An eye-opening treatment: Laser refractive surgery

Permitting us to go through our daily activities with ease, eye sight is a valuable part of our lives. When our vision becomes impaired, there can be an array of causes and conditions. Some of these may require laser refractive surgery as a treatment option. To tell us about this procedure, highly-qualified consultant ophthalmologist Mr Mohamed Elalfy has answered the basic, important questions.

Why is laser refractive surgery performed?

Laser refractive surgery, also referred to as laser eye surgery or laser vision correction, is the reshaping of the cornea (the clear window at the front of the eye) to allow for an improved focus; it is performed to correct myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism (blurriness in vision caused by the shape of the eye).

Laser refractive surgery can be a life-changing procedure by granting the freedom to overcome previous limitations caused by eye impairments. Some of the most common reasons for undergoing this procedure to improve eyesight include: living an active lifestyle; swimming without the increased risk of an eye infection from wearing contact lenses; general convenience; and cost-efficiency in comparison to the ongoing expense of glasses and/or contact lenses.

Surgery is typically carried out on people over the age of 18 who have had a stable prescription for at least two years. It is important to note that some high prescriptions are not suitable for laser surgery; the alternative in these cases are correction via a method referred to as clear lens exchange, a non-laser eye surgery.

Laser refractive surgery is considered a safe and effective procedure by The National Institute for Health and Clinical Excellence (NICE) who provide national guidance and recommendations in order to promote clinical excellence in England and Wales.

Mr Elalfy performs two kinds of laser refractive eye surgery: laser-assisted in situ keratomileusis (LASIK) and Photorefractive Keratectomy (PRK). LASIK eye surgery is the most commonly performed and best-known laser refractive surgery to correct vision problems. It can be used as an alternative to glasses or contact lenses and is performed using a corneal flap. PRK does not use a corneal flap and is more suited to patients with unusually thin corneas.

Before deciding to proceed with laser refractive surgery it is highly advisable for the individual to thoroughly understand the risks and benefits of the procedure. The common risks include: mild, gritty discomfort which can last between three to six months; visual disturbances which usually resolve naturally; and red marks on the white of the eye which will fade away within a month.

How do you prepare for laser refractive surgery?

When preparing for laser refractive surgery it is important to take measures to reduce any stress and pressure from yourself. If you live locally to where the procedure is planned to take place, then you should ensure you have arranged transportation home as you will not be able to drive yourself; if you do not live locally and are travelling further afield for your surgery then you should take measures to secure overnight accommodation following your procedure.

Simple dos and don’ts include:

• Do not drink alcohol for 24 hours prior to your surgery as this can cause dry eyes
• Do not use hairspray, perfume, or aftershave for 24 hours prior to your surgery as these products contain alcohol and can therefore dry out your eyes

• Do remove any make-up you are wearing to reduce any interference with the procedure
• Do wear comfortable clothing on the day of the procedure.

The best piece of advice we can give you in preparing for your surgery is to try and be as relaxed as possible and to trust us to ensure that your experience is as stress free as possible.

What happens on the day of the surgery?

On the day of your surgery, anaesthetising eye drops and a mild sedative will be administered; this will ensure that the procedure is painless. An ultrasound will then be used to soften the existing lens which is then emulsified and removed. The lens will then be replaced with a lens implant and secured by the back membrane of the lens.

Exactly how the procedure is carried out will depend on the type of surgery you have opted for. In LASIK, Mr Elalfy will use a laser to cut a thin flap on the surface of your cornea; the flap is then lifted up and another laser is used to reshape the cornea before the flap is smoothed back down.

In PRK, Mr Elalfy will use a laser directly on the surface of your cornea to reshape it, without cutting a flap first; the only difference between these treatments is the top layer is removed before the reshaping of your cornea.

The procedure itself will take between 30 and 60 minutes to complete and following a short recovery period in day care, you will be discharged the same day with shielding placed over your eye to protect it.

What happens after the procedure?

It is recommended that you wear a protective plastic shield over your eyes at night for approximately seven days. In addition, you will be prescribed eye drops containing antibiotics and anti-inflammatory medicines to encourage the healing of your eyes; this also creates artificial tears to keep the eyes comfortable during this time.

How long does it take to recover from laser refractive surgery?

Recovery time can vary depending on which type of surgery you undergo. With LASIK you may be able to return to work and drive the day after. However, it may take a few weeks with PRK. You should not go swimming for one week after your surgery and depending on the type of procedure you have had you may be advised to avoid contact sports for up to one month.

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

If you are soon undergoing laser refractive surgery or would like more information, you can book a consultation on Mr Elalfy’s profile.