Laser Eye Surgery - Is your View being Distorted?

Laser eye surgery is a safe, effective and increasingly popular vision correction procedure.

Sometimes referred to as refractive surgery, laser eye surgery aims to improve your vision and eliminate the need to wear glasses or contact lenses.

However, following the Which? report into laser eye surgery that was published in the UK, a number of national and regional newspapers have written articles about the topic that at best give a distorted view on the procedure and what is actually possible for your future vision.

Nearly all clinics offer one of two types of surgery; LASIK laser eye surgery and LASEK. LASIK stands for laser-assisted in situ keratomileusis. It is a surgical treatment for short-sightedness, some forms of long-sightedness and astigmatism. The procedure involves creating a flap from the surface of the corneas and then applying a laser to the underlying tissue to correct the shape of the cornea. In the vast majority of cases, LASIK can reduce the need for glasses or contact lenses.

LASEK differs from LASIK in the way the eye is prepared for the laser treatment. In this case the epithelium is treated with an alcohol solution and scraped away before the laser treatment is applied. It is then pushed back to cover the treated area.

However, there is now an alternative to both these treatments. It is called Trans-Epithelial LASIK and differs again in the way the eye is prepared for the laser treatment. Trans-Epithelial LASIK uses two laser treatments; the first removes the epithelium layer at the front of the eye, smoothing the surface like a snooker ball. The second laser treatment follows immediately after and changes the shape of the cornea so that light is refracted into the eye and onto the retina for clear focus.

The epithelium grows back in a couple of days under a bandage contact lens leaving the eye with no flap after surgery.

This treatment is only available at 3 clinics in the UK and is very popular with rugby players, members of the armed forces and those with thin corneas.

Another aspect of laser eye surgery that is not explained very well in news articles concerns age related long-sightedness or presbyopia. Many articles state that laser eye surgery cannot treat presbyopia and technically they are right. But what they fail to make clear is the type of treatment that can be offered to recover reading vision for many thousands of patients. This type of laser eye surgery is called Monovision and essentially it treats one or both eyes so that one eye is dominant for distance vision and the other eye is dominant for reading.

Your eyes act like bi-focal glasses, allowing clear vision close up and at distance. Before any surgery takes place a comprehensive consultation takes place to make sure that the patient is comfortable with this solution and will be able to optimise their future vision through it. Many patients feel released from glasses afterwards and comment that they are the only ones in their social group to be able to read a menu without having to search for their glasses!

There has been growing awareness of another condition affecting the eyes called Keratoconus. This condition can occur at any time between teenage years and mid forties. The structure of the cornea weakens and starts to bulge forward due to the internal pressure of the eye. If it is not treated in time a corneal graft will be required that leads to dramatically impaired vision.

Again, one treatment offered by a number of clinics is called Corneal Collagen Cross-linking. This is a non-laser treatment using riboflavin drops in the eye and followed up with exposure to ultra-violet light. This combination of treatments induces the collagen fibres in the cornea to ‘cross-link’ thereby strengthening the corneal structure. This strengthening continues over a number of weeks after treatment.

However, this treatment has now been enhanced further with the introduction of laser eye surgery. It is only offered by 3 clinics in the UK and involves a laser eye surgery treatment before the Corneal Collagen Cross-linking is applied. The reason for doing this is to smooth the curvature of the bulge in the cornea to help establish clearer sight after the treatment has been completed. The success rate has proven this method of treatment and left many patients with a future vision they would never have had.

It therefore pays to research laser eye surgery thoroughly BEFORE agreeing anything in a consultation as you may not be getting the best option for your vision needs. And it also pays to do your own research and not rely on national newspaper articles whose content is out of date and superficial on this very important subject.