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I can see clearly now – thanks to ten minutes with a laser surgeon

ASK around, and you’ll suddenly find that everyone you know either knows someone who has just had laser eye surgery, or they’re about to have it done themselves. It’s like with pop star Lily Allen – she had a big online presence for ages, but nobody one knew had ever actually heard of her. Until suddenly overnight, we were all humming her tunes.

After 20 years of existence (a bit like Lily Allen), laser eye surgery is finally becoming the cool kid on the block, accepted by the in crowd, the out crowd, and pretty much everyone who would once have balked at such a procedure. So despite a slight slowdown in customers throughout the recession, people seeking laser correction surgery are up by 15 per cent year on year, according to provider Ultralase. John Hughes, the company’s commercial director, says: “A lot of adults remember growing up hearing it was all new and crazy. Now we’re getting people who have grown up hearing about it working out – and the results are improving all the time.”

Yet the idea of a surgeon using a laser to cut through your eye in order to reshape your cornea is hardly pleasant. And it’s not cheap, either – around £3,000. These deterrents mean the UK lags behind countries including the US and Spain, where 10 per cent of the population has had the treatment. Here, only 2.5 per cent of people have. We know the surgery works. But is it really low-risk? What do we stand to lose? What actually happens?


WHAT IT DOES
Laser correction surgery reshapes the cornea so that it changes the focal point of the eye. Ideally, the focal point is changed so that it focuses perfectly on the retina, just like a normal eye. With short-sightedness, rays of light from a distant object are focused in front of the retina. This is either because the eye is too long or the cornea is too steeply curved and so has too much focusing power (or a combination of these factors). The laser flattens out the cornea, thus restoring perfect focus.


HOW IT WORKS
Modern surgery generally uses two forms of laser treatment. LASIK is most common, and uses a special laser to create a flap in the outer corneal tissue, which then makes way for another laser to reshape the underlying corneal tissue. The flap is replaced over the reshaped area and conforms to the new shape. The Rolls Royce of laser procedures is called Wavefront-guided intra-LASIK, whereby a Wavefront laser guides the measurement of the eye for ultra-accurate results. LASEK (with an e), by contrast, involves preserving the extremely thin epithelial layer of the cornea by softening it, then lifting it from the eye’s surface with a non-laser tool before the laser is applied for reshaping. After the procedure, the epithelium is replaced on the eye’s surface.


WHICH IS BEST?
LASEK was developed for people whose corneas are too thin or steep for LASIK, ie those whose corneas can not cope with the creation of a thicker flap. It is also sometimes used for players of contact sport who want to avoid the risk of pain or bruising from collision with the eye that has had the thicker flap added. However the healing process is slower and less comfortable. LASIK is the procedure of choice for most people as eyes heal incredibly fast – most people can drive within 24 hours. The second laser makes it slightly more expensive, though.


MYTHS AND RISKS
People fear blindness, infection, black spots, everlasting dryness, floaters, and the possibility that you will be back to square one 10 years down the line. It’s scary, tinkering with your eyes (the window to the soul, after all), so it’s no wonder we catastrophise the surgery.

The reality is quite different. David Gartry, ophthalmic consultant surgeon and refractive service director at Moorfields Eye Hospital, says: “It’s a great shame to be put off by risk – in terms of infection it’s safer than contact lenses. As for permanent damage to the vision that can’t be corrected – that is amazingly rare. Four per cent of patients have an extra procedure, simply because no surgeon anywhere can tell someone beforehand it’ll certainly succeed. I get a whole load of bankers, lawyers, actuaries and so forth in my Saturday clinic. By Sunday, their vision is better than driving standard – by Monday it’s 20/20.” John Hughes of Ultralase goes so far as to say: “No one has ever gone blind from undergoing laser surgery anywhere in the world.”


COSTS
Adverts claiming to offer correction “from” £395 per eye are grossly misleading, say Gartry and Hughes. As soon as your prescription is bigger than -1, the price starts to rise. Then, if you want an up-to-date procedure like Wavefront-guided intra-LASIK it rockets. Ultralase’s premium Ultra Elite procedure costs £2,095 per eye. Other providers, such as Gartry and his colleagues, charge around £3,000-£5,000, including a hospital fee.

LASER CORRECTION | WHERE TO GO
Moorfields Eye Hospital has a bevvy of surgeons at the top of their game. David Gartry and Julian Stevens are two at the forefront. www.moorfields.nhs.uk. Ultralase has clinics throughout the UK. www.ultralase.com

CASE STUDY: GILLES E, 28, CREDIT AGRICOLE CIB

MY LASER SURGERY
I went to Moorfields’ private clinic – it is probably the best place in London to get this surgery from what I have read, since this is a piece of cake for the surgeons after what they fix every day in the hospital.

The surgery lasted only 10 minutes, with only 50 seconds of laser I would say. It was not painful at all – my eyes were not red at all after surgery, just a bit dry, and I had to use drops a lot in the first three days; fewer after that. I went to work four days later but you technically can go back the next day. I would not advise it if you work on computers.

You see clearly straight away, soft-focus though, and it gets much better in a few hours. You see far very well the next day, though short vision takes a few days, and computer vision takes a week or eight days. You can still read the screen, it is just a bit blurry compared to before.

Laser surgery goes extremely well for the vast majority of people but if you trust links on the internet, you will get super scared.