My guest this week is Professor Sunil Shah, Consultant Ophthalmic surgeon at Midland Eye. If you are looking at having laser eye surgery done, or trying to decide what options would be best for you or simply just curious about laser eye surgery , then Sunil’s guest post is just for you….
Laser eye surgery reshapes your eye’s cornea, which is the clear, dome-shaped surface at the front of your eye. Using incredibly precise lasers, surgeons can modify the cornea’s shape to change how light enters your eye, helping to correct various vision problems that might currently have you reaching for your glasses or contact lenses.
Usually taking just 15-30 minutes for both eyes, it has become one of the most common elective surgeries in the UK. Yet, laser eye surgery isn’t a one-size-fits-all solution and sometimes there are better options to solve your vision problems.
Which Type Of Laser Surgery Could Help You?
The type of laser surgery that’s right for you depends largely on your specific vision problems. Let’s look at the main options and what they can help with:
Laser-Assisted In Situ Keratomileusis (LASIK)
LASIK is the most common type of laser eye surgery. The surgeon creates a small flap, reshapes the corneal tissue underneath with a laser, then puts the flap back in place. It’s particularly good for:
● Moderate to severe short-sightedness (up to -8D)
● Mild to moderate long-sightedness (up to +4D)
● Astigmatism (where your eye is rugby ball shaped: up to 6D)
The big advantage of LASIK is its quick recovery time – most people can return to work within a couple of days, and their vision stabilises relatively quickly.
Photorefractive Keratectomy (PRK) or the newer version called LASEK
PRK might be an older technique, but it’s still the best choice for some people.
LASEK (Laser epithelial keratomileusis) can theoretically combine all the advantages of LASIK and PRK and potentially avoid some of their complications.
With PRK, instead of creating a flap, the surgeon gently removes the cornea’s surface layer before reshaping the tissue.
With LASEK, a flap of the very top layer (the epithelium) is made without the need for any cutting.
While recovery takes longer than LASIK (usually 5 days), it’s often recommended for:
● People with thinner corneas
● Those involved in contact sports
● Military or emergency service personnel
● Treatment of lower prescriptions
● Those with relatively dry eyes
● Those scared of the ‘cut’ in LASIK
Small Incision Lenticule Extraction (SMILE)
SMILE is the newest addition to the laser eye surgery family. It’s a bit like keyhole surgery for your eyes – requiring only a tiny incision rather than a flap. It’s particularly good for:
● Higher degrees of short-sightedness
● Those concerned about dry eyes after surgery
What Laser Eye Surgery Cannot Treat
While laser eye surgery can help with many vision problems, it’s important to understand its limitations. Some eye conditions require different types of treatment entirely. For instance, refractive laser eye surgery can’t help with age-related macular degeneration, glaucoma, or severe diabetic eye disease (although there are other lasers available for those conditions).
Laser eye surgery also can’t prevent the natural ageing of your eyes. So, while it might give you perfect distance vision now, you may still need reading glasses as you get older – just like everyone else.
It’s important to note that while both procedures have “laser” in their name, laser eye surgery is quite different from laser cataract surgery or laser refractive lens exchange. Laser eye surgery reshapes your cornea to correct vision problems, while cataract surgery and refractive lens exchange—whether laser-assisted or traditional—both replace your eye’s natural lens with an artificial one rather than reshaping your natural lens.
Considering Every Option
While laser eye surgery is an effective treatment for those with moderate prescriptions who don’t need reading glasses, refractive lens exchange can prove a longer-lasting solution for many patients. In fact, most patients who initially come to Midland Eye Clinic for laser eye surgery opt to have refractive lens exchange surgery instead.
Not only can refractive lens exchange fix severe vision issues, but it can also help with reading issues in older patients. It also ensures that you’ll never suffer from cataracts as you are swapping a natural lens for an artificial one.
