LASIK (laser-assisted in situ keratomileusis) Q&As
Published by Bupa's health information team, April 2009.
Answers to questions about LASIK (laser-assisted in situ keratomileusis)
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Are ophthalmologists required to have a special qualification to perform LASIK (laser-assisted in situ keratomileusis) eye surgery?
- After LASIK will my vision be correct for the rest of my life?
- What's the difference between LASEK, LASIK and epi-LASEK eye surgery?
Are ophthalmologists required to have a special qualification to perform LASIK (laser-assisted in situ keratomileusis) eye surgery?
At the moment, your ophthalmologist (a doctor specialising in eye health, including eye surgery) doesn't need to have a special qualification to perform LASIK eye surgery. However, it's recommended that ophthalmologists have additional specialist training in this area.
Explanation
Although there isn't a legal requirement for ophthalmologists to hold a specific qualification to perform LASIK eye surgery, the Royal College of Ophthalmologists does recommend that surgeons performing LASIK should be fully trained ophthalmologists and that they should have taken some additional specialist training in LASIK eye surgery. They are also legally required to be registered with the General Medical Council (GMC).
Some surgeons will also be NHS consultants in ophthalmology. This means that they have completed at least eight years of training and have experience of a wide range of eye diseases as well as experience of eye surgery.
Information on the qualifications and experience that your surgeon has should be on display in his or her office. If it isn't, you can ask to see it.
The Royal College of Ophthalmologists is aiming to introduce a certificate in laser eye surgery that all surgeons carrying out this type of procedure will need to have in order to perform this type of surgery.
Further information
- Royal College of Ophthalmologists
www.rcophth.ac.uk - The Eyecare Trust
www.eye-care.org.uk
Sources
- A patients' guide to excimer laser refractive surgery. Royal College of Ophthalmologists. 2006. www.rcophth.ac.uk
After LASIK will my vision be correct for the rest of my life?
LASIK surgery has been used to treat many thousands of people successfully. The amount of improvement in your eyesight depends on how well your eyes heal - it can't be absolutely guaranteed. If your operation doesn't achieve the result you hoped for, you may need further LASIK treatment.
LASIK can't correct natural age-related long-sightedness, which will develop as you get older, as this is related to weakening of the lens of the eye rather than the shape of the cornea.
Explanation
Short-sightedness (myopia), long-sightedness (hyperopia) and an irregular-shaped cornea (astigmatism) are all eye conditions that can be corrected by LASIK (laser-assisted in-situ keratomileusis) eye surgery.
If you wear glasses or contact lenses, the strength of the corrective lens you need to correct your eye condition will have been worked out for you by your optometrist. The strength of the corrective lens is measured in units called dioptres (D). Mild myopia is from 0.5 to 3.0D and average myopia is 3.0 to 6.0D.
The National Institute for Health and Clinical Excellence (NICE) is an organisation that provides guidance on whether different medical procedures are safe and work well. NICE looked at the results from studies including thousands of people who had LASIK eye surgery. The evidence showed that 77 out of every 100 people treated for myopia or astigmatism were within 0.5D of the intended correction after treatment, and that 91 out of every 100 people were within 1.0D of the intended correction.
NICE hasn't reported the results of any studies on people who had LASIK eye surgery to treat long-sightedness.
The amount your eyesight improves will vary and you might get a little over or under the correction you were expecting. Some people will have to have further LASIK treatment, but others may need to wear glasses or contact lenses for some tasks, such as reading.
Near-focus (presbyopia) is the condition that usually occurs when you reach your early- to mid-forties and is when you have difficulty reading without glasses. A younger person with short-sightedness treated with LASIK will effectively become "normal sighted" for reading, but will usually need glasses to read when they reach 40 to 45 years of age. This age-related condition can't be treated with LASIK eye surgery.
If you would like more information on whether LASIK is a suitable treatment for you, or if there are any alternatives, see your surgeon for advice.
Further information
- National Institute for Health and Clinical Excellence (NICE)
www.nice.org.uk - Royal College of Ophthalmologists
www.rcophth.ac.uk - The Eyecare Trust
www.eye-care.org.uk
Sources
- High degree myopia. Royal National Institute of Blind People. www.rnib.org.uk, accessed 29 February 2008
- Photorefractive (laser) surgery for the correction of refractive errors. National Institute for Health and Clinical Excellence (NICE), 2006, Interventional Procedure Guidance 164. www.nice.org.uk
- A patients' guide to excimer laser refractive surgery. Royal College of Ophthalmologists. 2006. www.rcophth.ac.uk
What's the difference between LASEK, LASIK and epi-LASEK eye surgery?
LASEK (laser subepithelial keratomileusis), LASIK (laser-assisted in situ keratomileusis) and epi-LASIK (epikeratome laser-assisted in-situ keratomileusis) are all techniques that use a special laser called an excimer laser. Your ophthalmologist (a doctor specialising in eye health, including eye surgery) will advise you on which procedure is most suitable for you.
Explanation
Your eye bends (refracts) light rays and focuses them to create a clear image on your retina at the back of your eye.
Light enters your eye through a curved clear window called the cornea, which is normally perfectly dome-shaped. When it's out of shape, the light bends at the wrong angle so that the image isn't focused properly on the retina. This results in blurred vision.
Glasses and contact lenses refract the light before it enters the eye, helping the eye to focus objects sharply.
Laser eye surgery is a technique that changes the shape of your cornea using a special laser called an excimer laser.
LASEK uses a diluted solution of alcohol to loosen the surface of your cornea, which is then lifted out of the way, giving enough space for the laser to have access. A special soft contact lens is then worn for three to four days to allow the surface of your cornea to heal.
There are two types of LASIK surgery. Conventional LASIK uses an instrument called a microkeratome to cut a flap in the surface of your cornea, whereas all-laser or 'bladeless' LASIK uses a type of laser called a femtosecond pulse laser to cut a corneal flap.
Wavefront LASIK is an alternative to conventional LASIK treatment. Wavefront precisely tailors the laser treatment according to each eye's ability to focus, rather than using averaged measurements.
Epi-LASIK is a new procedure where the thin, protective outer layer of cells (epithelium) is softened with alcohol and folded aside using an epikeratome, which separates the layers rather than using a microkeratome, which cuts the cornea. The excimer laser beam is then applied under the epithelial flap.
The shape of your eye, how short- or long-sighted you are and also the thickness of your cornea, may affect which type of procedure is recommended for you.
To find out which type of laser eye surgery is most suitable for you, ask your ophthalmologist to explain each type to you.
Further information
- Royal College of Ophthalmologists
www.rcophth.ac.uk - The Eyecare Trust
www.eye-care.org.uk
Sources
- LASIK eye surgery. U.S. Food and Drug Administration. www.fda.gov, accessed 27 February 2008
- Photorefractive (laser) surgery for the correction of refractive errors. National Institute of Health and Clinical Excellence (NICE), 2006. Interventional Procedure Guidance 164. www.nice.org.uk
- A patients' guide to excimer laser refractive surgery. Royal College of Ophthalmologists. 2006. www.rcophth.ac.uk
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: April 2009
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