An Introduction to Laser Eye Surgery
If you're keen to get rid of those glasses and contact lenses, laser eye surgery is becoming an ever more popular solution. But what exactly does it involve?
How can laser eye surgery cure bad eyesight?
Laser eye surgery targets the cornea. This is the outer part of your eye, and most of the focusing is done here. Light entering the eye is focused onto the retina, a blanket of light-sensitive cells at the back of the eye that connect to your brain.
If the cornea is too powerful, or your eye is ‘too long', the light will be focused in front of the retina. This means you are short-sighted and can't see distant objects clearly. The aim of eye surgery is to reshape the cornea so that light is focused in the correct place, directly at the retina.
Laser eye surgery can also be used to correct long sight (where the cornea isn't powerful enough to focus light on the retina) although options with long sight are more limited. Laser eye surgery can also be effective in treating astigmatism, where an irregularly shaped cornea can disrupt vision.
What happens before laser eye surgery?
Laser eye surgery should be carried out by an ophthalmologist specially trained in eye surgery. Some people recommend that you consult more than one ophthalmologist, to get different opinions about the various surgery options, the risks and likely outcome in your particular case.
Before undergoing surgery, your cornea will be mapped in detail so that the doctor can work out where to target the lasers to correct its shape. Two things which can affect the outcome and suitability for surgery are corneal thickness and pupil size, so be sure to ask your doctor about these.
What happens during laser eye surgery?
The deeper layers of the cornea have to be targeted with the laser to bring about a permanent change in vision. To access this part of the eye, the top layer of the cornea needs to be temporarily removed.
LASIK (laser in situ keratomileusis) is the most common kind of eye surgery currently performed in the UK. A flap is cut in the cornea using a tiny blade (a microkeratome), and raised before a laser is used to shape the cornea as desired. The flap is replaced and is held back in place by natural suction.
IntraLASIK is currently being introduced in the UK. With this method, the flap is created using a laser rather than a blade. IntraLASIK is thought to reduce complications and improve the outcome, as the flap is cut more accurately, but the technique is still relatively new.
There are other types of laser eye surgery - PRK and LASEK, where the cornea is accessed in different ways. The recovery time is longer with these methods, and there is more pain, but they may be better options for certain patients. You should find out which option is best for you during your initial consultations.
What happens after laser eye surgery?
The whole procedure can take as little as 10 minutes and you will be able to go home soon afterwards. With LASIK, vision should be improved almost immediately. For the next week, you will need to use antibiotic eyedrops and protect the eye to prevent the flap being dislodged. You will get a check-up the next day and then typically 1 month, 3 months and 6 months later.
What are the possible complications with laser eye surgery?
Opinions vary on the likelihood of complications, but very roughly, mild complications occur in around 5% of cases and more serious complications at about 0.1-1%.
Complications include over- or under-correction of sight, problems with the flap (it may need repositioning) and eye infections. People often report seeing ‘halos' around lights, particularly at night, which might go away after a few months or might be permanent.
How much does laser eye surgery cost?
Laser eye surgery is not currently available on the NHS. You will need to go to a private clinic. Prices will vary depending on the severity of your eyesight and the exact technique used, but it is in the region of 1000-2000 pounds per eye.
Who can have laser eye surgery?
You need to be over 21, in general good health, and have had a stable prescription for a year. The prescription limits for LASIK are roughly -1 to -10 for short sight, and +1 to +6 for long sight. Age-related long sight cannot be treated by laser eye surgery. If you have very severe short sight, lens implantations may be an option.
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