First performed in 1987, laser eye surgery is the world’s most frequently performed elective surgical procedure. It is estimated that over 18 million treatments have been performed to date and can result in complete freedom from corrective glasses or contact lenses.
Laser vision correction is surgery so any questions you have should be answered to your satisfaction before you undertake to have the treatment. It is important that you understand the options including the alternatives, the risks and limitations of the procedure itself, and feel confident with your surgeon before you commit to any surgical treatment.
Rakesh has been performing laser eye surgery for nearly 9 years, specialising in laser eye surgery for 18 months as Corneal and Refractive Fellow at Manchester Royal Eye Hospital in 2008 before moving to Queen Alexandra Hospital, Portsmouth as Consultant in 2010.
For patients with normal corrected vision prior to treatment and targeted for distance visual correction, over 99% will achieve the driving visual standard without spectacle correction following one treatment of LASIK. The results are similar for surface laser procedures and are subject to continuous annual audit.
For patients who do not achieve clear vision following a first treatment, an enhancement may be offered to optimize treatment and is highly effective in treating any residual refractive correction. Fewer than 3% of patients undergoing LASIK will require an enhancement procedure.
Suitable candidates for excimer laser correction should have healthy eyes with a good standard of vision when wearing glasses or contact lenses and a stable prescription within the treatable range.
At the present time, excimer laser treatment is not recommended during pregnancy, nor for breast-feeding mothers. It can also be difficult to assess the healing response for patients with medical conditions such as diabetes and your general medical history must be taken into account in determining whether you are suitable for treatment.
Laser treatment can be effective in correcting myopia, astigmatism and hyperopia. However, it cannot overcome the problem of presbyopia. This is an age-related decline in the ability of the lens in the eye to change focus and enable you to read or undertake close work at the usual distance.
If you undergo laser treatment and become normal sighted, you will need to wear spectacles for reading once you become naturally presbyopic which typically occurs in the mid to late forties.
Treatment by either LASIK, LASEK or PRK can result in problems with scarring or haziness of the cornea, glare, haloes around bright lights, recurrent problems with the epithelium of the cornea causing pain or discomfort, infection, permanent long-sight or short-sight requiring correction with spectacles or contact lenses. In LASIK there can be additional complications related to the flap including ulceration of the cornea, loss or distortion of the flap, infection and inflammation under the flap.
The potential complications will be explained at the your initial consultation and examination. If you decide to proceed with treatment you will be given an Informed Consent Form that details the potential risks and complications that you must read and sign before proceeding.
Laser treatment may result in reactivation of old Herpes viral infection – if you have had presumed Herpes infection of the eye you should make this known.
Although the aim of excimer laser treatment is to improve unaided distance vision and reduce or eliminate the need for corrective lenses or spectacles, treatment can occasionally be unpredictable due to individual healing responses and the resulting level of vision cannot be guaranteed.
The surgical alternatives to laser eye surgery to correct refractive errors include intra-ocular lens implant surgery with a phakic lens implant, clear lens extraction or refractive lens exchange, corneal inlays and much less commonly, incisional corneal surgery.