I had this interesting question recently from Kevin:

Hi Doctor, Would you please advise if “zlasik” is still better and newer technology compared to “ilasik with iFS Advanced Femtosecond Laser”?  Thanks

Hi Kevin, I prefer the Ziemer system (Z-LASIK). We have the brand new Ziemer LDV Crystal Line system, currently the only one in the UK, and it is a remarkable flap creation tool. It has a 33 times faster repetition rate than the latest iFS 150KHz model, with energy per pulse far lower, tighter energy focus and the shortest suction-on time. We can do both eyes safely and very accurately in around 6 minutes.

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The choices can seem bewildering! You want to have laser eye treatment e.g LASIK and now you need to choose the clinic for your surgery.

But which one?

There are over 100 clinics in the UK, although 75% of those are made up of only three large business laser chains: Optical Express, Optimax and Ultralase. The other 25% are mainly owned by doctors and optometrists, who practice from their centres.

80% of UK centres have adopted the advanced blade-free femtosecond lasers, and so now offer blade-free LASIK (a.k.a all-laser LASIK, Intralase, Z-LASIK). These include:  FOCUS Laser Vision , Optimax, Optical Express, Ultralase, Moorfields Eye Hospital and Centre for Sight.

20% of UK centres have not yet invested in this technology, and only offer bladed LASIK, where a device containing a short blade is used to cut the LASIK flap. These centres include Advance VisionCare and Accuvision in London

Having your laser eye treatment with a blade free femtosecond method has rapidly become the standard of care for UK LASIK laser eye surgery.

WHENEVER a patient undergoes any type of surgical treatment there is a possibility for a complication. The main questions are: are these complications serious and could affect the final outcome – or minor and short lived and which do not affect the ultimate vision? Also, what are the chances of a complication occurring that would require adjustment or follow-up correction?

LASIK surgery is no different from any other operation, despite how it may be pitched by some clinics, in that it IS a surgical correction and should be approached as such. However, and fortunately, most complications are in fact minor and easily resolved.

Technology

LASIK risk continues to drop as doctors and engineers perfect the equipment used in the treatment. Advances in technology have made a big part of the difference here so make sure you are getting that latest equipment and not an older fashioned approach.

The risks drop as doctors continue to screen for the right candidates to have the procedure, and screen out those with any chance to have a problem. Research also shows that with the right pre-testing and surgical handling, the risk of complications in LASIK surgery is less than 1% and most of these are minor problems which will be fully corrected afterwards without undue ongoing problems.

The most common risk with LASIK surgery is a complication with the flap, created by the surgeon in the first part of the procedure.

In the original LASIK procedure, the flap is cut by a surgical blade device known as a microkeratome. The blade cut is, however, less precise than those from newer femtosecond lasers.

Blade Free LASIK

LASIK risk is reduced by the newer “bladeless” dual laser technique.

In bladeless (blade free) LASIK surgery, the risk of complications is lower because the blade or microkeratome is no longer used. It is replaced by special type of infra-red laser that greatly reduces human or machine error.

The original laser to make a LASIK flap came from the USA, manufactured by Intralase. You may see this surgery called IntraLASIK or iLASIK.

The newer machine is from Switzerland and produced by the Ziemer Group of companies. There appear to be some advantages of the tighter focus of the Swiss laser. This procedure may be called Z-LASIK.

Summary

When assessing these LASIK risks it is recommended that when you are considering surgery that you ask your doctor what technology the clinic has and whether or not a blade free dual laser approach will be used.

Here is Part 2 of the Essential UK Guide to Laser Eye Surgery slideshows. It covers how to read your prescription and know what all the numbers mean.

This is really useful to know for when you call up a clinic to find out if you are suitable for LASIK or PRK laser eye surgery, they will ask you for your prescription. They can also tell you what the maximum prescription treatable limit is, so you will know if you are within the range or not.

You can see it here:

Essential UK Guide to Laser Eye Surgery Part 2 – Reading Your Prescription

[tags]clinic, guide, laser eye surgery, LASIK, London, PRK, UK [/tags]

There are FOUR key points to look at when choosing a clinic:

1. The laser technology
2. The surgeon
3. The clinic
4. The price

Let’s look at these in more detail:

1. Laser technology
The improvements in success rates and safety of laser eye surgery, including LASIK and PRK, have been mainly down to improvements in sophistication of the laser technology. The lasers are dramatically better than they were even a few years ago.
NOTE: not all lasers are made equal, so you MUST look at clinical results to get accurate performance information.

Focus’ data are available on the results page of the Focus Laser Vision clinics website.

99.4% of patients saw 20/20 or better 6 months after Z-LASIK. 100% saw 20/25 or better.

