Lasik Eye Surgery, Lasik Eye Treatment

What is LASIK?

LASIK (Laser in situ keratomileusis) uses a specialized, precise, and computer-controlled corneal flap-making instrument, called Intralase, to create a thin corneal flap of corneal tissue.

A surgeon gently lifts the corneal flap and uses the sophisticated Bausch and Lomb Z100 Laser to reshape the corneal by removing a small pre-determined amount of corneal tissue.

The surgeon places the corneal flap back down and within minutes; the flap naturally heals without the need for stitches. A specially designed soft contact lens is placed on the eye to protect the corneal surface overnight. This is important as it aids healing in the crucial initial stage.

LASIK is used to correct short-sightedness (myopia), long-sightedness (hyperopia), and astigmatism.

Who removes the contact lenses?

We strongly insist you do not touch the lenses (even if you are an experienced lens wearer). You will have them removed by a surgeon or specialist Laser optometrist the next day.

What is the advantage of wavefront treatment?

Wavefront describes the aberrations (imperfections) in your eyes and wavefront treatment corrects those aberrations caused by your corneas. This personalized form of treatment available at Advanced Vision Care means your resulting vision after surgery is of superior quality. It eliminates side effects such as night glare and haloes.

Why does the price of wavefront differ so much between clinics?

This is where the jargon can cause confusion. Clinics often have different names for wavefront such as ‘Optimised wavefront’. It should be noted that optimised wavefront is not wavefront in its true form and this is where meeting the surgeon is crucial so he/she can tell you exactly what surgery is going to be performed on your eyes. Alternatives to true wavefront are, naturally, cheaper.

INTRALASE LASIK (Blade Free)

What are the advantages of Intralase over the Microkeratome (blade)?

Intralase produces stronger flaps, thus improving wound healing. The visual outcome is far superior with intralase along with faster healing and an enhanced safety profile. Customized flaps are created (i.e. not all of the same uniform thickness) and as a result of all these reasons the quality of vision is enhanced.

Do you still have to ever use the Microkeratome?

Yes. It is important to remember that every patient is unique and that is exactly how they should be treated. So, although Intralase is the most advanced technique available for flap creation if you are found to be more suited to the microkeratome then this is best for you. The surgeons at Advanced Vision Care have extremely strict parameters and will do what is going to give you the best result.

There are a number of microkeratomes available and used with the most technologically advanced being the XP. There is no longer a need to use older models such as the Hanstome.

Is the Intralase method painful?

The surgeon will apply anesthetic drops to numb the eye so no pain is felt. Rather, some patients report a sensation of pressure for a few seconds whilst the flap is being created.

Is the Intralase method safe?

Most definitely. Millions of procedures have been performed worldwide safely and effectively using the Intralase method. This is the gold standard of Laser eye practice all over the world.

Why do some clinics use a microkeratome routinely?

This is rare in the top specialist clinic but common in those with less expertise. That is often the reason why as the surgeons and the clinic do not practice with the latest technology and methods. As a result they are able to offer cheap Laser surgery but as we all know you get what you pay for.

General Laser FAQ

Can I have Laser eye surgery if I am diabetic?

This depends on the control. If you are well-controlled insulin dependent diabetic with no associated retinal problems you are able to have Laser surgery. However, if you have uncontrolled diabetes (type 1 or 2) we are unable to treat you as the corneal healing will be compromised and it would not be in your best interest to undergo surgery.

Can Laser eye surgery treat amblyopia (lazy eye)?

A lazy eye usually develops during childhood and cannot be improved no matter what prescription lens is put in front of the eye. This is because this development is on a cortical level and not just a prescription issue and is often the same with surgery which in most cases can only restore vision to the same level attainable with corrective lenses. However, in some cases patients do improve after surgery, especially in those who have a mild lazy eye. For further information please do call AVC to discuss your prescription over the phone. A final decision can only be made after your initial screening.

Can Laser eye surgery treat strabismus (squint)?

A strabismus is a turn in one eye or sometimes both. Refractive surgery changes the refractive error (ie. prescription) of each eye individually and will not solve a squint problem (unless the squint is the type that straightens with prescription). Following Laser eye surgery, squint surgery is often required to straighten the eye.

Squints are often associated with amblyopia and the visual outcome you should expect will be discussed at your initial assessment.

Can I have Laser eye surgery if I am taking prescription drugs?

It is very important that you inform the clinical team of all medication you are taking so the surgeon is aware of this. Prescription drugs are not a contraindication to surgery.

