Laser eye surgery in the NHS

Laser eye surgery in the NHS

In July 2012 the Tertiary Corneal Service at the L&D was established. The service offers state of the art corneal transplant surgery, keratoconus surgery, advanced cataract and intraocular lens surgery, anterior segment and ocular surface reconstruction and laser eye surgery for NHS disease indications. We are now one of only a handful of units in England to offer this kind of comprehensive cornea and refractive service and have been featured widely in both local and national media for our work. Although it only represents a small amount of our NHS workload nothing prompts as much public interest as Laser Eye Surgery. I am fortunate to be one of only a handful of corneal surgeons to have fellowship training in laser refractive surgery which allows me to treat many of the most complex problems amenable to laser eye surgery.

Laser eye surgery has become the commonest procedure that adults chose to have in the Western World with millions of procedures having already been safely carried out. It can be used to treat myopia (close/nearsightedness), hyperopia (far/longsightedness), astigmatism, reading vision problems or a combination of these problems. There is now superb accuracy, predictability and stability of treatments delivered by the most high technology lasers. In fact in the right hands patients are now more likely to suffer a sight threatening infection from contact lenses than to have a significant problem from laser eye surgery. Despite this it is still extremely important that the surgeon who operates these high technology lasers has been trained to the highest level (Consultant Cornea and Refractive Surgeon) and can therefore react appropriately in the rare event of unexpected problems. The majority of laser eye surgery is carried out for people who no longer wish to wear glasses or contact lenses. For these indications people must seek care in the private sector ideally with someone who holds or has held a substantive NHS Consultant Cornea position. However there are certain corneal disease indications where NHS care at select tertiary centres such as the L&D Cornea service is possible. These include: scarring conditions on the front of the cornea, unwanted refractive errors after cataract surgery and for patients who have had a corneal transplant.

On a personal note I became intolerant of contact lenses in 2011 and being unable to operate or examine patients properly with glasses underwent laser eye surgery myself in the same year. In 2013 my wife had laser eye surgery and in 2014 my Brother underwent the procedure. In the last month of 2014 I treated 4 other surgeons including another eye surgeon. For appropriately selected patients in the right hands and with the right technology laser eye surgery is a wonderful operation with unparalleled safety and predictability that has a positive impact on patients’ quality of life