David Garty Consultant Ophthalmic Surgeon
Graduating in 1978, David Garty earned a first class honours degree in Optometry from Glasgow Caledonian University. Following this, and his pre-registration training at Moorfields eye Hospital in 1979, Garty studied Medicine at University College London.
Throughout his educational career, Garty has accumulated a number of academic awards and achievements. He has received the Colebrook and Porter Prizes, Master's Prize, J. Stephen Dawson Memorial Award and the Sir Stewart Duke-Elder Prize.
David Garty is a member of a number of professional and historical societies. In 1988, he became a Fellow of The Royal College of Surgeons and The Royal College of Ophthalmologists. Less than a decade later he was made a member of The Royal Institution, the most famous scientific institution in the UK. Just some of the other titles and memberships Garty has held include President of The British Society for refractive Surgery, member of the European Society of Cataract and Refractive Surgeons and member of the American Society of Cataract and Refractive Surgeons.
Another notable achievement was the UK's first laser eye surgery procedure, performed by David Garty in 1989.
David Garty is currently a Consultant Ophthalmic Surgeon and former Refractive Service Director at the Moorfields Eye Hospital in London. Additionally, he holds the title of Honorary Visiting Professor at City University, London and Caledonian University, Glasgow. Garty also serves as an examiner and advisor for the Royal College of Ophthalmologists.
Areas Of Expertise
Given his academic and professional record, David Garty's areas of research interests and expertise are wide ranging. To date, he has produced over 40 scientific papers. Notable examples of his interests include laser refractive surgery, cataract surgery, corneal graft surgery and lens implant surgery.
Having carried out approximately 18,000 procedures to date, David Garty has a wealth of experience in various laser eye surgery techniques such as LASIK and LASEK.
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Laser Eye Surgery And Treatments Offered
Founded in the 1980s, the first UK excimer laser refractive procedure was performed by David Gartry in November 1989 at St. Thomas’ Hospital. The technique done by David Gartry is a technique named PRK (photo-refractive keratectomy).
PRK was succeeded by LASIK (laser-assisted in-situ keratomileusis), in the mid-1990s, as the main procedure of choice. Recent developments and technological advancements have taken the technique further still with wavefront guided LASIK as the default treatment method now, largely due to the speedy recovery time. LASIK uses the IntralLase iFS femtosecond laser to create the corneal flap with a high level of safety and precision. Then, the excimer laser is employed to reshape the cornea and correct the overall vision of the patient. LASIK is a more popular treatment than LASEK, but the LASEK treatment could be argued to be less invasive as no flap is created and is the preferential treatment for those involved in physical contact professions (such as police, contact sports or mixed martial arts).
LASEK is often thought of as a middle point between PRK and LASIK, however, it is considerably more uncomfortable than LASIK in the first week after treatment. Patients are advised to take one full week off work and avoid driving during this time, as visual recovery is slower than that associated with LASIK procedures. LASEK is a variant of PRK, but instead of scraping away the protective epithelial layer, a solution of alcohol is applied to the eye. This softens the epithelium, and consequently it can be moved aside so that the cornea can be re-shaped with the laser. A soft ‘bandage’ contact lens is applied to safeguard the corneal surface, regardless of whether the epithelial cells are replaced, and this lens is removed five or six days later.
Am I Suitable For Laser Eye Surgery?
A number of factors, such as your corneal thickness and your prescription, will determine whether LASIK or LASEK will be best for you. This will be assessed at your initial consultation.
At this consultation, a number of routine eye tests will be carried out. Many of these may already be familiar to you, whilst others are more specific to the refractive surgery assessment process. For instance, your surgeon will perform a wavefront scan of your eyes in most cases. The wavefront scanner will detect if there are any tiny imperfections or aberrations in the eye, and locate precisely where they are. It is these aberrations that lead to defect and distortions in vision when combined with short sight, long sight and astigmatism.
The consultation will also include a discussion of what you would like the procedure to achieve, your expectations, the potential risks and the benefits. Here, and throughout the whole process, you can ask your surgeon questions to make sure that the most appropriate treatment is chosen for you.
What Should I Expect With Laser Eye Surgery?
If you are planning to proceed with treatment, please read the following information carefully before your consultation.
On the day
It is standard practice to treat both eyes on the same day with laser eye surgery, and this is known as a bilateral simultaneous treatment. Before the day of treatment and the day itself, there are certain things that you can expect and are expected of you. These are the following:
- Please leave contact lenses out for 24 hours before surgery.
