Laser Eye Surgery - Separating The Fact From The Fiction

Since becoming a more frequent procedure in recent years, a number of misconceptions have arisen about laser eye surgery.

From its development in 1987, the pioneering surgery has become commonplace, with over 35 million procedures having been carried out worldwide. However, the surgery has also fallen subject to misinformation, with fiction circulating online and amongst friends that can be off-putting for people considering the operation. However, it’s important to note that the vast majority of this misinformation can and has been debunked by medical professionals, and the fact remains that laser eye surgery is one of the most common, successful and safe procedures in the world.

Here, Mr Alexander Ionides, Consultant Ophthalmologist at Moorfields Eye Hospital, separates the facts from the fiction, and gives us the truth about laser eye surgery:


Video Transcript

1: I Can’t Blink or Move During Surgery

"There’s no need to blink because there’s a lid guard that holds the eye open. That sounds like a form of torture but it’s not because you have numbing drops so the desire to blink is gone, you don’t want to blink and you’re quite happy with that lid guard keeping your eye open. The idea that you’re held down is not at all true, you’re just lying down on a bed. Some places will have a pillow with kind of a dimple in it that helps to support your head a little bit, but if you did want to get away and run away you’re not confined or restrained alas in anyway whatsoever, so you can get up and run away.

The laser is following your eye movements though, so it will follow your eye movements. If you make a big eye movement and get up and run down the stairs, it won’t chase you out into the street, it will just stop and then when you’re back lying down again the laser will pick up where it left off to complete the treatment.

2: It Only Lasts for a Few Years and Then You’re Back in Glasses

For shortsighted treatments, they are more stable and that is on the whole not true. Sometimes people say “how long is going to last for, will it last forever?” It tends to be if we were to take 100 people with your age and your prescription and not laser them but follow them for 5, 10, 20 years, we’d find that a reasonable minority, maybe 15 or 20% instead of being minus four, for example, might be minus five, five and a half in 10, 20 years time.

All we can do is look for stability beforehand and hope that you’re in the 80% or so that remains stable, but a small percentage of people will carry on getting a little bit shortsighted and the laser treatment doesn’t stop that gradual progression, it just treats the shortsightedness up to that age of treatment. So on the whole for shortsighted treatments, no—it will last, but for longsighted treatments, they are less stable for the other reasons about the eye and the aging of the eye, they are more likely to become longsighted once more. So for those treatments they can be back in glasses after, sometimes after a year or two. As long as they know that beforehand then they’re not misguided, there are no surprises there.

3: I will Smell My Eyes Burning

It’s not burning, the excimer laser oblates and reshapes the cornea, it takes apart the molecules that are made up of carbon, hydrogen, and oxygen, which is what we humans are largely made up of and disperses those atoms into the air, and if the carbon atoms go into the nostrils and you smell them, you think oh barbecue, something’s burning but it isn’t, you’re just aware of the carbon atoms in the atmosphere.

It isn’t actually burning because the laser doesn’t burn in that sense, not like a James Bond film where in Goldfinger the laser is burning its way through the table to get closer and closer to Bond. That’s a thermal burning, excimer laser does not burn.

If you have a small short treatment you probably won’t smell it but the longer treatments, minus four, five, six, seven, they are more likely to smell it because it builds up more of a cloud, even though the cloud is continually being removed by a vacuum.

You don’t smell burning because there is no burning, but what you do smell is the carbon in the atmosphere."

Mr Alexander Ionides, Consultant Ophthalmologist at Moorfields Eye Hospital


If It Goes Wrong, Laser Surgery Will Leave Me Blind

Blindness caused by laser vision correction is all but impossible. Laser eye surgery is in fact an incredibly safe procedure, with complications arising in less than 5% of cases. In fact, medical professionals estimate that there is a 0.1% chance of having a minor visual complication, and even if this should be the case, expert surgeons can normally correct this quickly. While any surgical procedure carries an element of risk, it’s important to note that laser eye correction is among the safest procedures you can undertake, and that the chances of losing vision as a result of it are roughly 1 in 5 million.

