Laser eye surgery is about to arrive on the high street in a big way, but what does it involve, how much does it cost and what are the risks?
If you’ve set your sights on treatment, go into it with your eyes wide open. SIMON PARKIN looks into the pros and cons.
The adverts promise perfect vision from £595 per eye. It seems like the answer to the prayers of short-sighted people whose previous big decision used to be what shape and colour of spectacles to choose. Today, the big issue is whether to abandon glasses or contact lenses altogether and spend £1,500 or more on an operation to correct their sight. Laser eye surgery has moved from the specialist preserve of the wealthy to a mainstream choice open to almost everyone whose eyesight is less than 20/20.
National chain Optical Express is about to open a major new laser surgery clinic on the high street in Norwich, making the prospect of recapturing perfect vision ever clearer. About 100,000 laser eye surgery procedures are already carried out every year in Britain, making it the most common eye operation after cataracts, and numbers are rapidly increasing. The most popular form of laser eye surgery is “laser-assisted in-situ keratomileusis”, or LASIK for short. More than 85% of laser eye surgery patients In Europe and the US opt for it. The procedure involves rolling back a flap of tissue on the surface of the eye and using a laser to modify the inner layers of your cornea – the transparent tissue on the very front of your eye.
It usually takes no more than a few minutes per eye and the aim Is 20/20 vision. For people not suitable for LASIK, a similar procedure, LASEK (laser epithelial keratomileusis), is an option; however it involves a longer healing time of three to four days. Previously, two issues stopped many people from looking into laser surgery further: cost and risk.
Now prices have fallen into the reach of most people and fast-developing medical advances and better procedures have limited the risk of complications. Last year, NICE (the National Institute for Health and Clinical Excellence) after weighing up the evidence, gave the green light to laser refractive surgery, though for cost reasons its not routinely available on the NHS. The body said it was satisfied about long-term safety, though its latest guidance does not gloss over the risks. “People should be clear about the benefits and the potential risks of the treatment” it states. “You should understand the benefits and risks before you agree to it, and should weigh these up against the advantages and disadvantages of wearing glasses or contact lenses.” Although more than 9O% of patients are delighted with the results of their treatment, complications can still occur.
According to NICE, about six LASIK patients in 1,000 will have worse vision than before: patients with mild short- sight do better than those with severe problems. Between one and 10% will have to have the treatment repeated and a small number will develop an infection – though infection rates are lower than with contact lenses. Claims against laser eye surgeons now account for one in three of all ophthalmology cases dealt with by the Medical Defence Union. “On average, the cost of litigation against laser eye surgeons is triple that of ophthalmic surgeons who do not carry out laser eye work” says Dr Karen Roberts, MDU clinical risk manager. “Patient dissatisfaction with vision post-operatively and corneal scarring are the most common reasons.” Virtually all laser eye surgery is carried out privately and some eye specialists are concerned that mostly clinics are competing on price.
Charges range from £700 an eye for basic LASIK at some chains, to more than £2,000 an eye for more sophisticated techniques in hospitals. “Whenever you have healthcare mixed up with the commercial sector there is a chance that people will not be given all the information they require” says Larry Benjamin, of the Royal College of Ophthalmologists. However, the procedure is highly regulated and reputable high street chains go out of their way to point of the seriousness with which they take minimising risk.
In its blurb, Optical Express says all Its ophthalmologists specialise in refractive surgery and are annually assessed by the International Medical Advisory Board. It goes on to state: “In terms of a medical procedure, laser eye treatment has a very low complication rate of less than one per cent.
The vast majority of complications are minor, the procedures used in laser eye treatment have passed extensive scrutiny from public health agencies and the medical health profession, and after more than a decade of research, complications significantly affecting vision are extremely few.” There are hundreds of thousands people who can testify that the outcome can be not just successful but potentially life changing, even improving vision beyond what can be achieved by contact lenses and glasses.
One of them is David Woodsmith, who, having previously worn contact lenses, decided to have LASIK surgery two years ago and reckons it is one of the best things he has ever done. “It’s been excellent” he said. “Your eyes are clamped open. They put drops in to anaesthetise them and it was fine – there was no pain at all.”
The only discomfort was from the burning smell. After wearing plastic goggles for 48 hours, he was able to focus on the world again: “They came off and it was amazing. It took a bit of getting used to, but its so good not to have to bother with contacts any more. That’s the big advantage for me – it’s not a vanity thing!”