Written by Kristie Nealy M.D

With recent medical advances, laser eye surgery is becoming a popular alternative to wearing glasses or contacts to correct vision problems.  The more recent LASIK eye surgery has dramatically reduced the discomfort and recovery time associated with laser vision correction, making it possible for many people to get back to work within a few days.

Laser Eye Surgery Guide (PRK and LASIK)

Choosing to have laser eye surgery is a big decision. While the benefits are great and the most common comment afterwards is "I wish I had done it years ago" there are always questions to ask and things to take into consideration.

This guide will explain what laser eye surgery is, how it works, what to expect before, during and after the procedures and whether laser eye surgery is right for you . We’ll also have a look at other procedures, cover where to find a surgeon and answer some common questions.

Introduction to Laser Eye Surgery

Laser eye surgery is a surgical procedure used to correct vision using a cool beam of light called an excimer laser.  The cornea is the transparent surface of the eye in front of the coloured iris. The extent to which it is curved determines its focusing power. Laser eye surgery reshapes the cornea:

• In Short-sightedness (Myopia): the centre is made flatter by removing more tissue from the centre than the edge

• In Long-sightedness (Hypermetropia): the centre is made steeper by removing more tissue from the edge than the centre as in a ring doughnut shape

• In Astigmatism: the curve has to be evened out (ie: the cornea converted from a rugby ball shape to a football shape).

Improving the shape of the cornea helps images focus better on the retina, allowing many people to eliminate or reduce their need for glasses or contacts.

The two main techniques used in laser eye surgery for vision problems are photo-refractive keratectomy (PRK) and laser assisted in-situ keratomileusis (LASIK).  Both forms of laser eye surgery are performed under high magnification with an operating microscope.  Both are day stay procedures and take approximately fifteen minutes.

The main difference between the two lies in how the surgeon reaches the stromal cell layer of the cornea and in the difference in recovery time.

Is Laser Eye Surgery Right for You?

If you are over 21, in good general health and your vision has been stable for at least a year, then laser vision correction may be right for you.

About 90% of laser vision correction patients achieve vision of 20/40 or better (perfect is 20/20), in many cases reducing or eliminating the need to wear corrective lenses.

It is important to talk to your surgeon to make sure you have realistic expectations of the improvements laser eye surgery can achieve for you.

Laser eye surgery is not suitable if the cornea has become thin or protruded into a cone shape (keratoconus). Laser eye surgery is also not recommended if you are:

• under 18
• pregnant or breastfeeding,
• have immunodeficiencies,
• diabetes or other diseases that could prevent the eye from healing properly
• are on medications like steroids that could prevent the eye from healing properly.

What Vision Problems Does Laser Eye Surgery Treat?

Laser eye surgery can correct refractive errors of the eye.  In other words, laser eye surgery can fix conditions where there is a problem focusing light on the retina.  Refractive errors include:

• Nearsightedness or myopia - an eye condition caused by a cornea that is too steep, causing trouble with distance vision.

• Farsightedness or hyperopia - an eye condition caused by a cornea that is too flat, causing trouble seeing objects up close.

• Astigmatism - an eye condition caused by differences in degree of curvature of the cornea in two different meridians, causing problems seeing fine details.

Is Laser Eye Surgery Safe?

Laser eye surgery has been performed safely on millions of patients. According to the Royal College of Ophthalmologists complications occur in less than 5% of cases. Some people have a problem with dry eyes after surgery and some experience glare or halo effects when night driving, particularly just after treatment.

The majority of laser eye surgery patients achieve good vision correction, decreasing or eliminating their dependence on glasses and contacts.  However, since this is a surgical procedure there are certain risks you should be aware of.

• Infection
• Under or overcorrection
• Problems with the corneal flap in LASIK
• Corneal ectasia
• Decrease in best-corrected vision
• Regression
• Poor night vision

The Royal College of Ophthalmologists suggests anyone considering the operation should ask their surgeon for details of their training, qualifications, length of practice and results.

PRK Laser Eye Surgery

PRK stands for Photorefractive Keratectomy.  PRK was the first type of laser eye surgery to hit the market, and it was invented in the early 1980s.  The PRK procedure involves scraping the epithelial cells of the cornea off to reveal the stromal cells below.  Then, a cool laser is used to reshape the cornea and correct vision.  PRK is useful when patients have a thin cornea or large pupils, making them poor candidates for LASIK.  Vision improvement is more gradual in PRK than LASIK.

More on PRK Laser Surgery

LASIK Laer Eye Surgery

Laser in situ Keratomileusis (LASIK) is a more recent form of laser surgery and seems to provide improved results for people with greater degrees of myopia, hyperopia and astigmatism.

The LASIK procedure involves cutting a flap in the outer layer of the cornea to reveal the stromal cells, and then using a cool laser to reshape the cornea.  The flap is then repositioned and adheres within two to three minutes without the need for stitches. Recovery and vision improvement is more rapid in LASIK than in PRK.

More on LASIK Laser Surgery

Laser Eye Surgery Prices

The price of laser eye surgery depends on a number of things; which laser eye surgery treatment, where you choose to have treatment, the experience of the surgeon and the degree of correction required.

The initial consultation is usually free but a small deposit (around £30) may be required.

Laser Eye Surgery prices start from around £350 per eye. The cost of treatment usually includes after care for one year.

Many laser eye surgery clinics do offer finance options.

More on Prices