Royal College Of Ophthalmologists Guidelines , Standards and Information for Patients.

Vision correction surgery is performed to improve vision and reduce or eliminate the need for spectacles or contact lenses. A thorough eye examination and consultation are necessary before a treatment decision can be made.

LASIK

LASIK is a safe, reliable and painless way to improve vision. LASIK, which stands for laser assisted in-situ keratomileusis, is a form of refractive surgery that changes the way light is bent, or refracted, as it passes through the cornea so that it focuses properly on the retina in the back of the eye and objects can be seen clearly. The procedure is effective for many patients with short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism.

During the procedure, a microkeratome or a femto-second laser creates a flap in the outer layer of the cornea. The corneal flap, which is only 100-150 microns, is lifted and an excimer laser beam adjusts the corneal curvature by ‘sculpting’ it, so an image can be focused on the photographic layer of the eye. The cornea is steepened for hyperopic patients, flattened for myopic patients, and made more spherical for patients with astigmatism. The flap is then closed.

The entire LASIK procedure takes only 5 minutes per eye, and patients are often ready to leave the hospital within half an hour. Antibiotic and anti-inflammatory eye drops will be prescribed for a few days, along with other medication and full post-operative instructions. Full recovery takes a few weeks.

LASEK

LASEK, or Laser Assisted Subepithelial Keratomileusis, is a modification of the LASIK procedure. The cornea is bathed in a special solution. Then the very superficial layer- epithelial flap (50 microns) is lifted so the underlying cornea may be treated with an excimer laser. More of the cornea can be treated than with LASIK, making LASEK a better choice for patients who have a high prescription. After treatment the flap is replaced and allowed to heal. A contact lens may be worn for a few days until recovery is complete.

People who have difficulties with presbyopia (the need for reading glasses) may benefit from monovision presbyopic laser correction.

LASER treatment can also be enhanced with wavefront based ablation.

Wavefront Technology is the next generation of laser vision correction. Light travels in a flat uniform beam. When there is nothing disturbing it, such as light going through space, it is perfectly flat without error. This pattern of a straight beam of light is called a wavefront. As light goes through objects, the light beam becomes distorted or becomes more like a wave. Our vision is very similar. When light enters the eye, the light rays become distorted because of the many components of the eyes optical system. Some of these components include the cornea, lens and aqueous fluid, although the greatest amount of distortion occurs when light enters through the cornea. Using wavefront technology we have the potential to provide patients a truly customized treatment based on data that would be impossible to get from an ordinary eye exam. This type of custom treatment has been available at Manchester Royal Eye Hospital / Manchester Centre for Vision for the last 6 years.

In addition to wavefront based treatment, Topolyzer (topography optimized) treatment is available for people with irregular astigmatism or eyes that have had previous laser treatment.

Refractive Lensectomy / Implants

Some people's eyes are unsuitable for laser vision correction but their eyes' focusing abnormalities can be corrected by specialised intraocular implants. Refractive lensectomy is very similar to cataract surgery, the most commonly performed eye surgery in the world.

For more information on implants, click here