If you are looking into having laser eye surgery you are likely to have seen that clinics offers variations of LASIK and LASEK treatments and occasionally PRK treatment (although this is becoming less common now). This article will give you an overview about each treatment and the typical costs involved. If you are looking to compare prices in clinics nearby please fill in the short form on this page.
LASIK stands for laser-assisted in-situ keratomileusis and is a form of surgery aimed at primarily improving the vision of those who are long or short-sighted or who have an astigmatism. The surgery involves the use of Excimer laser to change the shape of the cornea which is the part of the eye that light filtrates to hit the retina. Altering the shape of the cornea allows light to enter the eye differently therefore correcting the patient’s sight deficiency.
The cornea is shaped through once the surgeon has cut a flap in it using either a laser or microkeratome. The surgery itself is painless and lasts only 15 to 30 minutes with most patients resuming normal activities within a couple of days of the surgery.
Types of LASIK Eye Surgery
Wavefront LASIK. Computer imaging provides the surgeon with a three dimensional map of the patients eye. This allows more accuracy with the procedure and a higher chance of the patient obtaining 20/20 vision post-operation.
Standard LASIK. This involves reshaping the tissue of the cornea using a laser. Access to the cornea is obtained by cuttinga flap in the outer layer to allow the laser entry.
Epi-LASIK. Here the surgeon cuts a thin layer from the cornea to allow him or her to reshape it using the laser. Sometimes the layer is replaced or it may be removed completely. The patient is provided with a soft contact lense to allow the cornea to heal unharmed.
How Much Does LASIK Eye Surgery Cost?
You can expect to pay between £1,600 to £2,500 per eye for LASIK treatment depending on your prescription and choice of clinic. You can see current average prices of LASIK surgery here.
LASIK Surgery Recovery & Aftercare
It’s important to rest the eyes and take care they don’t come into contact with any foreign substances such as shampoo, face cream, make up etc following LASIK eye surgery. This means no washing hair or even having a shower (because of the steam), wearing sunglasses when out in the sun and avoiding any contact sports for up to a month. Other activities that should be avoided include swimming and driving – the latter for up to one week post-surgery.
How the procedure is carried out:
- As with other laser eye surgical procedures, LASIK starts with the surgeon putting anaesthetic eyedrops in the eye to be treated to numb it and clamps the eye open with a speculum.
- The surgeon will use a microkeratone, a high precision instrument, to cut a flap in the cornea. The flap is then peeled back to expose the stromal layer.
- The laser is now beamed onto the cornea to cut and reshape it. This will require you to stare into a red or green light.
- After between 30 seconds and 2 minutes the laser will stop.
- Once the procedure is done the surgeon will replace corneal flap and may wash out the area.
- Your eye will be left to dry naturally and the flap will be left to bond to the rest of your cornea. Most surgeons will put protective goggles on the patient to let them protect the treated eye on the way home and during the first 24 hours after surgery.
LASIK patients have a shorter recovery period than PRK and LASEK patients, as the eye starts healing as soon as the corneal flap is replaced. Many get their normal vision back within 24 to 48 hours.
What are the main risks of LASIK Laser Eye Surgery?
The surgery was introduced in the 1980s and to date there does not appear to be any future risk to patients. For some patients (around 5%) the operation may need to be performed again but this is due to natural eyesight deterioration rather than any long-term effects of the surgery. The surgery can prove painful for those who have dry eyes since this is one of the after effects of the operation. The eyes can be routinely relieved with eye drops but in extreme cases more extensive treatment may be required. Hazy vision is a common after effect of the operation and it may be difficult to drive at night for the first six weeks or so until the eyesight settles.
Drooping eyelids can also be a side effect but again this too will improve and resume its normal position as time goes on. More serious complications of a laser eye operation include an under or over correction of the original problem. However this can be rectified by another operation. Another risk is that an infection in the eye could arise as the cornea is cut. The flap of the cornea may also wrinkle, causing slightly distorted vision. The operation could also destabilise the cornea, causing the eye to bulge more than usual. The latter also affects vision.
LASEK stands for laser epithelial keratomileusis. Like PRK described below, this procedure works on the Bowman’s layer of the cornea but does not involve the removal of the epithelium.
How the procedure is carried out:
- The procedure starts with the surgeon putting anaesthetic eyedrops in the eye to be treated. The eyelids are then held back with a speculum.
