Laser eye surgery

Your health expert: Mr Ali Mearza, Consultant Ophthalmic Surgeon
Content editor review by Liz Woolf, February 2021
Next review due February 2024

Laser eye surgery is also known as refractive surgery and laser vision correction. It can correct problems with your eyesight such as short-sightedness, long-sightedness and astigmatism.

This treatment can mean you don’t have the inconvenience and limitations of wearing glasses or contact lenses. But as with any procedure, there are potential risks to consider.

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How does laser eye surgery work?

There are various types of laser surgery. The most common ones in the UK are LASIK, surface laser treatments (PRK, LASEK and TransPRK) and SMILE. All use lasers to change the shape of the clear layer that covers the front of your eye (your cornea). This corrects short- or long-sight by enabling your eye to focus correctly. Laser eye surgery may also help with age-related sight changes. For more information on this, see our FAQ section below.

Each procedure involves a slightly different technique. Different procedures suit different people. Your surgeon will explain which one is best for you.

Who can have laser eye surgery?

Laser eye surgery isn’t suitable for everyone. Usually, you’ll only be able to have laser eye surgery if you:

  • are over 18
  • are in good general health
  • have healthy eyes
  • have had a stable prescription (very little change in your eyesight) for the last two years

Laser eye surgery usually works best within a given prescription range. Your eye surgeon will check if you’re suitable. There may sometimes be reasons why laser eye surgery isn’t best for you. Your surgeon (ophthalmologist) will discuss these with you.

You may not need to have had a stable prescription if you’re considering treatment for age-related long sight. For more information on this, see our FAQ section below.

Deciding on laser eye surgery

Before deciding whether or not to have laser eye surgery, you need to meet your eye surgeon (ophthalmologist) so that they can assess you. Your surgeon should suggest a variety of tests to check the health of your eyes and your eyesight and determine if you’re eligible for surgery. These tests may include checking the shape and thickness of your cornea and the size of your pupil. Most clinics don’t charge for these tests but some do, so make sure you check beforehand.

Your surgeon will ask you not to wear contact lenses before this assessment. This is because contact lenses can change the shape of your cornea and this may affect the measurements your surgeon takes. The period of not wearing contact lenses may be three to five days for soft lenses, and up to two weeks for hard lenses.

During your appointment, take the opportunity to discuss the procedure with your surgeon. Make sure to ask about all the benefits and possible risks and find out about:

  • all the costs involved, including for your care after the procedure
  • what to expect from your treatment
  • how long recovery is likely to take
  • any possible complications

The Royal College of Ophthalmologists have produced a checklist (PDF 225KB) you can use when discussing the procedure with your surgeon. If you decide to go ahead with surgery, your surgeon will ask you to sign a consent form.

What happens during laser eye surgery

You can have laser eye surgery and go home the same day. The surgery itself usually takes less than half an hour. Your surgeon will ask you to lie down and will put drops of a local anaesthetic into your eyes to numb them. During the surgery, they’ll use a special clip to keep your eye open during the procedure. It’s natural to feel anxious, and your surgeon will talk you through every step.

Your surgeon may use a gentle suction device to hold your eye still. They’ll also ask you to look at a target light during the treatment. This helps to keep your eye in position.

Exactly how the procedure is carried out will depend on the type of surgery you’re having.

In LASIK, your surgeon uses a laser to cut a thin flap on the surface of your cornea. They lift this flap up and then use a different type of laser to reshape the cornea below. Finally, they smooth the flap back down over the top.

In PRK, LASEK and TransPRK your surgeon uses a laser directly on the surface of your cornea to reshape it, without cutting a flap first. The only difference between these treatments is in how your surgeon removes the top layer before reshaping your cornea. Your surgeon may suggest this type of treatment if your cornea is relatively thin.

In SMILE, your surgeon makes a small keyhole opening instead of creating a flap. The laser also cuts out a small piece of tissue from your cornea. Your surgeon then removes this tissue through the keyhole.

