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Laser Eye Surgery Myths: What Is The Procedure?

David Moulsdale, chief executive officer of Optical Express answers a range of commonly asked questions about laser eye surgery.

For people who have struggled with impaired vision all their lives, the idea of being able to see clearly without wearing glasses or contact lenses may seem like a dream come true. But the reality of undergoing laser eye surgery may be a bit intimidating.
 To help clear up the myths and bring out the truth about laser eye surgery, we asked David Moulsdale, chief executive officer of Optical Express, to answer some of the most commonly asked questions:


How can a patient be sure that laser eye surgery is really the best choice for them – and that they are not being sold an unnecessary procedure?

“Quite often patients come in seeking laser eye surgery, but they don’t really need it. While our surgeons have treated more than 620,000 patients, we have actually refused to treat more than 500,000 to date.

“We have declined to treat that volume of patients mainly for clinical reasons – for example, if they have an underlying medical condition that means they won’t achieve a satisfactory outcome. We will only treat a patient if they are deemed to be clinically suitable by one of our experienced clinicians, if it’s truly in their best interests and if we believe it is possible to achieve their desired visual outcome.”

“We have probably recommended about a million people to go ahead for surgery.”


How long will the results last?

“Laser eye surgery does last; it is a myth that it does not. That said, there are a small percentage of people who regress and these patients can benefit from an enhancement or secondary procedure. This is a result of the natural healing process that takes place following the procedure.

“We all heal from medical procedures at different rates and following laser-assisted in situ keratomileusis (Lasik), a small number of patients will underheal or overheal, meaning they regress from the desired outcome.

“With modern-day Lasik, we have an enhancement rate of about 4 per cent. For those that do require an enhancement, this is normally carried out at three to six months after the original treatment and to correct a significantly lower eye prescription than that initially corrected.

“As we age, natural age-related changes occur that affect our ability to focus at near. These changes typically occur when we reach our mid to late forties, and are basically a result of the natural lens within our eye not being able to change shape as readily as it used to be able to do when we change our focus from a distant object to a near one.

“These inner-eye changes are totally unrelated to laser eye surgery applied to the outer window of the eye. For those treated before the onset of such associated near-vision symptoms, supplementary treatments are an option to restore near-vision and provide as high a level of uncorrected near-vision as that experienced in the distance.”


What does the procedure involve?

“There are two different methods of laser eye surgery. Lasik is best suited to the majority of patients, around 90 per cent.

“The Optical Express Lasik treatment offered is iLasik, an all-laser treatment comprising two computer-guided, ultra-fast, precision lasers that use cool laser beams; the first to create a thin protective flap on the outer window of the eye (the cornea); and a second to correct your vision by gently reshaping the clear inner layers of the eye.

“In the case of laser epithelial keratomileusis (Lasek), the surgeon removes a very thin layer on the front of the eye and uses a laser beam on the eye to change the curvature. Approximately 10 per cent of our patients have this type of procedure.

“Both treatments correct myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism. For most patients, laser eye surgery provides a permanent alternative to their spectacles or contact lenses.

“The most advanced form of Lasik or Lasek procedure available today is an iDesign one that is available at all Optical Express locations or at Moorfields Eye Hospital in London.

“With iDesign, 1,257 individual micro eye prescriptions are determined using sophisticated diagnostic technology. Each one of these measures the eye prescription to 0.01 of a dioptre strength – this is 25x greater than what a spectacle or contact lens prescription is measured to.”


Is there any pain involved?

“Obviously we’re all different and have different pain thresholds. For the vast majority of patients, laser eye surgery is painless, although some patients - particularly those undergoing Lasek - do report some mild discomfort over the course of the first couple of days. No symptoms of pain are experienced during the procedure itself as the outer window of the eye is anaesthetised by eye drops.”


How qualified are the surgeons?

“Optical Express surgeons have treated more than a million patients worldwide. Globally they have a combined surgical experience of more than 1,000 years practising ophthalmology and more than 700 years performing refractive surgery. Every Optical Express ophthalmic surgeon specialises in the field of refractive surgery and each is registered with the General Medical Council (GMC).”


How soon after the procedure will patients notice the improvements?

“The majority of patients notice a significant improvement immediately, but it really depends on the individual and the treatment they’ve undergone. All patients will experience an improvement within 24 hours of the procedure.”


There seem to be many myths about laser eye surgery. What have you done to disprove them?

“For many patients considering laser eye surgery, their first port of call is their optometrist. However, many optometrists are not trained on this specialist subject and are unable to offer advice, or if they do, it can be inaccurate.

“In 2013 we carried out an initiative to change the misperceptions and myths in the eye care industry. We offered free laser eye surgery to optometrists to give them a better understanding of the procedure and treated more than 800 optometrists as a result of the initiative.

“Ninety nine per cent of those treated said their knowledge and understanding of laser eye surgery had been significantly enhanced and that they would have no hesitation in recommending laser eye surgery to their family, friends and patients.”