrected. The map is then used to control the laser so that it can reshapes the cornea exactly to the patient’s specific requirements.	This is best for those who can are eligible for standard LASIK and LASEK procedures but have the budget to pay the extra to get superior results.
SMILE Small Incision Lenticule Extraction	ReLex SMILE is a new, minimally-invasive laser eye treatment which offers a great alternative to LASEK and LASIK treatment. Rather than creating a flap in the cornea for the laser, this procedure involves making a small hole in the cornea using a state of the art laser that places a series of pulses in the centre of the cornea.	It is generally used for correcting higher degrees of myopia with or without astigmatism. More people are suitable for this treatment than for LASEK and LASIK treatment.
PRK Photorefractive Keratoctomy	PRK is the oldest type of laser eye treatment and involves the removal of the epithelium in order to access the cornea. The cornea is reshaped with laser and the patient will then have to wear a protective lens during the recovery period.	Best for those on a budget and who qualify. It is rarely used these days, but PRK a good alternative to LASIK and LASEK for people with very thin corneas who would otherwise not be considered as candidates for laser eye treatment.

Which Eye Conditions Does Laser Eye Surgery Treat?

Laser eye surgery is appropriate for you if you have a moderate degree of:

Myopia (also known as short-sightedness), whereby you are able to see nearby objects to a higher level of clarity, but distant objects appear blurred.
Hyperopia (also known as long-sightedness), whereby you are able to see distant objects clearly, but objects at short distances appear blurred.
Astigmatism, caused by unequal curvature on the eye surface, and manifests in overall blurry vision.

Still Not Sure If You Are Suitable? Do not worry if you are not sure as your vision will be assessed if you book a consultation (free in many clinics) who’ll be able to determine whether or not you’re a suitable candidate for laser eye surgery and which type.

Step 1: Anaesthetic Eye Drops

The eye is quickly numbed with some anaesthetic eye drops.
Step 2: Surgery

You'll only be in the surgical theatre for around 10 minutes and the actual laser will only be used from just a few seconds to two minutes depending upon the complexity of your prescription. The procedure should be painless.
Step 3: Recovery

The length of your recovery period depends on the type of laser eye surgery you’ve had and your overall health. In general, LASIK surgery patients can expect to have normal vision and return to work within 24-48 hours after surgery. Patients who underwent LASEK surgery may take up to one week to recover. Your surgeon will give you an expected recovery duration in your initial consultation.
Aftercare

Clinics will typically offer some aftercare provision as standard for all patients which is included in the price. This normally involves 2 to 4 checkups over the course of 3-12 months, depending on the clinic. You will also be provided antibiotic and anti-inflammatory eye drops to use after your procedure.

How Is Laser Eye Surgery Performed?

The particular laser eye treatment that is right for you will depend on your budget and eye condition. Click the tabs below to get an overview of the treatment types offered.

Followup surveys across multiple clinics in the UK indicate that more than 95% of patients report being satisfied with the results they’ve had through their surgery, with 33% going as far as deeming it ‘life-changing’.

Is It Safe?

Whilst the procedure has a very good safety record and does not hurt it is important to understand there are some risks and potential side effects with any surgery as shown in the tabs below.

It should be noted that serious issues are rare and in the UK, regression occurs among only 5% of laser eye surgery patients. People who are likely to have regression are those with high prescriptions and/or are longsighted.

Potential Side Effects
Risks

It’s common to experience some of the following side effects after your procedure but these will often disappear with time:

Vision changes. These include starbursts, glare, ghost images and halos. These are more common if you had a high prescription but should disappear within a few months.
Eye blurring and/or discomfort. As well as the dry sensation mentioned previously, some patients may find their eyes blur intermittently. Again, this should rectify itself within a few months.
Infection. Although rare, you are at risk of infection post-surgery, particularly if you’ve had a surface ablation (e.g. PRK).
Appearance. Red blotches can appear in the whites of your eyes and are caused by small blood leaks, but these aren’t harmful and don’t affect your eyes’ health. They should disappear within a few weeks.

You can read more about the potential side effects here.