Laser Eye Correction Is A Painful Surgery

Laser eye surgery will not be painful to undergo. You will be given numbing drops ahead of your surgery, so in fact patients report feeling nothing at all! It is common for some patients to encounter “dry eye” following the surgery, which is completely normal as the laser depletes the amount of natural lubrication in the eye. This can be treated with a course of prescription eye drops.

I Will Be Faced With A Long Recovery Time

Especially for prospective patients with full-time jobs, children and other responsibilities, the idea of being off their feet with compromised vision simply isn’t feasible. However, the recovery period for laser eye surgery is incredibly quick; in fact, most patients report vision returning to normal within 24 hours, and are able to resume full activities within a week.

I’m “Too Old” For Laser Eye Surgery

In the UK, you have to be 21 years old or over to have laser eye surgery, however, there is no “upper limit” when it comes to age. As long as the eyes are healthy (and not affected by any age-related eye diseases such as glaucoma or Cataracts), there is no reason older patients cannot undergo the procedure with success.

The Laser Will Feel Hot And “Burn” My Eyes

One very common misconception is that the laser used during the surgery will cause a burning “smell” in the room, and will feel hot during the procedure. Vision corrective surgery is most commonly carried out using an excimer laser, which unlike a thermal laser does not emit heat or burn the eyes whatsoever. This laser actually emits a cool beam of ultraviolet light that is so precise it can split collagen molecules, which releases carbon atoms. Patients who describe smelling “burning” therefore smell this carbon in the atmosphere, but can rest assured there is no burning happening as these lasers do not burn.

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Laser Eye Surgery Doesn’t Yield Permanent Results

facts about laser eye surgery

The permanence or longevity of laser eye treatment is often a major factor when deciding whether or not to go ahead with it. The simple answer is that once the laser has changed your cornea, this change is in fact permanent. However, like the rest of our organs, your eyes change and alter over time. If your vision worsens as a result of your aging eyes, laser eye surgery can be used for further correction.

I Won’t Be Able To Blink, Sneeze Or Move During My Surgery

For many people, the idea of being constrained during a surgical procedure is enough to induce panic, but this is not the case with laser eye surgery. Patients are not held down or confined in any way, and most surgeries will help you feel as comfortable as possible. Lid-guards will hold the eye open, and the numbing drops will negate your desire to blink. If you need to itch, sneeze or move in any way, you can just say so and the surgeon will wait until you’re comfortable. Laser eye surgery only takes between five-ten minutes per eye, so you do not have to sit still for long!

You Can’t Have Cataract Surgery After Laser Eye Correction

Age-related cataracts are incredibly common, and it is perfectly ok to have surgery to remove these after you have had laser eye surgery. Similarly, if you’ve already had cataracts removed, you can still have your vision corrected with laser treatment.

Laser Eye Surgery Won’t Work For People With Glasses

Advances in technology allow for the correction of many different vision issues, such as short-sightedness (myopia) long-sightedness (hyperopia), and astigmatism. This eliminates the need for the patient to wear glasses or contact lenses while enjoying improvements to the vision after just one day.

There Could Be Unknown Consequences Of Corrective Laser Eye Surgery

Laser eye surgery is by no means a new treatment, having been around for more than 25 years. The procedure has been refined, perfected and moved forward by technology, but it is a tried and trusted technique that has improved the vision of millions of people worldwide. There has been no evidence to suggest there are any long-term negative effects as a result of the laser treatment; in 2005, research from the National Institute for Clinical Excellence revealed that academics and surgeons were in agreement that there were no concerns regarding the long term safety of laser vision surgery.

As always, doing your due diligence and selecting the right eye surgeon is crucial to the success of your laser eye surgery.

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