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.

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Continuing from yesterday:
Some surgeons recommend PRK or LASEK (both forms of surface laser eye treatment and basically the same) over LASIK. The article referred to by Kay in her original post and advocating LASEK was written by ophthalmic surgeon Sunil Shah, who was one of the creators of that particular approach (and so has some personal interest in writing about it one presumes).

One of the very vocal and respected advocates of surface laser (PRK) over keratome LASIK was Professor John Marshall in London, UK, a founding father of laser eye surgery back in the 80s. Prof Marshall argued convincingly that the cornea was considerable stronger after PRK compared to mechanical (thicker flap) keratome LASIK.

However, the game has changed with the introduction of femtosecond lasers with much thinner flaps. Even Professor Marshall now supports the move to thin-flap LASIK using a dual laser, blade-free approach.

So if a clinic cannot offer dual laser LASIK (and many still can’t) they may offer PRK/LASEK instead. There are some clinical reasons to perform PRK instead of LASIK but the percentage of these cases has shrunk from 10-15% down to around 5% today, with dual laser technology. Patients much prefer femto-laser LASIK over PRK, as the latter is fairly unpleasant for a few days post-op.

In summary, there are definite clinical reasons why we as treating clinics have moved over to wavefront LASIK and using a blade-free dual laser approach. More accurate treatments so better vision, removal of an older mechanical device technology and improved long-term safety.

We discussed in the last post about the two options you have: LASIK or PRK (surface laser), and how 90%+ of treatments are done via LASIK.

LASIK comes in two flavours now: blade or blade-free. The older traditional LASIK technique uses a mechanical device containing a blade (called a keratome or microkeratome) to cut a flap during the first part of the procedure. The newer, more advanced method is to use a special laser (known as a femtosecond laser) to create a flap without a blade.

These femtosecond lasers are hugely expensive (about a quarter of a millions pounds each!) so expect to pay more for this technology. Some clinics have not yet invested in femto lasers due to the high cost involved and continue to use a blade.

The benefits of a laser flap over a blade flap are becoming clear: more accurate treatment, better healing of the flap, greater strength in the cornea post-op due to significantly thinner laser flaps and greater residual thickness. Blade flaps have been used for many years and have been proven safe to date, but thinner laser flaps have added better accuracy and strength. You will see a gradual phasing out of blade flaps over laser flaps over the coming few years.

More tomorrow!

You can see more information in the first featured article above on how laser eye surgery is now used to correction problems with reading vision.

Most people start to need reading glasses after the age of 45 and previously were not eligible for laser eye treatment. All that has changed with advances in technology. FOCUS Laser Vision has been very active in this increasingly popular area of laser eye correction.