- The surgeon will use an instrument called trephine to make a cut in the epithelium which is then peeled back to expose the Bowman’s layer of the cornea.
- The surgeon will now use the laser to reshape the cornea.
- Once the cornea has been reshaped, the surgeon will put the epithelial flap back over the cornea.
- The surgeon will now place a soft contact lens over the eye to protect it.
The recovery period: It will take the patient from three to six days to regain normal vision. It could take up to a month for vision to stabilise. In highly complicated cases, it could take up to nine months for this to happen.
Suitability: LASEK is suitable for a range of refractive problems, including nearsightedness, longsightedness and astigmatism. It’s ideal for patients with thin corneas and those who engage in activities that carry the risk of facial injuries, such as baseball players.
Risks: Some LASEK patients may feel a mild stinging sensation or even moderate pain during the early stages of recovery. Corneal haze is also likely to happen. Over- and under-correction also occurs in some cases.
LASEK Eye Surgery Cost: You can expect to pay £1200 per eye for standard (non Wavefront) LASEK surgery and £1600+ for Wavefront guided LASUK surgery. You can see more LASEK price information here.
PRK stands for photorefractive keratectomy and was the first major type of laser eye surgery treatment to be used. As it is not effective as the other treatments it is rarely used and most clinics no longer offer it.
How the procedure is carried out:
- The surgeon will put anaesthetic drops in the patient’s eye in order to numb it. A speculum is used to keep the eye open once the anaesthetic has taken effect.
- The surgeon will scrape off the epithelium, the thin outermost layer of the cornea, in order to expose the Bowman’s layer.
- The surgeon will now use an excimer or femtosecond laser to reshape the cornea. The laser is guided by a computer that will tell it which parts of the cornea to vaporise in order to give it the right shape. This part lasts for just a few seconds.
- Once the procedure is done, the surgeon will put a soft contact lens as ‘bandage’ to protect the eye while the epithelium is regrowing. The patient will also get painkillers to take during the recovery period.
The recovery period: The PRK procedure normally lasts less than two minutes, but the healing period can take from two days to over a week.
Suitability: PRK is especially suitable for treating longsightedness and astigmatism. It’s a good alternative to LASIK for patients with thin corneas, corneal scars, large pupils, or who have a history of certain eye surgical procedures such as radial keratotomy and corneal transplants. Exceptions include those who are pregnant or breastfeeding, and patients suffering from glaucoma.
Risks: PRK patients might experience mild to moderate pain during the healing process. They may also suffer from corneal haze (cloudy vision) during the recovery period although this is rate. A study by the National Institute of Clinical Excellence (NICE) found 0- 2% of people experienced this depending on the clinic assessed. Under- or over-correction is also a possibility with PRK.
PRK Eye Surgery Cost: From £800 per eye
Which Treatment Should You Go For?
As we mentioned above, PRK is rarely used these days because of the inconvenience of pain and a longer recovery period for patients so if you can afford it LASIK or LASEK would be the best option – ideally with Wavefront. LASIK is the main procedure used for laser eye surgery patients because of its versatility and the fact that it is painless and has a shorter recovery period.
LASEK, however, serves as a good alternative to LASIK for treating patients who otherwise would not be eligible for laser eye surgery such as those with thin corneas. Currently, only around 5% of laser eye surgery patients undergo LASEK. Here is a summary of the main differences:
LASIK Eye Surgery
- Wider range of suitable refractions: +5.00D to -12.00D (LASEK: +4.00D to -8.00D)
- Only one day recovery time compared to 3 or 4 days for LASEK
- Only one day visual recovery time compared to 1 to 3 days for LASEK
- Vision tends to stabilise sooner with high corrections
- Less discomfort after surgery (assuming there are no complications)
LASEK Eye Surgery
- Fewer complications and less risk of failure
- No corneal incision
- The cornea is not weakened making it more suitable for athletes, fighter pilots, or anyone who is at risk for corneal trauma (in LASIK surgery the flap created can remain for up to 7 years which makes it too risky for anyone who is at risk for corneal trauma)
- Easier for the surgeon to learn and perform for the surgeon
- Can be performed more than once
To determine which procedure will be best for you, you will need to have a proper consultation which are free at most clinics in the UK.