This is why having a thorough consultation is so important; it helps ensure you have realistic expectations about what the surgery can and cannot achieve and a full range of options for your particular situation. The best eye surgery is the one that is right for you long-term, not which solves an issue for the time being.
The Journey To Clearer Vision
Getting laser eye surgery typically starts with a thorough assessment. If you are having vision issues and think that laser eye surgery could help, start by chatting with your optician, or you could self-refer to a specialist eye clinic like Midland Eye.
If your consultant believes that laser eye surgery might help improve your vision problems, they will then book in an initial consultation. During your initial consultation, your eye care team will:
● Take detailed measurements of your eyes
● Create a 3D map of your corneas
● Check your overall eye health
● Discuss what you’re hoping to achieve
● Talk through which type of surgery might suit you best
Recovery and Results
The recovery journey after laser eye surgery is usually straightforward, though it varies depending on which procedure you’ve had. Most people find their eyes feel a bit uncomfortable for the first few hours after surgery – rather like having a grain of sand in your eye. This is completely normal and usually eases quickly.
Your vision will typically be a bit blurry at first, rather like looking through a steamy window, but this gradually clears over the first few days. You’ll need to use eye drops regularly during this time to help with healing and keep your eyes comfortable. Many people are pleasantly surprised by how quickly they can return to their daily routine, though it’s wise to take things easy for the first few days.
Over the following weeks, your vision will continue to settle and improve. While many people notice dramatic improvements within days, your eyes need about 3-6 months to fully stabilise. During this time, you might notice your vision fluctuates slightly – being a bit sharper or blurrier at different times of the day. This is perfectly normal and gradually settles down.
Most people achieve very good vision after their surgery, with many reaching 20/20 vision or better. However, it’s important to remember that everyone’s eyes heal slightly differently, and while the vast majority of people are delighted with their results, a small number might need a follow-up procedure to achieve their best possible vision.
Depending on your clinic and the scope of the surgery, there may or may not be an additional cost for the follow-up procedure. At Midland Eye, for example, we provide a free follow-up surgery for further correction as we specialise in complex prescriptions, where it is difficult to predict the exact outcome of surgery.
The Financial Side
Cost is often a key factor in decision-making. Laser eye surgery typically isn’t available on the NHS unless you have specific medical conditions affecting your vision. For most people, it’s a private treatment costing between £2,000 and £4,000 per eye, and many clinics offer payment plans to spread the cost.
Consider that refractive lens exchange surgery costs around £3,000 to £4,000 per eye and can treat more severe vision issues, prevent cataracts and help with reading issues as you age, and it is clear why so many choose it over laser eye surgery.
Making Your Decision
Laser eye surgery can be life-changing, but it’s important to:
● Take your time deciding
● Ask plenty of questions
● Have realistic expectations
● Choose a reputable provider
● Your vision will typically be a bit blurry at first, rather like looking through a steamy window, but this gradually clears over the first few days. You’ll need to use eye drops regularly during this time to help with healing and keep your eyes comfortable. Many people are pleasantly surprised by how quickly they can return to their daily routine, though it’s wise to take things easy for the first few days.
Remember, while laser eye surgery has an excellent safety record and high satisfaction rates, it’s still a surgical procedure. Take time to weigh up your options, and don’t feel rushed into making a decision.
About Professor Sunil Shah & Midland Eye
Professor Sunil Shah is a Consultant Ophthalmic Surgeon at Midland Eye. Midland Eye was founded by four ophthalmic surgeons who wanted to provide patients with a comprehensive, specialist service for the diagnosis and treatment of all eye conditions. The team are leaders in their field and offer a consultant-only service to all patients requiring eye care or surgery. Every consultant is qualified to treat common eye conditions such as cataracts, but each one also has a particular area of specialisation, ensuring that patients get the best possible outcome, no matter what the diagnosis.
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All photographs have been published with the kind permission of Professor Sunil Shah & Midland Eye (apart from where stated)
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