What is the minimum age limit for Laser eye surgery?

The legal minimum age limit for Laser eye surgery is 18. However, our limit is 21 as prescriptions often do not stabilize till this age. Stability of prescription will be one of the many factors determined at your initial assessment.

Is there an upper age limit for Laser eye surgery?

No, there is no upper age limit for Laser surgery, as long as your eyes are healthy. Some older patients may experience a longer healing period after Laser surgery and this would be discussed at your initial assessment if relevant. In addition, some older patients are more suitable for alternative treatments and this can be determined at your consultation.

Can I have Laser eye surgery if I have glaucoma?

Yes in most cases. However the surgeon will make the final decision at your initial assessment. Please note that Laser surgery is not a treatment for glaucoma.

Can I have Laser eye surgery if I have thin corneas?

If you have been told you are unsuitable for treatment due to corneal thickness we would love to see you! Treatment on those with thinner corneas is highly dependent on the technology and surgical expertise of a clinic. In addition, if we find you to be unsuitable we have successful alternatives to Laser eye surgery; Implantable Contact Lenses and Clear Lens Exchange, in which we are the country’s leaders.

Can I have Laser eye surgery if I am pregnant or breastfeeding?

Hormonal activity during pregnancy and the breastfeeding period affects vision. Therefore, Advanced Vision Care will not treat patients during this time as it is not possible to obtain accurate prescription readings and measurements of the eye. In addition, medication may be required following treatment making it an unsafe option. We request you wait one month after stopping breastfeeding before your initial assessment.

Can I have Laser eye surgery if I have keratoconus?

Keratoconus is a bilateral, progressive and non-inflammatory disease of the cornea, affecting approximately 1 in 2000 of patients. It is characterized by paraxial stromal thinning, which causes the normally round-shaped cornea to progressively become stretched, resulting in the development of a cornea like a bulge. This bulge changes the corneal refractive error producing irregular astigmatism and myopia and thus, visual distortion.

Laser treatment is not possible due to the weak corneal tissue. At Advanced Vision Care, we are able to stabilize the progression of Keratoconus with a new treatment called Cross linking and/or Intacs.

Can I have Laser eye surgery if I have macular degeneration?

Yes, although the visual outcome depends on the severity of your condition and suitability will be determined by the surgeon at your initial assessment. Laser eye surgery does not treat macular degeneration.

Can I have Laser eye surgery if I have dry eyes?

This depends on the severity and cause of the dryness. A detailed tear film assessment will be part of your initial consultation and if treatment is required prior to surgery the appropriate medication will be prescribed.

Can I have Laser eye surgery if I have large pupils?

This depends on the technology and expertise used. At Advanced Vision Care we use the advanced Bausch and Lomb Zyoptix 100 system which allows bespoke wavefront Laser eye surgery resulting in superior visual outcomes. The Advanced Nomogram that we use means we are proud to say we have never had to turn a patient away for their pupil size alone.

I have read a great deal online about complications and side effects?

Unfortunately, as useful as the internet is for information, there often can be cases of being misinformed and left confused. When researching Laser eye surgery it must be remembered that without knowing the patients prescription, circumstances, surgery method, clinic details, the information about the experience is meaningless.

Unfortunately there are a number of clinics where quantity prioritizes over quality and regrettably this leads to complications and unhappy patients. Be assured that at Advanced Vision Care our parameters are extremely strict and we will only treat you if we can make a positive difference. We want you to enjoy the experience and the outcome.

Why is the price so varied?

Advanced Vision Care adopt a strict transparent pricing policy. The price you receive is a global one including the consultation, all surgery, and aftercare for one year and medication (for one month). There are no hidden extras. Your eyes are priceless and one should not make a decision on “ price “ alone as the high street UK clinics tend to sell Laser eye treatment as a “ commodity “. In AVC, everyone is treated as an individual, not as a number and offered a world class expertise.

We can easily advertise as starting from a cheaper price and then by the end charge you much more than that but we do not feel this is fair on you. At the end of the day you get what you pay for and are only going to undergo this life changing experience once and we endeavor to make sure it is exactly what it should be; affordable, safe, easy and truly amazing!

Can I bring someone with me to surgery?

Price is not the only transparency at Advanced Vision Care; the Laser surgical theatre is too! Advanced Vision Care have absolutely nothing to hide are the only clinic in the UK where your loved ones can watch you have surgery live as it happens. Through the glass theatre they can watch it all take place on a screen which is directly linked to Mr Pillai’s microscope, ie. They see exactly what he does.

