Q: What is LASIK?
Lasik eye surgery has been performed since 1991 and is a popular type of laser eye surgery because of rapid healing, minimal discomfort and fast visual recovery. During LASIK a very thin protective flap is first created with a femtosecond laser (Intralase) under which the cornea is reshaped to correct vision.
Most patients gain 20:20 (6/6) vision within 24 hours of their surgery. We perform femtosecond IntraLASIK with wavefront correction for the best possible results. LASIK can treat prescriptions between +5 to -10 and astigmatism up to 5 dioptres.
Q: What is LASEK and TransPRK?
PRK was the first performed laser treatment in 1989. During LASEK and T-PRK the laser is applied directly to the surface of the eye to finely reshape the cornea. LASEK/PRK is better suited for those in the armed forces, police and those who practice combat or extreme sports. People with thinner corneas will also not be able to have LASIK and are better suited to LASEK or T-PRK as are younger patients. . The visual results of LASEK and TransPRK are identical to LASIK.
Q: What is Relex SMILE?
Small incision lenticule extraction, or SMILE for short was first performed on a sighted patient more than 10 years ago. Since then this technique has recently received FDA approval and is considered to be safe and results equivalent to other laser techniques such as LASIK and LASEK. SMILE can correct a combination of -10 of shortsight and 5 dioptres of astigmatism. The entire laser procedure is performed using a femtosecond laser.
Q: Is laser eye surgery safe?
Laser eye surgery is one of the safest forms of surgery and complications are very rare. As a surgery performed on normal healthy eyes the emphasis on safety is paramount. There have been more research papers published on laser eye surgery than any other form of surgery in ophthalmology. The risk of permanent damage or sight loss is very small and thought to be less than the risk associated with contact lens wear.
Laser eye surgery is very safe when performed on people who should have this type of treatment. The main aim of your first consultation is to exclude people who shouldn’t have laser eye surgery at all. There may be alternative types of vision correction techniques such as the Visian ICL implant where laser surgery is deemed unsuitable. Major advances in laser surgery over the last 2 decades have been in screening technologies to exclude patients from having laser surgery. This means that the techniques are safer than ever.
Q: How soon will I be able to see after LASIK?
Recovery of vision after LASIK is very rapid and you will notice an improvement within a few hours of surgery. Your vision will become very much clearer 24-48 hours after surgery. A protective bandage contact lens is sometimes used in the first 24 hours and once this is removed vision improves further. It is normal for peripheral vision to be a little fuzzy in the first few days.
Q: How soon will I be able to see after LASEK?
Recovery of vision after LASEK is slower than after LASIK. Most people notice some improvement just a few hours after surgery. The protective bandage contact lens remains in place for a week after your surgery and your vision will be a lot better once this is removed. At 1 week after surgery most people have driving standard vision or better (6/12). Vision improves almost daily and is usually very good just 2-4 weeks after surgery.
Q. Can laser eye surgery correct astigmatism?
Yes! Up to 5 dioptres. The Scwhind Amaris laser is one of the most effective lasers for correcting astigmatism due to its ability to accurately track the eye.
Q: How soon will I be able to drive after surgery?
It is recommended that you don't drive for at least a day after your surgery if you have LASIK and up to 5 days after LASEK, until you are seen and your vision is confirmed by the surgeon. The simple guidance on this is that you shouldn't drive until you are comfortable to do so and you are able to see a number plate clearly at a distance of 20.5 meters. This is the DVLA standard and your insurer may not cover you if you have an accident without your vision being confirmed by your surgeon.
Q: Will I be able to see what the surgeon is doing during the surgery?
During the surgery you will need to look straight ahead at a bright light. You will not be able to see anything very clearly during this. You will be able to see movement and shadows.
Q: What if I move my eye during the laser treatment?
Modern lasers use sophisticated eye trackers that follow even the slightest eye movement and immediately adjust the laser pulse position. If you make a sudden big movement the laser will automatically cut out and stop firing. The response time is 1 millisecond (1/1000 of a second)
Q: Will I be able to keep my eye open during the surgery?
During the surgery a small clip is placed between your eyelids to gently hold your eyelids open. You will not be able to blink during the procedure.
Q: Will the surgery hurt?
Surgery is performed after local anaesthetic drops are placed on the eye. You will not feel any pain once the anaesthetic starts to work. If you are having LASIK performed you will feel some pressure on the eye during flap creation.
Q: How long does the surgery take?
Surgery will take around 10 minutes for both eyes. The actual laser component of this takes 10 to 40 seconds. During the laser you should try and remain as still as possible.
Q What will my eye look like after surgery?
It is common to have some redness on the white part of the eye after LASIK.
This occurs because the femtosecond laser used to make the flap during LASIK applies gentle suction to the white part of the eye which can rupture the tiny capillaries there. This does not in any way affect the accuracy of the laser treatment or do any harm to the eye. These red areas do not hurt and disappear within 14-21 days.
Bruising is uncommon after LASEK, although your eye may look a little pink for a couple of days after surgery.
Q: Will I need drops after surgery?
