If You’ve Got Problems With Your Sight, You’ll Almost Certainly Have Considered This Option. But It’s Not Without Its Risks.
Top Santé writer Sharon Parsons chose to undergo the most popular elective surgery in the world – but not without weighing up all the pros and cons first…
I’m lying on a bed in a small operating theatre, clutching a ‘lucky’ soft toy I’ve been given by a nurse. Without my glasses, my surroundings are hazy, but I’m aware of the soaring equipment above me, bright lights, an enormous spaceship-sized control panel and several people in scrubs. My heart is pounding as I wonder how the anaesthetic I’ve been given – just a drop in each eye – can possibly be working. Then my surgeon appears behind my head, and I start concentrating on following the instructions he’s giving me.
Professor Dan Reinstein is a pioneering laser eye surgeon and I’ve chosen to have my surgery done at his clinic after months of exhaustive research – he had the best recommendations from both friends and press.
Like most people with poor eyesight, I considered having the procedure done for many years before finally taking the leap – quite honestly, I was scared it would hurt, that I’d suffer side effects, and that, worst of all, I could end up blind.
In fact, according to Professor David Gartry, consultant surgeon and refractive service director at Moorfields Eye Hospital in London – and the first surgeon in the UK to perform Laser Eye Surgery – side effects are normal, but most are fairly mild and will correct themselves within a few months. He says these can include dry eyes, night-vision problems (like halos and starbursts) and – in one in 5,000 cases –nfection (though drops usually sort this out). and surely, I figured, the 100,000 people who have Laser Eye Surgery in the UK each year can’t be wrong? In spite of a few scare stories, Professor Gartry reassures me that some 80-85% of people come out of laser eye surgery with 20/20 vision. oK, some may still need glasses for fine tuning, but practically everyone is left with driving-standard vision. of course, your eyes will continue to change as you get older and so may require either a laser tune-up or a thin pair of glasses. and even if you’ve had successful surgery, you will probably still need reading glasses at some point in the future.
While Laser Eye Surgery has always been able to correct short and long-sightedness with astigmatism, it can now also correct ageing near vision. However, Professor Gartry says there are some people who are not suitable candidates: ‘Those under 21, people with abnormal corneas or diseases like glaucoma, those with severe dry eyes or certain medical conditions, like rheumatoid arthritis, those with high prescriptions beyond the range of the laser (over -10 or +5) and the elderly,whomightbebetterserved by cataract surgery.’ a recent Which? report found in 50% of cases, a person’s medical background wasn’t fully checked by the clinic, so it’s vital you’re aware of this yourself and raise any queries in your consultation.
But the phenomenal advances in state-of-the-art technology and surgical expertise mean that today, severe complications are extremely rare (less than 5% of cases a year), and if there are problems, most can be corrected. ‘It is virtually impossible for anyone to lose their sight with modern Laser Eye Surgery performed by a qualified, expert surgeon and the latest technology screening,’ Professor Reinstein tells me. ‘Probably around a one in five million chance.’
Mr David o’Brart, consultant ophthalmic surgeon at st Guy’s and st Thomas’s, agrees that Laser Eye Surgery is safer than ever. ‘Equipment is now so sophisticated and precise that most of the procedure is under complete control anyway. The vital thing is that a surgeon knows who isn’t suitable for treatment and how to deal with complications, should they arise. The procedure has now been performed for over 20 years and the follow-up data has shown no long-term safety concerns.’
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Both Mr o’Brart and Professor Reinstein stress the importance of doing your research – especially as, in the UK, Laser Eye Surgery is not regulated. ‘a surgeon should be able to produce documentation of their own safety record – not simply generic outcomes for the industry,’ says Professor Reinstein.
If you’re thinking about Laser Eye Surgery, Professor Gartry advises finding out whether your surgeon holds the Certificate of Competence – accreditation awarded by the Royal College of ophthalmologists (RCo) to surgeons who have undergone the necessary training – and ask how many procedures they carry out a year, how long they’ve been doing it, and how many patients come back for further treatment. you should also expect to see the clinic’s success and complication rates. according to the Which? report, six out of 10 clinics gave unsatisfactory advice and failed to point out the risks.
Costs can differ wildly, too, from brand to brand, clinic to clinic, and even from the advertised rate. ‘The high-street optician I went to see advertisedthateacheyewouldcost from £399,’ says Jayne Moore*, from Bath. ‘But after my consultation I was told the price was prescription- banded. Mine (-2.50) meant that I was given four options for both eyes: from £1,590 for “standard” Lasik, to £2,890 for “advanced”. It was quite a shock!’ Treatment, according to the RCO, typically costs between £1,000 and £1,500 an eye, although in some cases this can rise to £2,300.
As for me, I feel no pain at all, just light pressure as I follow instructions to look at the green light and flashing red stars. Then the bed is swung to the left, and stage two gets underway as Professor Reinstein alters the contours of my corneas, using a second laser. When it’s all over, I sit up and, through a mist (which every patient is warned about), I look at the clock on the wall. I can see – and it’s overwhelming. armed with a hefty kit of drops, pain relief and eye shields to wear at night, I am instructed to relax in a darkened room with my eyes closed for at least three hours. I must only open them to apply the lubricating drops. That evening, I go out for dinner – in sunglasses – and can read the menu.
The following day, I have my post-operative check-up, where I’m told that my eyes have now completely healed. as I leave the clinic, I drop my glasses into the big bowl in the waiting room where other patients have left theirs. It’s amazing to realise I won’t be needing them any more.
For more information about Laser Eye Surgery at The London Vision Clinic, call 020 7224 1005. Sharon’s surgery, including consultations and aftercare, came to £4,900 for both eyes. For more information on all aspects of Laser Eye Surgery, visit the RCO’s website at www.rcophth.ac.uk.
How Does Laser Eye Surgery Work?
This procedure changes the curve of the cornea, which determines how the eyes focuses. Here are the main types:
LASIK is used in 90% of cases. An incredibly thin, circular flap is created in the outer cornea, so that a precise amount of tissue can be removed from the bed underneath, before the flap is replaced. This usually heals within a maater of hours. Wavefront Lasik is a more sophisticated method, which uses sensors to map the eye’s contours before surgery. PRK or LASEK – along with number of minor variations – are surface procedures used for these with a cornea that’s too thin for the above. The cornea’s outer skin is removed before the laser reshaped the exposed cornea and the skin grows back over a few days. Our writer Sharon opted for Professor Reinstein’s own pioneering treatment – PRESBYOND® Laser Blended Vision – to enable distance and reading vision to be corrected together.