The College of Optometrists

In recent years a number of surgical techniques have been used to correct eyesight and reduce the need for glasses. Most often the surgery involves re-shaping the cornea - the transparent surface at the front of the eye – using a type of laser known as an excimer laser. Different techniques are used to correct short sight (myopia), long sight (hypermetropia) and astigmatism.

 

The Royal College of Ophthalmologists (RCO) recommends that doctors carrying out the surgery should be fully trained ophthalmologists and have additional specialist training in refractive surgery. It publishes a detailed ‘Patients’ Guide to Excimer Laser Refractive Surgery’ as well as advice on other refractive surgery techniques.

 

The guide explains the types of surgery available, the indications and contraindications, what happens during the surgery, results and complications. It also includes guidelines on how to choose a surgeon and the recommended procedures that surgeons should follow.

 

There is now a wide range of techniques available. The most common are: 

LASIK has been performed since the mid 1990s and is the commonest procedure currently offered in the UK. Most types of refractive error can be corrected with LASIK but it may not be suitable for correcting high prescriptions. A cut is made across the cornea and a flap of tissue is raised. The exposed surface is then re-shaped using the excimer laser and the flap is replaced.

 

PRK has been performed since the late 1980s but since the development of LASIK and LASEK is now mainly used for correcting low prescriptions. The cornea re-shaped by the excimer laser without cutting a flap.

LASEK is similar to PRK but the surface layer (epithelium) of the cornea is retained as a flap. Retaining the epithelium is thought to prevent complications and speed up healing. 

Wavefront-guided LASIK is a technique used to reduce the natural irregularities (aberrations) of the eye that can cause light rays to focus incorrectly and improve the visual result of the surgery.

Other techniques are described in the RCO’s guide and public information.

 

Your optometrist will discuss the various methods of correcting your vision and the advantages and disadvantages of spectacles, contact lenses and refractive surgery.