Yes, you'll need to put drops in immediately after surgery and for a few weeks afterwards. Initially these are antibiotic and steroid drops. Later on you may need to use lubricant moisturising eye drops for a few months after surgery. Lubricant drops help prevent dryness particularly if you use computers a lot.
Q: Is there anything I shouldn't do after surgery?
It is important not to rub your eyes in the week after surgery. Also, don't splash tap water directly into your eyes or get shower water into them. Shower with your eyes shut. You should also not go swimming for 2 after surgery.
You should wear the sleeping goggles that you will be given to prevent you rubbing your eyes whilst you are asleep for the first week after your laser vision correction. Always wash your hands before touching your eyes
Q. When can I smoke after laser eye surgery
There aren't any issues with smoking tobacco after laser surgery. Tobacco smoke can however irritate the eyes. Smoking marijuana in the first week or two after laser surgery can effect tear production and exacerbate dry eye symptoms. There is no evidence regarding vaping after laser eye surgery.
Q. When can I wear makeup after laser eye surgery?
Don't wear any eye make up for at least 3 days after LASIK surgery as small particles of mascara and foundation can get into the tear film and under the flap after LASIK and also can cause infections after surgery. No make up for 1 week after LASEK or transPRK, until the doctor has seen you.
Q. When can I exercise after laser eye surgery?
Exercise 2 days after LASIK is fine. For LASEK and transPRK take a week off after the procedure. Bikram or hot yoga should be avoided for 2-3 weeks after surgery. You can return to swimming 3-4 weeks after surgery.
Q: Are there any problems after surgery?
Most patients do not have any issues after surgery.
Perhaps the commonest symptom is dry eye which can develop to some degree in up to 50% of patients for a few weeks after surgery. We give you lubricant drops to use after the surgery. In the majority of these patients dryness is mild and may occur in air conditioned environments or when using the computer for long periods of time. Moisturising lubricant eye drops may need to be used during the day for a few months after surgery. A few patients may notices more symptomatic dryness, particularly if you have had dry eye in the past or are post-menopausal. This may require use of lubricant drops for longer.
A few patients may notice haloes and glare around bright light sources such as car headlights at night for a short period after surgery. This usually settles after a few weeks and rarely causes any long terms problems.
Q: Is laser eye surgery safe?
Laser eye surgery has been performed since the early 90's and over 20 million surgeries are estimated to have been performed worldwide. 95% of patients who have had surgery are pleased with the results of their surgery. The surgery now is safer than ever due to huge advances in laser technology and also due to sophisticated technologies that detect patients who should not have surgery at all.
Despite these advances, laser surgery like any surgery carries a small risk of complications. The chances of losing your vision (blindness) due to laser eye surgery is estimated at being around 1 in 10 million. The risk of a serious infection that could cause scarring of the cornea is less than 1 in 1000 (0.001%). Risk of progressive thinning of the cornea (ectasia) is estimated as being roughly 0.0005%. Complications such as corneal neuralgia are rare and the rate of this complication is unknown. Lasting dry eye problems are uncommon. Patients with pre-existing dry eye symptoms will continue to have these symptoms. Patients with moderate to severe dry eye should be excluded from having laser eye surgery and can consider alternatives such as Visian implantable contact lens surgery or simply continuing with glasses or contact lenses.
Q What is mitomycin C and why is it used in laser eye surgery
MMC or Mitomycin C is a drug that prevents scarring. It has been used in surface laser eye surgeries such as LASEK and transPRK for 20 years to prevent corneal scarring. MMC is also commonly used in other eye surgeries where scarring needs to be prevented. In particular glaucoma surgeries. MMC is also used as an anti-cancer drug and has antibiotic properties. MMC is not licenced in the UK for specific ocular use despite its widespread use in Ophthalmology. No complications have been published in patients after laser eye surgery even after long term follow up.
Further information is available online
Q: Will my glasses prescription return after laser surgery?
A small degree of your previous prescription can sometimes return after laser eye surgery. This tends to happen in patients who have a high prescription to start with and is called regression. Studies have demonstrated a change of 1 diopter over a 20 year period in myopic patients. This may actually be beneficial as you age and develop presbyopia.
Regression is usually mild but can require further laser surgery to perform enhancement in around 5% of patients. You are covered for enhancement surgery if you require it within 2 years of your initial surgery.
Younger patients having laser eye surgery in their early 20s can see some low return of prescription by their 40s. Further refinement is possible is required at this age.
Q: How long will laser eye surgery last?
The longevity of your laser eye surgery result will depend on your age and type of treatment. Laser eye surgery doesn’t stop you and your eyes aging. As you age changes like presbyopia (needing reading glasses) in your 40s and cataract (60s and onwards) are inevitable. There are sight correction options for all of these issues.
Q: What do I do if I have a problem with my eye?
Moorfields Eye Hospital offers a 24 hour service 365 days a year. If you develop an acute problem with your eye, particularly if it becomes red or painful, or your vision suddenly changes, you need to be seen urgently and you should report to the 24 hour eye emergency service at Moorfields Eye Hospital.