Glare, halos and double vision. Most common at night, these symptoms do tend to disappear within several.
Dry eyes. For up to six months after your operation you may experience dry, gritty sensations in your eyes, which can affect the quality of your vision. Eye drops often help ease these symptoms, though.
Undercorrection or overcorrection. Sometimes, not enough or too much tissue is removed which may mean you need further surgery. The latter is harder to rectify due to the amount of tissue that’s already been removed.
Astigmatism. This occurs when tissue is removed unevenly and glasses, contact lenses or more surgery may be required.
Changes to or loss of vision. In extremely rare cases, vision loss can arise due to a complication in surgery. Some patients also find they can’t see as sharply or clearly as they did before the procedure.

Prices

Prices for both eye can vary from £1,190 to over £6,000 based on the treatment type, the clinic selected and sometimes the severity of your prescription. To get more detailed information on prices broken down by treatments and clinic read our guide on laser eye surgery costs.

If you’d like to get prices for your local clinics please complete our short comparison form.

Where Can I Get Laser Eye Surgery?

You will most likely have to pay for the surgery at a private clinic as laser eye surgery for long and short-sightedness or blurred vision caused by astigmatism is not covered by the NHS or most private health insurance policies.

If you decide you’d like to proceed with the treatment it is best to shortlist 1-3 clinics and visit their website to see exactly what they offer, their prices (including any additional fees), their terms and conditions and any guarantees they offer. If you are satisfied with what you read it is a good idea to arrange a free consultation so you can meet the surgeon and team in person. You should prepare some questions to ask like the following:

Does the surgeon have a Cert LRS qualification or are they on the General Medical Council’s register for ophthalmology?
Is the surgeon fully insured to carry out this procedure in the UK (you’re entitled to see a copy of this insurance)?
Is the clinic or hospital regulated?
- England - Care Quality Commission
- Scotland - Healthcare Improvement Scotland
- Wales - Healthcare Inspection Wales
- Northern Ireland - Regulatory and Quality Improvement Authority
How many procedures has the surgeon carried out previously using the same laser they’ll use on your eyes?
Does the surgeon have any reviews you can read, or are there previous patients you can talk to?
What are your expectations, and are these realistic? Discuss what you want from the operation and whether or not the surgeon feels this is possible.
Do you feel comfortable talking to the surgeon? Have they given you enough time to talk through the procedure and answer your questions?

What Are the Alternatives to Laser Eye Surgery?

If you are not a primary candidate for laser eye surgery, or want to weigh up your options? Then there are some alternatives available:

Lens Surgery

When you’re looking for permanent vision correction, you may find lens replacement surgery a more suitable solution. Evolving from cataract surgery, these state-of-the-art procedures include refractive lens exchange (RLE) and phakic intraocular lenses (PIOLs).

In essence, PIOLs are like having permanent contact lenses placed in your eyes because the natural lens isn’t removed beforehand although they are removable if cataract surgery is needed or other vision changes take place. They also eliminate many of the restrictions faced with contact lenses as this lens is inside your eye. This type of surgery is often recommended for younger patients who have a high degree of astigmatism or myopia, aren’t suitable for laser eye surgery or have a high eye prescription.

In contrast, RLE is often better for older people who aren’t suitable for laser eye surgery, have a high eye prescription or are suffering from the start of cataracts. This procedure is the same as cataract surgery as the natural lens is removed before a monofocal, multifocal or toric lens is put in its place.

Persisting with Glasses or Contact Lenses

Another alternative is to stick with what you’ve already got – your glasses or contact lenses.

And when weighing up your options as to whether or not this is a suitable choice for you, you’ll need to consider the limitations of contact lenses and glasses which include being unable to participate in sports, the aesthetics of wearing glasses (for some), the fact contact lenses can also increase your risk of irritation and infection and the ongoing costs involved in replacing these. That would explain why 42% of those who wear prescription glasses have considered having laser eye surgery.

You can find further information in our FAQ section of in the PDFs below.

Sources

Laser Vision Correction Surgery Patient Leaflet (Reviewed May 2018). Royal College of Ophthalmologists. www.rcophth.ac.uk.
Refractive Surgery, By Deepinder K. Dhaliwal , MD, L.Ac, University of Pittsburgh School of Medicine. MSD Manuals. Last full review/revision May 2020
LASIK for Correction of Myopia. Medscape.Updated Dec 2018
Small-Incision Lenticule Extraction (ReLEx SMILE). Medscape. Updated 27 June 2017
LASIK – Laser Eye Surgery. American Academy of Ophthalmology.Dec 2019