Also note that each clinic makes a claim that they have the best technology, but this of course cannot be true. They can’t ALL have the best laser equipment, as they all have different systems. Focus Laser Vision bought the WaveLight Allegretto system from Germany as it had the best overall FDA clinical results in extensive trials.

2. Surgeon
Equally important for your result and safety is the surgeon who will perform the procedure and assess your suitability for treatment. The most important decision is who NOT to operate on. In the UK you can look for one or more of the following points in your surgeon: 1. NHS Consultant appointment, 2. Fellowship training in refractive surgery and corneal disease, 3. Extensive experience in treating your kind of prescription, 4. Has performed more than 5000 procedures, 5. Works in refractive surgery on a full-time basis or at least two days every week if involved in other areas of ophthalmology (the more time in refractive surgery, the better), 6. Teaching and presenting on refractive surgery skills, vision outcomes and research.

3. Clinic
Look at the support that each clinic will offer to you. Individual independent clinics can usually offer excellent continuity of care so you see the same clinician each time, but may not be as well geographically placed as some of the nationwide chain centres. Ask if you will get your surgeons private phone number after treatment in case of problems or advice being needed. This number is very reassuring for patients.

4. Price
Last of all, look at the price. You want the above three factors to be the best you can get first of all. If you are completely satisfied you have not compromised there, then you can look at price, but ONLY then. High price is not a guarantee of quality, of having the best laser technology, of getting the best surgeon. It may give you these things, but you have to look and make sure for yourself.

In summary, look for yourself and ask the right questions. I have more information of the FOCUS Laser Vision clinics website on this and other related topics.

I got an email this week from a Mr. John Andrews, who was confused about LASIK laser eye surgery pricing.

John wrote:

Having visited your site I am not clear what criteria you used to determine the cost of treatment. What level of myopia do you treat for £295 per eye assuming a thick cornea and no astigmatism?

And here is my reply to John:

Dear Confused

Let me clarify!

There are two pricing models in the UK. One based on prescription and the other a fixed price per treatment type. We base short sighted correction prices on prescription, in the same way that Optical Express does.

Prices for keratome based lasik start at £295 for WAVEFRONT based lasik. This covers up to 1.5D of astigmatism and up to 1D of myopia. Anyone with up to that prescription gets wavefront treatment at that price.

NOTE: You can see the £395 headline price from Optical Express and Optimax is not what you will pay at all when you want modern wavefront LASIK. Those prices are for non-wavefront treatments and you have to pay extra if you want up to date wavefront LASIK. They start at these clinics at £795 per eye.

Our prices are for wavefront based treatment with FDA confirmation that this method outperforms ALL other lasers for custom treatments (see our web site under results.)

We are cheaper than ALL other London based clinics for a range of prescriptions. Check out my blog on this topic with a graph comparison of prices for various prescriptions at various London clinics. (keratome (bladed) wavefront LASIK)

lasik-truth.com/2008/01/25/how-much-should-you-pay-for-lasik/

To clarify, if you want keratome (bladed) lasik, for the above prescription range, then it will cost £295 per eye. If you want to upgrade to a dual laser system (most , but not all, want to take the upgrade by choice) then that will be £595 per eye. This is still markedly cheaper than other London centres.

SO:
Cheaper price, NHS consultant corneal and laser fellowship trained specialist, lasers with best FDA results.

Easy choice, isn’t it??

If you still not sure, ping me a reply!

It is quite confusing for people looking at where to go for their laser eye surgery treatment. Especially so in London where there are many laser eye clinics to choose from.

In other cities you can usually find one or more of the big three chains: Optical Express, Ultralase and Optimax and these centres are probably doing about 80% of all laser eye surgery in the UK, partly because of their wide geographical footprint and so easy access for many people.

Most people really are not sure what to look for in a laser eye surgery provider. They don’t understand the difference between different laser systems and they don’t have easy access to the true performance or knowledge about individual surgeons.

So most people default to the ‘look and feel’ of the website and clinic if and when they attend for a consultation, or follow up from a word of mouth referral to a centre where someone has already had treatment.

Most of the brochures are pretty interchangeable, all making the same claims about experience, technology etc. You could swap the company name and not really notice the difference in various claims.

There are FOUR key points to look at when choosing a clinic, and these are coming tomorrow in my next blog post. Watch this space!!

Prices for laser eye surgery treatment in the UK have fallen by up to 80% for correction of short sight. However, tremendous variation between clinics means a difference in price of up to £4,000 ($8,000) for the same glasses prescription.

You can see the press release article on the fall in LASIK laser eye surgery prices here