Laser eye surgery: Cost, risks and how long the effects last

The popular procedure can help correct many vision issues with very little risk. Here’s what you need to know – and if it’s right for you

I’m one of 30 million people who undergo laser eye surgery every year, with the very first procedure carried out in 1989. It’s the burning smell I remember most during the operation to correct an astigmatism (an imperfection in the curvature of your cornea that results in blurred vision). It was caused not by my delicate cornea being decimated by a laser, but by carbon atoms being released into the air by the laser. 
Disconcerting, yes, except for the fact that, as soon as the lasering was over, I could immediately see right across the room with perfect clarity. After 40 years of relying on glasses and contact lenses, my shortsightedness had gone in an instant. 
But there are still many unhelpful myths about laser eye surgery, including that “people with astigmatism have been told by their optician that they can’t have a certain type of laser treatment, when they can,” says Prof Dan Reinstein, a laser eye surgeon at the London Vision Clinic.
Here we clear up the myths from the facts and guide you through the procedures that exist today.
Jump to:
Most commonly, a laser is used to change the shape of the cornea to alter the way light is reflected into the eye, correcting a whole range of vision issues.
There are a range of techniques for refractive surgery – also known as laser eye surgery –  used to correct eyesight issues such as astigmatism, long and short-sightedness.  
With lasik (laser-assisted in situ keratomileusis), a high-precision laser is used to create a thin flap on the surface of the cornea to allow access to the tissue beneath. Following the reshaping of the cornea with the laser, the corneal flap is folded back into the place. Lasik is used to correct nearsightedness, farsightedness and astigmatism.
Smile (small incision lenticule extraction) is keyhole lasik surgery, and as it’s a smaller incision, it heals faster. It is suitable for many but not all patients. It doesn’t suit patients with thin corneas.  
Also known as laser blended vision or presbyopia surgery, presbyond is an advanced laser for irregular astigmatism.
The procedure corrects both distance and near vision for ageing eyes (presbyopia). With this procedure, one eye is adjusted to see mostly at a distance, and a little close-up, while the other is mostly up close and a little at a distance. The brain compensates for this, combining the two images to give much greater depth of vision.
“Presbyond was developed 15 years ago to correct distance and near-sightedness in older patients, without the need for replacing the lens which is a much more invasive procedure with more risks and side effects,” says Prof Reinstein. Presbyond can also be performed after cataract surgery.
Back to page navigation
Laser eye surgery is most appropriate for people who are in good health and have moderate vision problems. “At your consultation ask the surgeon what’s the safest option for your eyes and how well you’ll see,” says Prof Reinstein.
“In the case of ageing eyes, 100 per cent of us will eventually need reading glasses or bi-focals, because as we age, distance correction doesn’t work for seeing what’s nearby, because the lens inside your eye can’t zoom anymore. If your reading glasses work it means you don’t have cataracts, so don’t need lens replacement. You need laser surgery,” Prof Reinstein adds.
“For laser eye surgery, short-sightedness is the most reliably treated. People are usually older than 21, or have a stable prescription. The corneal scans undertaken at the consultation show their cornea to be safe for lasik, and these people do very well from laser eye surgery,’” says Alex Ionides, a consultant ophthalmologist and the lead clinician at Moorfields Private Eye Hospital. “Astigmatism can also be lasered safely.” 
The effects of laser eye surgery will usually last for life for some prescriptions, although long-sightedness can be an exception. 
“While laser for long-sightedness is perfectly good in some people, it is less likely to be long-lasting and stable and more likely to need a bit more laser treatment later on down the line,” says Ionides. 
“Hyperopic (long-sighted) treatments are less stable, owing to the shape the laser makes on the cornea, as well as some of the long-sightedness from the natural lens not being able to be treated by laser.” In some cases, corrected vision can regress years after the procedure.
The most common type of laser eye surgery in the UK (all-laser bladeless lasik eye surgery) ranges from £1,495 to £3,000 per eye, according to the Laser Eye Surgery Hub. 
Avoid caffeine, don’t wear contact lenses and remove all eye make-up before surgery. Make sure you have someone collecting you, and that you have a few days to recover. To help you relax before your surgery, you will be given the option of taking a mild sedative.
Numbing drops are put into your eyes, then a suction ring and eyelid speculum are placed on your eye. Next a thin flap is made in the front of your eye, and you are asked to focus on a light aimed toward your eye while the laser is used to reshape the cornea. Once done, the corneal flap is put back in place.
Wearing bandage contact lenses or a protective shield over your eyes, they may feel gritty and be watery for a while, and your vision blurry. You stay at the clinic or hospital for a few hours until you are comfortable to be taken home. Driving is forbidden for 24 hours after surgery.
You may notice a gradual improvement in vision. It’s important to use any antibiotic and anti-inflammatory eye drops the surgeon has given you, and to wear sunglasses, as your eyes will be sensitive to light and UV rays can affect the healing process. 
Stay at home to allow your eyes to heal and avoid taking showers. At your follow-up examination, your surgeon will check how your eyes are healing and whether your vision is improving. You may experience mild discomfort, light sensitivity, glare, halos around lights, or dry eyes.
Avoid exposing your eyes to irritation, so this means no soap, water, make-up or toiletries around the eyes. You will have been given an eye shield to wear at night to prevent irritation and eye rubbing, and should avoid alcohol, which can interfere with the healing process. For most patients, vision stabilises within the first three months. 
Back to page navigation
Benefits of laser eye surgery:
Risks of laser eye surgery:
On the whole, yes. The national average complication rate following laser eye surgery is less than 5 per cent. The chance of it causing blindness is less than one in five million. “Laser surgery has excellent outcomes, and a long, proven track record,” says Prof William Ayliffe, a consultant ophthalmologist based at the Lister Hospital in London. In fact, it is generally safer than long-term contact lens use. But choose a clinic with a solid reputation, checking its success rate as well as its complication rate. 
Alternatives to laser eye surgery include:
This is a corrective lens implant inserted into the eye over your natural lens. 
PRK – photorefractive keratomileusis – is the oldest and most invasive procedure, involving the complete removal of the corneal epithelium (the layer of tissues protecting the cornea). Prof Reinstein says: “A surface procedure that is less commonly needed, but can be useful for specific corneal conditions, it has a longer recovery time compared to Lasik and Smile.”
The lens of your eye is replaced with a synthetic one called an intraocular lens. Apart from being used to remove or prevent cataracts, this procedure can correct long sightedness, short sightedness, astigmatism and even presbyopia.
Back to page navigation
Recommended