After your surgery, your surgeon may place a transparent plastic shield over your eye to protect it from bumps or being rubbed. Your surgeon may also put in a ‘bandage contact lens’ to protect your eye while it heals. This looks like a normal contact lens, but you wear it day and night until your doctor removes it. It may need to stay in place for up to a week.

What happens after laser eye surgery?

You’ll be able to go home when you’re ready, but you’ll need someone to drive you. Your surgeon may recommend that you wear a protective plastic shield over your eyes at night for the first week or so. You’ll be prescribed eye drops containing antibiotics and anti-inflammatory medicines to help your eyes to heal, and artificial tears to keep them comfortable. Make sure you use these as directed, and follow all the advice from your surgeon.

Recovery time depends on the surgery you’ve had. You may be able to return to work and driving the day after LASIK, but it may take a few weeks with other procedures. You shouldn’t go swimming for a week after your treatment. Depending on the type of procedure you’ve had, your surgeon may ask you to avoid contact sports for up to a month.

By three months after surgery, your vision should be stable and unlikely to change further. But it can take longer in some cases. It will only change again should you develop another eye issue such as age-related long sight (presbyopia) or a cataract.

What are side-effects of laser eye surgery?

Most people get some mild side-effects after surgery. These usually improve over time, although occasionally they may not go away completely. They include:

  • dry eyes
  • hazy or blurry vision
  • glare or halo effects – especially when driving at night
  • red blotches in the white of your eye

It’s normal to have some changes in your vision in the first few weeks. Your eye is likely to be sore for a few days while it recovers, particularly after laser treatment to the surface of the eye (PRK, LASEK and TransPRK). But if it becomes increasingly painful or your vision changes (for example, any blurring continues or worsens) contact your eye surgeon. You should also contact your surgeon if your eye becomes sensitive to light or you have an eye injury.

More serious problems are unusual after laser eye surgery. Fewer than one in 10 people may need a second operation. For people who do, it’s often because of under- or over-correction of their eyesight. Very occasionally, damage to your cornea may cause loss of vision. The risk of serious complications that affect your sight is very low. It is similar to the risk of serious complications you have if you wear contact lenses.

Where can I have laser eye surgery?

Laser eye surgery is rarely carried out on the NHS, so you will usually need to book treatment at a private clinic yourself. There are many clinics offering laser eye surgery. Your optometrist (optician) can advise you on clinics in your area.

It’s very important that wherever you have laser eye surgery, you check that your surgeon is properly qualified. Your surgeon must be registered with the General Medical Council (GMC). The Royal College of Ophthalmologists recommends that surgeons are on the GMC’s specialist register in ophthalmology, or have a certificate in laser refractive surgery (Cert LRS). You can check a surgeon’s credentials on the Royal College of Ophthalmologist’s website, or on the General Medical Council’s website. Your surgeon should also be fully insured to carry out laser eye surgery in the UK.

How much does laser eye surgery cost?

Laser eye surgery for correction of long-sightedness and short-sightedness isn’t usually available on the NHS, and isn’t covered by private health insurance. Costs for the surgery vary between clinics; they will depend on what procedure you’re having, and what your prescription is. Be sure to check if any costs you’ve been quoted cover initial consultations, follow-up visits, and any extra treatment you may need.

As you get older, you may find yourself holding books and newspapers further away to help you read properly. This is called presbyopia. It is caused by the lenses in your eyes stiffening with age and becoming less able to change shape to focus properly.

You can have laser eye surgery to help with presbyopia, but it’s done a little differently. Your eye surgeon can treat one eye to improve close vision and the other so that it focuses well for distance vision. This is called monovision.

Monovision doesn’t suit everyone. So, your eye surgeon is likely to suggest that you try it out with contact lenses before deciding to have the treatment.

You don’t need to have a stable lens prescription to have this treatment if you have presbyopia. The prescription tends to change year on year, as your lens stiffens further.

Your eye surgeon will take this into account when they treat you.

Depending on your age, there are other possible treatments including lens replacement. Before deciding, talk to a recommended eye surgeon to discuss your options.

More on this topic

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This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

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