Laser eye surgery

Expert reviewer Professor Simon Taylor, Consultant Ophthalmic Surgeon
Next review due November 2021

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

Many people choose to have laser eye surgery so that they don’t have the inconvenience and limitations of wearing glasses or contact lenses anymore. But as with any procedure, there are some potential risks you should consider.

An older woman smiling

How does laser eye surgery work?

There are various types of laser surgery. The most common ones in the UK include LASIK, surface laser treatments (PRK, LASEK and TransPRK) and SMILE. All these procedures use lasers to change the shape of your cornea – the clear layer that covers the front of your eye. This allows your eye to focus images correctly, correcting your short- or long-sightedness. Laser eye surgery can now also help with age-related long-sightedness – although it can’t cure it.

Each procedure involves a slightly different technique (see the section below, What happens during laser surgery?) The different procedures suit different people better. Your surgeon will explain which one is best for you.

Who can have laser eye surgery?

Laser eye surgery isn’t suitable for everyone. You’ll usually only be able to have it if you:

  • are over 18 years of age
  • 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 certain prescription range. Your eye specialist (optician/optometrist) will check whether you’re suitable. There may sometimes be specific health reasons that laser eye surgery isn’t your best option. Your surgeon (ophthalmologist) will discuss these with you.

    Deciding on laser eye surgery

    Before deciding whether to have laser eye surgery, it’s important that you meet the surgeon (ophthalmologist) who would carry out the procedure, so that they can assess you. Your surgeon should offer you a variety of tests to check the health of your eyes and your eyesight, to see whether you’re eligible for surgery.

    You’ll be asked not to wear contact lenses prior to this assessment, as they can change the shape of your cornea, affecting the measurements your surgeon takes. This may be for two weeks for soft lenses, and longer for hard lenses.

    This is also your chance to discuss the procedure with your surgeon, including all the benefits and possible risks. Make sure you find out about all the costs involved, what to expect from your treatment, how long it’s likely to take to recover, and any possible complications. The Royal College of Ophthalmologists have produced a checklist (PDF 117 KB) 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 on the same day. The surgery itself usually takes about half an hour. Your surgeon will ask you to lie on a reclining chair. They will put local anaesthetic drops in your eye to numb them, and use a special clip to prevent you blinking at the wrong moment during the procedure. It’s natural to feel anxious, and your surgeon will talk you through every step of the procedure.

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

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

    • In LASIK, your surgeon will use one laser to cut a thin flap on the surface of your cornea. They’ll lift this up and use a second laser to reshape the cornea below, before smoothing the ‘flap’ back down over the top.
    • In surface laser treatments – PRK, LASEK and TransPRK – the surgeon uses a laser directly on the surface of your cornea. These treatments differ in how the top layer of the cornea is removed.
    • In SMILE, your surgeon will use laser to remove a small piece of tissue from your cornea through a small incision.

    After your surgery, your surgeon may place a transparent plastic shield over your eye to protect you bumping it and rubbing your eyes. Your surgeon may also place a special contact lens (called a ‘bandage contact lens’) in your eye while it heals. This may need to stay in place for a few days.

    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 take these as directed, and follow any advice given to you by 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 up to a few weeks with other procedures.

    Your vision is likely to become stable within a few months after surgery. However, it can take longer in some cases.

    What are the risks 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 whites of your eye

    More serious problems are unusual after laser eye surgery. Up to one in 10 people may need a second operation, often because of under or over correction of their eyesight. Very occasionally, damage to your cornea may cause loss of vision. In rare cases, you may need cornea transplantation to restore your vision.

    You should contact the centre where you had your surgery straightaway if you experience any problems with your vision after surgery.

    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 and will depend on what procedure you’re having, and what your prescription is. Be sure to check whether any costs you’ve been quoted cover initial consultations, follow-up visits, and any extra treatment you may need.

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    Related information

      • Laser vision correction. Royal College of Ophthalmologists., revised May 2018
      • Refractive surgery. MSD manual., last full review/revision February 2017
      • LASIK myopia. Medscape., updated 18 February 2016
      • Photorefractive Keratectomy (PRK) for myopia correction. Medscape., updated 7 April 2017
      • Small-Incision Lenticule Extraction (ReLEx SMILE). Medscape., updated 27 June 2017
      • Laser-Assisted Subepithelial Keratectomy (LASEK). Medscape., updated 28 March 2017
      • Refractive surgery checklist for patients. The Royal College of Ophthalmologists, April 2017.
      • LASIK – laser eye surgery. American Academy of Ophthalmology., published 12 December 2015

    • Reviewed by Pippa Coulter, Freelance Health Editor, November 2018
      Expert reviewer Professor Simon Taylor, Consultant Ophthalmic Surgeon
      Next review due November 2021

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