Your initial consultation: When more really means more

Laser Eye Surgery deals with one of the most complex organs in the body and one of our most valued senses.

Rightly so, you may worry about what is the best option for surgery and have you chosen the right clinic to perform your treatment. There are so many fancy named treatments that don’t mean anything, technologies that don’t do anything, and added extras that make little to no difference to your outcome (except for the cost). You’re probably confused about what your Laser Eye Surgery should really include and sceptical whenever clinics try and offer you more.

This creates a bit of a dilemma because, whereas you don’t want to fork out more than you need, you also want to get the best and most effective treatment for your eyes and vision.

So, who can you trust?

Well, a good place to start is to consider how much time and energy the clinic is willing to invest in you, what is and what isn’t included in the treatment fees.

For instance, the initial consultation is one part of the Laser Eye Surgery process in which you always want more. The treatment takes just five minutes and can last a lifetime, so spending as much time as possible beforehand in measuring and assessing your eyes makes all the difference.

Many clinics rush through the initial consultation, spending as little as an hour before they draw up your treatment plan. The initial consultation at our clinic is three and a half hours long. We understand how complex and unique your eyes are, and thus use nothing less than state-of-the-art technology combined with world-class expertise to map your eyes in incredibly fine detail.

In fact, we’re confident our assessment will be one of the most comprehensive eye exam you’ve ever had. To show you why that is and why more is always better, let’s dive into some of the technologies and devices we use.

Much more than your average clinic

There are several technologies Laser Eye Surgery clinics use to measure your eyes.

The actual measurements and tests performed depend on where you go, but the industry standard tends to include topography and tomography (shape of the cornea), pachymetry (thickness of the cornea), and pupillometry (size of the pupil).

Topography/Tomography is a type of scan that measures the curvature and elevation of your cornea. The shape of the cornea is one of the most important factors in determining your suitability for Laser Eye Surgery. A topographical map of your cornea looks a bit like a map of a mountain range. The more powerful the device, the more detailed the map of your cornea. Here at the London Vision Clinic, we use not 1, but 3 different devices: Zeiss Atlas 9000, Oculus Pentacam, and CSO MS-39.

Pachymetry is a technique used to measure the thickness of your cornea. It can be performed in a number of ways. Many clinics use a handheld ultrasound probe. We, again, feel more is better and have 4 different devices that can measure the corneal thickness. One of the most accurate ways to measure thickness is using high-resolution corneal OCT, which we use for every patient before and after surgery.

Pupillometry is the measurement of pupil size and its reactivity. This is crucial to determine your habitual pupil size and ensure the treatment is effective across the full range of lighting conditions. We go one step further than many clinics and use Procyon infrared pupillometry to measure your eyes in complete darkness. This minimises the chances of side effects like halos and starbursts.

In addition to these tests, we use several other devices to provide even more detailed information.

Beyond the standard measurements and your glasses prescription, your eyes obtain tiny, unique imperfections known as ‘higher order aberrations’. These small irregularities are known as the ‘wavefront’ of the eye and can be measured using a wavefront aberrometer. By recording data from several spots or markers, a wavefront aberrometer creates a detailed 3D map of the surface of your cornea (some equate this as the “fingerprint” of the eye). As with many other technologies used in measuring your eyes, the quality of this data depends on the type and specs of the machine. Wavefront aberrometers can range from measuring as few as 60 to as many as 650 spots. We use a new state-of-the-art device which provides us with as many as 40,000 unique points!!!

Finally, we perform epithelial thickness mapping on every prospective surgery patient. Epithelial thickness mapping, does exactly as it says, provides a thickness map of the corneal epithelium. This thin layer of cells that make up the outermost layer of the cornea can be used to screen for even the subtlest of changes that mean it might be unsafe to perform Laser Eye Surgery.

Even with all of this additional testing, there are still cases when we feel it is not enough. These patients go on to have an Artemis Insight 100 very high-frequency digital ultrasound.

The Insight 100 is the most accurate corneal scanner in the world, and, as it was co-invented by our founder Professor Dan Reinstein, we are fortunate enough to have one at our clinic. As well as measuring the entire corneal thickness in unrivalled accuracy, the Artemis Insight 100 VHF ultrasound scanner also measures the different individual layers of the cornea. Such advanced technology is one reason why we can treat much higher prescriptions than other clinics.