Laser eye surgery
Your health expert: Mr Ali Mearza, Consultant Ophthalmic Surgeon
Content editor review by Rachael Mayfield-Blake, June 2023
Next review due June 2026
Laser eye surgery can correct problems with your eyesight, such as short-sightedness, long-sightedness and astigmatism. This can mean you can wear contact lenses and glasses far less often, or for most people, not at all. But as with any procedure, there are potential laser eye surgery risks to consider.
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About laser eye surgery
Laser eye surgery is also known as refractive surgery and laser vision correction. There are different types of surgery. The most common ones in the UK are:
- LASIK
- surface laser treatments (PRK, LASEK and TransPRK)
- SMILE/SmartSight
These procedures 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 – see our FAQ section below.
Each procedure involves a slightly different technique. Different procedures suit different people. Your surgeon will explain which is best for you.
Who can have laser eye surgery
Laser eye surgery isn’t suitable for everyone. Whether you can have it depends on things like the thickness and shape of the clear layer that covers the front of your eye (your cornea). 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 certain prescription (your glasses/contacts prescription) range. Your eye surgeon (ophthalmologist) will check if it’s an option for you. There may be reasons why you can’t have laser eye surgery and your surgeon will discuss this with you.
Considerations for laser eye surgery
Before deciding whether or not to have laser eye surgery, meet with an eye surgeon (ophthalmologist) so they can assess you. Your surgeon will do some tests to check the health of your eyes and your eyesight to see if you can have surgery. These tests may include checking the shape and thickness of your cornea and the size of your pupil. Check if your clinic will charge you for these.
Your surgeon will ask you not to wear contact lenses before this assessment. How long can vary – it’s usually three to five days for soft lenses, and up to four weeks for hard lenses. This is because contact lenses can change the shape of your cornea and this may affect the measurements your surgeon takes.
During your appointment, ask your surgeon about the benefits and risks of laser eye surgery and find out:
- what laser eye surgery costs, including your care after the procedure
- what to expect from your treatment
- how long the recovery is
- any possible complications
The Royal College of Ophthalmologists has produced a helpful checklist (PDF 225KB). If you decide to go ahead with laser eye surgery, your surgeon will ask you to sign a consent form.
Laser eye surgery procedure
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 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 during some parts of the procedure. They’ll also ask you to look at what’s called a fixation light during the treatment to keep your eye in the right position.
What happens next will depend on which type of procedure you have.
- In In LASIK, your surgeon will use a laser to create a thin flap on the surface of your cornea. They’ll lift this flap up and use a different type of laser to reshape the cornea. Finally, they’ll smooth the flap back down over the top.
- In PRK, LASEK and TransPRK, your surgeon will use a laser directly on the surface of your cornea to reshape it, without creating a flap first. The only difference between these three treatments is how your surgeon removes the top layer before they reshape your cornea. Your surgeon may suggest this type of treatment if your cornea is relatively thin.
- In SMILE or SmartSight, your surgeon will use a laser to create a small keyhole opening instead of a flap. The laser will also separate a small disc-shaped piece of tissue within the cornea, which your surgeon will pull out through the keyhole opening.
After your surgery, your surgeon may place a see-through plastic shield over your eye to protect it. Your surgeon may also put a ‘bandage contact lens’ in your eye to protect it 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.
Aftercare for laser eye surgery
You’ll be able to go home when you’re ready, but ask a friend or relative to drive you.
Your surgeon may recommend that you wear a protective plastic shield over your eyes at night for the first two days or so. They’ll prescribe you eye drops that contain antibiotics and anti-inflammatory medicines to help your eyes heal, and artificial tears to keep them comfortable. Make sure you follow your surgeon’s advice.
The recovery time from laser eye surgery will depend on which type of surgery you had. You may be able to return to work and drive the day after LASIK, but it may take a week or so with other procedures. Don’t go swimming for a week after your treatment. Depending on the type of procedure you’ve had, you may need to stop playing any contact sports for up to a month (other sports, such as running and going to the gym are fine).
By three months after surgery, your vision should be stable and unlikely to change further, but it can take longer. It’s still possible that your prescription may change later at some point in life, but this is usually related to another eye problem that may develop, such as a cataract, or age-related long-sightedness (presbyopia).
Side-effects of laser eye surgery
Most people get 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 may be sore for a couple of days while it recovers, particularly after 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. Also contact your surgeon if your eye becomes sensitive to light or you have an eye injury.
Complications of laser eye surgery
Complications of laser eye surgery are rare and serious problems are very unusual. 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.
There are some laser eye surgery risks. Complications that affect your sight, like a post-operative infection or damage to the cornea are extremely rare – similar to the chance of getting them from wearing contact lenses.
Where can I have laser eye surgery?
Laser eye surgery is rarely carried out on the NHS, so you’ll usually need to book treatment at a private clinic.
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 with the Royal College of Ophthalmologists, or the General Medical Council. 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’ll depend on what procedure you’re having, and what your prescription is. Check if your quote covers initial consultations, follow-up visits, and any extra treatment you may need.
Laser eye surgery can help with age-related long-sight, but it’s done a little differently. An eye surgeon can treat one eye to improve your close vision and the other to focus well for distance vision. This is called monovision.
Monovision doesn’t suit everyone. Your eye surgeon will probably try the concept out by suggesting you wear adapted contact lenses or glasses first before you decide to have surgery.
Laser eye surgery will permanently reshape the tissue in the front of your eye (your cornea) and these changes last your whole life. But while laser eye surgery makes permanent changes to the cornea, your vision may still change over time due to changes within your eye that can happen with age, such as a cataract.
Laser eye surgery isn’t painful because your surgeon will put drops of local anaesthetic into your eyes to numb them before they start. But after your procedure, your eye may feel sore for a couple of days while it recovers. Particularly if you have surface laser treatments, such as PRK, LASEK and TransPRK.
If your eye becomes increasingly painful, contact your eye surgeon.
See our laser eye surgery procedure section and aftercare for laser eye surgery section for more information.
Laser eye surgery can be good for eyes as it can correct problems with your eyesight, such as short-sightedness, long-sightedness and astigmatism. This can potentially mean you don’t have to wear contact lenses and glasses, or at least not as much. But there are potential risks of laser eye surgery to consider.
See our complications of laser eye surgery section for more information.
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