Comments on: How Much Should You Pay for LASIK?

By: Dave Allamby

Dave Allamby — Sun, 26 Apr 2009 21:36:34 +0000

Hi Kent
Sorry for the delay, thought I had replied already. Best to come along for a consultation and see me personally for a specialist exam. If you call on 0845 5000 500 and say we have discussed this as a Focus specialist case, they can book you in. The fee for that is £170 – it wouldn’t be suitable for a routine consult with an optometrist.
Best regards
Dave

By: Kent Claxton

Kent Claxton — Tue, 21 Apr 2009 15:11:10 +0000

Thanks for the response Dave,

The prices appear good however the question is should I contact your clinic for consultation appointment?

Given that Optical Express said yes and Ultralase said no to my right eye, and both gave me different procedures for my left eye your answer certainly has the first hint of not a factory line answer.

I fully understand my situation is not standard and thus if you are willing to proceed further please do let me know who to contact and if to quote our discussion.

Many thanks

Kent

By: Dave Allamby

Dave Allamby — Wed, 15 Apr 2009 15:45:04 +0000

Hi Kent
Interesting mail, thank you. You are fortunate actually that your RK operated right eye remains shortsighted and has not become long-sighted as many of them do long term after RK. It may be possible to leave this right eye for some reading as Ultralase said, but the astigmatism may well get in the way of that. You seem to be naturally left eye dominant, which helps with the combination of left eye for distance and right for reading. We would also need to look at the degree of aberrations in the right eye though, as to whether that eye could be left for reading.
Treating the left eye for distance is probably straight forward with wavefront blade free LASIK, what we call Z-LASIK, and the cost would be £1345 based on your numbers.
Treating the right eye can be more complex, as RK eyes are not structurally stable as a virgin eye. It may need a custom treatment, either based on wavefront or topography measurements, and is best done through PRK (surface) laser correction, avoiding yet another cut in this cornea from a LASIK approach, which can weaken the cornea further. If I was to tackle the right eye, I would charge £2,300 as a complex case, and it may require two procedures to get the best result.
Best regards
Dave

By: Kent Claxton

Kent Claxton — Wed, 15 Apr 2009 12:31:18 +0000

Hi Dave,

Have read most of posts, the Denise Van Outen story as well as the link to the procedure done Paul Ross. First let me say that your openness and candidness is very much appreciated in an industry that perhaps has many grey areas.

I am in need of some advice from some one that has your expertise.

I had RK done on my right eye back in 1990 and got okay results but not what is being achieved with current technology. It was done by a Dr. Marvin Kwitko in Montreal Canada who was one of the pioneers in Canada in those days.

My prescription for glasses is
Left Eye -5.5/-1.0 axis 75
right eye -0.5/-1.5 axis 125

I am 42 years old and eyes seem in good health but I am using my left eye as the dominant one when I have glasses or contacts on and the right eye when not wearing anything.

I went to Optical Express 2-3 months ago and they did their consultation, not with the consultant, but an optometrist and they said they would be happy to go ahead with wavefront lasek on both eyes at a charge of £1295 per eye.

I felt I needed another opinion so I went along for a second opinion to Ultralase last week and they also did a consultation and mentioned that they would not do the right eye. The optometrist felt that as the sight was not so bad in the right eye it would be useful to have this as I got older and furthermore they felt their eye surgeons did not have the necessary expertise to look at this situation. They however said they would do the ultra lasik and intralase on the left eye at a cost of £1995. I must say I was disappointed with the level of discussion in their consultation given the fee they were looking to charge.

I accept it would be very hard for you to make a decision without examination and as I am yet to see a consultant at the two aformentioned places, can you work on eyes that have previously had RK?

I plan to give your clinic a call but thought to send you this post to hear your thoughts.

Best regards

Kent

By: Kirsty

Kirsty — Wed, 25 Mar 2009 11:35:43 +0000

Hi Dave

Thanks for your advice. I’ll go out and buy some flaxseed capsules today. And the infection they believe was an irritation/sensitivity to a new brand of contacts which I trialled. So hopefully we are fine on that front.

Regards
Kirsty

By: Dave Allamby

Dave Allamby — Tue, 24 Mar 2009 17:52:18 +0000

Hi Kirsty
We would need to check your dryness and measure it. You can take flaxseed oil capsules which often help (4 grams daily starting 6 weeks before your consultation/surgery). Having the infection previously is no problem unless it was diagnosed as herpes virus.
Best regards
Dave

By: Dave Allamby

Dave Allamby — Tue, 24 Mar 2009 17:49:06 +0000

hi Sam
You could use Optrex Infected Eyes, three times a day for 5 days to be on the safe side. The conjunctivitis may well be viral and the drops won’t be any help but no harm done. Use separate towels and face cloths for your child and regular had washing. If you do contract it we will postpone your surgery for 1 month.
Best regards
Dave

