Laser Refractive Surgery

About Laser Refractive Surgery

Modern surgical lasers are able to alter the curvature and focusing power of the front surface of the eye (the cornea) very accurately to correct short sight (myopia), long sight (hyperopia), and astigmatism.

Three types of procedure are commonly used in the UK: LASIK, surface laser treatments (PRK, LASEK, Trans PRK) and SMILE. Risks and benefits are similar, and all these procedures normally produce very good results in the right patients. Differences between these laser vision correction procedures are explained below.

If you are suitable for laser vision correction, your surgeon will discuss which type of procedure is the best option for you.

Symptoms

Symptoms indicating that you might benefit from laser corrective surgery are:

  • Blurred or distorted vision that glasses or contacted lenses do not fully correct
  • Dependence on glasses or contact lenses for clear vision in daily activities
  • Difficulty seeing clearly at specific distances; near vision (presbyopia or hyperopia) or distance vision (myopia)
  • Discomfort of dryness from contact lens wear
  • Active lifestyle where glasses or contact lenses are inconvenient or unsafe.

Diagnosis

Diagnosis involves detailed measurements and tests to ensure your eyes are healthy and suitable for surgery and that the expected benefits outweigh the risks.

Treatment

All laser vision correction procedures are performed using eye-drop anaesthetic and a spring clip to allow you to blink safely during surgery. You will be lying down throughout. It is usual to operate on both eyes and the surgery typically takes about half an hour. You can return home on the same day as surgery.

LASIK

LASIK (laser in situ keratomileusis) is typically performed using two lasers: one (femto-second laser) to prepare a thin protective layer (the LASIK flap), which is lifted up before a second (excimer laser) removes a lens shaped piece of tissue to reshape the cornea beneath. The protective layer is then smoothed back and sticks in place and without stitches. 

Surface Laser Treatments

Surface laser treatments (PRK, LASEK and Trans PRK) use the same excimer lasers to perform an identical removal of a lens shaped piece of tissue immediately beneath the clear skin layer of the cornea. The clear skin layer regrows over a period of about a week, then smooths off optically to complete the visual recovery over the next three months. While the skin layer is regrowing, the eye surface is normally very sore. This is one of the main differences between surface laser treatments and LASIK, which both aim to keep the corneal skin layer intact. All surface laser treatments produce similar results and the only difference between them is the way in which the corneal skin layer is removed. In PRK and LASEK the skin layer is removed by the surgeon – in LASEK dilute alcohol is applied to loosen the skin layer first. Some modern excimer laser systems are able to remove the skin layer as part of the reshaping treatment. This is called Trans PRK. The area of skin layer removal in Trans PRK is reduced to the minimum required for reshaping the cornea beneath, shortening recovery by 1 to 2 days in comparison with PRK and LASEK.

 

Costs

A consultation including comprehensive assessment is at a cost of £350.  The cost of any surgical treatment required will be discussed at the consultation appointment.

The Process

A thorough eye exam and consultation with an ophthalmologist or refractive surgeon are necessary to determine suitability and discuss risks and benefits.

 

  1. Comprehensive Eye Examination

Measurement of your current vision and refractive error (nearsightedness, farsightedness, astigmatism).

Checking for stable vision

 

  1. Corneal Thickness Measurement (Pachymetry)

Uses ultrasound or optical devices to measure corneal thickness, ensuring there’s enough tissue for safe laser reshaping.

 

  1. Corneal Topography

Creates a detailed map of the cornea’s shape and curvature to detect irregularities like keratoconus that may affect surgery suitability.

 

  1. Pupil Size Assessment

Evaluates pupil size in different lighting conditions to predict risks like night glare or halos post-surgery.

 

  1. Tear Film and Dry Eye Evaluation

Assesses tear production and ocular surface health to rule out dry eye conditions that could affect healing.

 

  1. General Eye Health Check

Examines the retina, lens and overall eye health to exclude other conditions that may contraindicate surgery.

 

  1. Discussion of Medical History and Lifestyle

Reviews your overall health, medications and daily activities to assess risks and benefits.

FAQs

Risks include dry eyes, glare, halos, under-correction or overcorrection and rarely, vision loss. A thorough evaluation helps minimise risks.

Laser surgery primarily corrects focusing errors, but specialised treatments or lens implants may be needed for presbyopia.

The surgeon uses a precise laser to reshape the cornea, improving how light focuses on the retina. The procedure usually takes 10–20 minutes per eye.

Results are generally long-lasting, but natural age-related changes in vision can still occur.

Many patients notice improved vision within 24 to 48 hours, with full recovery over several weeks.

No, people with thin corneas, certain eye diseases, or unstable prescriptions may not be suitable candidates.

Most patients experience little or no pain during the procedure due to numbing eye drops. Some mild discomfort can occur afterward.

Laser corrective surgery reshapes the cornea using a laser to correct vision problems such as nearsightedness, farsightedness and astigmatism.

Candidates are typically adults with stable vision, healthy corneas of adequate thickness and no significant eye diseases.

Some patients may still need glasses for certain activities like reading or night driving, depending on individual factors.

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