- Remove all traces of eye make-up, aftershave or perfume on the day of the surgery. Please note that eye make-up is not permitted for one week afterwards, but you may have your eyelashes tinted before surgery and wear other make-up post treatment.
- Allow approximately one hour for your appointment.
- Arrange to be picked up after your procedure, as you will be unable to drive. It is recommended you avoid taking public transport home to reduce the risk of dust entering the eyes.
- Bring a pair of dark sunglasses to wear after the treatment. Your vision will be slightly blurred, but you will be able to get around well enough. The sunglasses will also protect your eyes from dust and grit on your way home.
The procedure takes only 15-20 minutes for both eyes and is conducted in a sterile operating theatre – it is well conditioned, filtered, sterile and under positive pressure. You will be taken through the various steps by your surgeon and will not be required to stay overnight.
The main steps of the treatment are as follows:
- To ensure that you are comfortable, local anaesthetic eye-drops are instilled and work almost immediately. This also reduces the tendency to blink during the procedure.
- You will lie on a reclining couch underneath the laser with fully-trained ophthalmic nurses there to assist you at the surgery.
- For those having LASEK treatment, a diluted solution of alcohol is applied to the surface of each eye to soften the protective outer layer known as the epithelium.
- If you are having LASIK treatment, you will lie underneath the femtosecond laser that operates silently and the corneal flaps will be created for both eyes. It is normal for vision to be blurred at this point and for you to feel a dull ache in the eye, but this only lasts 20 seconds per eye.
- The excimer laser is then used to re-shape the cornea and to treat either your short sight, long sight or astigmatism. The eyelids and eyelashes are covered with strips of soft sterile plastic and the second eye is patched to prevent distractions whilst the first eye is being treated.
- Following this, you will be asked to stare at a bright red flashing light. You should try to blink normally and to not try to close your second eye deliberately. So as not to worry about blinking during the procedure, a special instrument is placed between the upper and lower lids to keep the first eye apart.
- For LASIK patients, the flap is lifted and you will be asked to concentrate again on a flashing red light. For LASEK, the softened epithelium will be gently folded aside and you will also be asked to look at the flashing red light.
- Whilst operating the laser makes a repetitive tapping sound, but this only lasts for 30 seconds on average depending on the strength of the prescription treated.
- Then the LASIK flap or LASEK epithelium is repositioned.
- Finally, there is a period of approximately one minute in which the flap/epithelium settles back into place. Once this is done, you will be asked to continue to stare at the red light.
Following treatment, your vision will be blurred for a few hours, and sunglasses should be worn after this point. Plastic goggles will be supplied to you and should be worn whenever sleeping for the first week. The sunglasses and goggles ensure that you are unable to accidentally rub or knock your eyes while asleep, and reduce the risk of dirt getting into your eyes.
Your surgeon will give you a detailed list of aftercare instructions that include guidance regarding how to use the standard eye drops in the first week, along with how to take the reduced dosage required in the two to four weeks following your procedure to ensure the optimum results. The recovery process varies from patient to patient and also between the eyes themselves, which is completely normal. Biological variability makes it difficult to predict the exact nature of your recovery with accuracy, but your surgeon will be able to tell you what can be expected. If there is a planned delay before treating the second eye, then an optical imbalance called anisometropia can result, and wearing glasses may be difficult. This is why most LASIK surgeons like to treat both eyes on the same day.
After LASIK treatment, a slight pricking or ‘foreign body’ sensation can occur, along with watering of the eyes for the first few hours following the procedure. All of this is perfectly normal. The eyes might be slightly inflamed, but the redness should disappear completely within a few weeks. It is important to remember that recovery from the LASEK treatment is more uncomfortable and eyes tend to sting and water for two to three days after treatment.
Visual clarity with the LASIK procedure is quick, with vision improving a few hours and achieved in the same evening. The vast majority of patients achieve near to their best potential clarity the next day, and within one to two weeks have clear vision. It is important to remember that for some it can take up to three months to gain the best optical quality post treatment.
With LASEK treatment, visual clarity takes longer and it is recommended to take one week off work during this time to allow for a full recovery. You should also avoid driving a vehicle during this time. For those patients in their mid-40s onwards with a successful correction of short sight, they will need to wear reading glasses as the lens within the human eye loses elasticity with age, resulting in presbyopia.
A follow-up examination is performed within 48 hours post treatment to confirm that everything is well. Laser eye surgery, like all other types of surgery, is not predictable and it is important to have realistic expectations from the outset.