Are both eyes treated at the same time?

Absolutely! Mr Pillai was the first surgeon in the UK to perform bilateral treatment many years ago after which other surgeons began following in suit.

I wear glasses for distance and reading; can you treat both with Laser?

Presbyopia is a part of the natural ageing process and describes the inability of the eyes to focus on close objects gradually over time. This results in the need for separate reading glasses or varifocals. Laser eye surgery corrects distance vision only and following this, reading glasses would be required. There is a form of Laser treatment called monovision Laser where one eye is corrected for distance vision and the other eye for reading and the brain adapts to this to see both distance and near. However, this does need a trial in the form of glasses or contact lenses to confirm you are tolerable to this.

At Advanced Vision Care we are able to treat you with a sophisticated alternative method; Clear Lens Exchange with multifocal implants which correct for distance and near vision without the need for monovision. This is a permanent solution and has the advantage that in the future you cannot develop a cataract, thus never needing further surgery.

Where does the Laser treatment take place?

All our Laser surgery takes place in a transparent glass theatre in Harley Street which you will be familiarized with during your initial consultation with us.

Are there any dos and don’ts for the day of surgery?

On the day of surgery we ask you to come in wearing comfortable clothes, having had something to eat to keep your blood sugar levels stable. We request you wear no make-up, face creams, perfume and alcohol based deodorant on the day of surgery. We offer a low dose of Valium to all patients as naturally you may be feeling anxious and nervous and this helps you relax during treatment.

What happens if I move my eyes during surgery?

If you have surgery at Advanced Vision Care you do not need to worry about this thanks to the highly sophisticated multidimensional eye tracker system used. During your initial consultation we will take pictures of your irises (iris fibre patterns are completely unique between individuals and each eye). This image is transported to the Laser so when you are lying underneath it recognizes and follows this. Any eye movements made are compensated for by the Laser with a reaction time of 6.6milliseconds.

Will I meet my surgeon prior to surgery?

Yes we believe it is essential patients meet a surgeon before having treatment as it is only the surgeon who can make the final decision for treatment. In most of the clinics in UK, patients are seen by an optometrist and the surgical decision is made by them. The patients are often seen by the surgeon only on the day of the surgery which is not a healthy practice.

We regularly hear of patients who have been seen for a consultation elsewhere and on the day of surgery the surgeon makes a last minute change or worse still deems them unsuitable. Be assured that the clinical team at Advanced Vision Care is highly trained, but it always stands that only the surgeon can make the final decision.

How do I choose a Surgeon?

This is a very important decision and sufficient research should be undertaken before making it. The following criteria is useful

1. Is the surgeon accredited by the Royal College of Ophthalmology UK??

2. Whether the surgeon has highest qualifications like FRCS or FRCO in UK??

3. Does the surgeon perform Laser eye treatment as a primary profession?? Some surgeons do Laser treatments as part of their eye practice??

4. What is the experience of the surgeon in terms of years and the number of procedures??

5. Laser treatment is a corneal treatment and so to ensure the best result possible your surgeon should be a corneal specialist with the expertise to handle pre operative and post operative complications should they arise.

What is the difference between a Professor and a ‘normal’ surgeon?

Be aware of jargon when it comes to surgeon’s titles. ‘Professor’ is often misused as in the USA; surgeons are able to call themselves this without any academic or research backing and is used as a general title. However, in the UK and in Europe Professors are true Professors as they are only able to use the title by working in academic institutes and undertaking research. It is a legal title reserved for this limited group of experts.

How do I choose a Laser eye clinic?

This should be based on a number of factors and definitely not just be price driven. Your first experience with a clinic will be the assessment and following this you should have a very good understanding into that particulars clinic working standards, ethos and expertise. It is important you feel absolutely comfortable with the clinic and clinical team, the surgeon (his/her manner, qualifications and experience), the technology they will be using on your eyes and of course the money you are paying for these privileges.

It is important you are able to ask all the questions you would like to and are not felt to be pushed into making a decision. Be aware of clinics or surgeons using mobile Laser as the calibration and technology vary among the Lasers.

Can I drink alcohol after treatment?

It is not advisable to drink alcohol the day before and the day after treatment as this can cause dryness in the eyes. Drinking will not damage your eyes but will affect tear film stability resulting in dryness and the need for extra drops.