By: Dave Allamby

Dave Allamby — Tue, 24 Mar 2009 11:32:47 +0000

Hi Phil
The price would be the same for the left eye and £1245 for the right.
The reasons behind why clinics buy a certain laser are mixed and not always straightforward – pre-existing affiliations and preferences, financial considerations, contracts, discounts as well as clinical performance. For NASA, I could never see the American Space Agency promoting anything else than the American laser – the other brands are German and Japanese, despite the WaveLight laser (which we use) getting the overall best results in the American FDA trials.
We enhance the result depending on both patient happiness and expectations and the likelihood of being able to improve the vision, and it’s a decision we take together with the patient. Of course, it is based on the reason why the vision isnt optimum.
I like GP wearing patients to switch over to daily disposable lenses where possible and use those for 4 weeks as needed with no GP use. You would then leave out the daily lenses for 5 days prior to the consultation and 48 hours before treatment. If leaving them out isnt possible prior to the consult, you could have that exam anyway and then leave them our for 5 days prior to the treatment, but we would need to remeasure all prior to treatment on the day itself – generally though I like to get all the info up front so there are no surprises on the treatment day, when the patient is usually a bit anxious anyway!
Hope that answers all your questions
Dave

By: Sam Fiorani

Sam Fiorani — Tue, 24 Mar 2009 11:22:20 +0000

Hi David,
I am scheduled to see you on 8 April to have Z-Lasik on both eyes. One of my children has just got conjunctivitis, so far it looks like I’m fine, but I was thinking of using over the counter antibiotic drops for a few days (to make 100% sure I don’t have it). On the other hand, I’m not sure this approach is the right one being, as I am just a couple of weeks away from the procedure. What is your advice please?
Thanks very much for your help,
Sam

By: Phil Levin

Phil Levin — Mon, 23 Mar 2009 21:48:39 +0000

Hi Dave,

Thanks for that. I’ve just been to OE for a consultation and they examined my eyes.

It turns out my prescription may well have changed since last year but I still wear GP lenses once a week so not too sure how accurate it is. Anyway they quoted just under £3000 (both eyes) for this prescription:

(L) Sph -3.5 Cyl -0.50 Axis 90
(R) Sph -4 Cyl -0.25 Axis 95

Would it still be £1145 per eye for this prescription?

I couldn’t help feeling that I was just getting processed at OE and that they weren’t all that fussed whether I got my treatment done there or not. Also they rather rushed though their success rate stats. I couldn’t help thinking it might be because they know they don’t have the best laser but I’m in no position to judge.

They did make sure to mention that Moorfields use the same laser and that it’s endorsed by NASA. Why wouldn’t Moorfields use the very best laser?

What would happen if my post-treatment vision ended up being not as sharp as I’d hoped (compared with the decent clarity I get now with GP lenses), despite being told that I now had 20/20 vision?

Do you generally only perform further surgery if you don’t get to 20/20 first time round or due to other complications rather than because the customer isn’t entirely convinced about the clarity of their “new” eyesight?

As I wear my GP lenses once a week for about three hours a week for football, how long before consultation/surgery with Focus should I definitely stop wearing them? Could I use daily/monthly disposable soft lenses in the run up to the consultation/surgery without affecting the result?

Looking forward to arranging my consultation with you soon.

Many thanks and regards,
Phil

By: Dave Allamby

Dave Allamby — Sun, 22 Mar 2009 13:22:48 +0000

Hi Phil, no problem!
Minimum time from consult to treatment is one day; no real maximum but we have to repeat all measurements if more than 3 months.
Yes, all customers can apply for interest-free credit
We see a return to myopia in 1-2% of cases overall, which will in fact help your reading as you move to presbyopia so it isnt necessarily a big problem. The London study showed regression in only 1-2% over 16 years. Interestingly, we are seeing myopia progressing in recent years due to the great increase in near work we all do these days, esp working with monitors. So myopia is not as stable as in years previously so we cannot assume now that the eyes will not themselves change, depending on our lifestyle and work habits. We have to tease out then between true LASIK/PRK regression, which can occur, against myopia progression which is getting more common. Of course, both events could occur together. Fortunately, enhancements are relatively straight forward but may not be needed – a patient entering presbyopia with a prescription of -0.50D in each eye will be very happy and remain glasses free for several years more than their normal sighted friends (but may sometimes need glasses in the car for night driving).
Hope that helps
Dave

By: Phil Levin

Phil Levin — Sun, 22 Mar 2009 13:02:53 +0000

Hi Dave,

Thanks for getting back to me so fast.

I’ve just got a couple more questions if I may…

What’s the minimum/maximum amount of time in between the consultation and surgery?

Does your 10 month interest-free credit offer apply to all customers (subject to status)?

I appreciate that I’ll probably need reading glasses when I’m older, but is it likely that the laser treatment will cure my myopia for literally decades to come or could I start getting more short-sighted again? From what I can tell my prescription has been pretty stable in recent years.

Many thanks and regards,
Phil

By: Dave Allamby

Dave Allamby — Sun, 22 Mar 2009 12:34:58 +0000

hi Phil
It would be £1145 for that prescription for blade free Z-LASIK.
Best regards
Dave

By: Phil Levin

Phil Levin — Sun, 22 Mar 2009 12:31:02 +0000

Hi,

Could you please give me an idea how much I could expect to pay for Z-LASIK treatment? I’m 33.

Here’s my prescription (3/4/08):

(L) Sph -3.25 Cyl -0.50 Axis 90
(R) Sph -3.50 Cyl -0.25 Axis 95

Many thanks in advance.
Phil

By: Dave Allamby

Dave Allamby — Tue, 17 Mar 2009 18:48:32 +0000

Hello Les
We are usually cautious in patients with glaucoma and needs liaison with your consultant. The general issue for someone in late 70s is whether there is any cataract. Removing any cataract and using the right approach would lessen most of that astigmatism anyway and clear the distance vision. Or have you already had cataracts removed?
Regards
Dave