Laser eye surgery is a type of treatment that corrects blurred vision to give you a life without glasses or contact lenses. It’s a rapid procedure which can be done in just a few minutes, and without any discomfort. For those undergoing SMILE and LASIK eye surgery the procedure is described as painless, for patients  undergoing LASEK eye surgery they  can expect some discomfort which should settle within a week or so. 

Laser eye surgery can correct refractive conditions such as short-sightedness, long-sightedness, and astigmatism.

A state-of-the-art laser is used to reshape the cornea of the eye to give you clearer vision. Thanks to the latest advancement in technology, laser eye surgery is completely safe and the most popular elective surgery in the world.

After you arrive at the hospital, our team will ensure you are comfortable and at ease prior to surgery. You can ask our specialist team any questions you have about the surgery or aftercare process while we explain the day’s procedure from start to finish.

Here are the surgical steps involved in LASIK (the most common laser eye surgery procedure):

1. Anaesthetic eye drops are applied. These numbing eye drops will ensure that your eyes remain pain-free during the procedure.
2. Creation of the Flap. For LASIK, a small, hinged flap is created on the outermost layer of the cornea (the clear front surface of the eye) using a femtosecond laser. This flap is gently lifted to expose the underlying corneal tissue.
3. Laser Reshaping. An advanced laser is used to precisely reshape the exposed corneal tissue based on your specific vision prescription. This reshaping removes microscopic amounts of tissue to correct the refractive error.
4. Flap Repositioning. After the cornea is reshaped, the protective flap is carefully repositioned. No sutures are required for closure.
5. Post-operative Care. You will be monitored for a brief period to ensure everything is in order, and your eyes may be shielded for protection.

The technique used for SMILE is slightly different. No flap is created for SMILE procedures. Instead, SMILE uses a femtosecond laser to create a small, disc-shaped lenticule within the corneal tissue, which contains the portion of the cornea to be removed for vision correction.

The surgeon makes a tiny incision on the cornea to access the lenticule, which is then removed through this incision. The lenticule is carefully separated and removed, reshaping the cornea to correct the refractive error.

LASEK involves removing the outermost layer of the cornea, the epithelium, as a thin sheet or with the use of an alcohol solution. This layer is then temporarily set aside.

Similar to LASIK, an excimer laser is used to reshape the underlying corneal tissue.

After reshaping, the epithelial sheet or alcohol-treated epithelial layer is repositioned on the cornea’s surface and secured with a soft contact lens to protect and facilitate the healing of the epithelium.

LASEK typically involves a longer and sometimes slightly more uncomfortable recovery period compared to LASIK due to the need for the epithelium to regenerate and heal. Vision improvement may be more gradual.

Whichever procedure you have, if you think you may be anxious on the day, you can opt for a mild sedative to relax you.

After the surgery is complete, you’ll be able to relax in a comfortable recovery area. Eye drops and complete aftercare instructions will be provided. You can leave for home as soon as you’re comfortable. Your first aftercare appointment will be set up before you leave the hospital.

You will be able to see after your treatment, although your vision might be a little hazy.

While laser eye surgery is a safe and effective option for many individuals with refractive vision problems, it may not be suitable for everyone.

Factors that can make someone unsuitable for laser eye surgery include:

Age: Laser eye surgery is typically not recommended for individuals under the age of 21 because their eyes are still developing. On the other hand, it may not be ideal for people over the age of 40 who are experiencing age-related vision changes, as they may require reading glasses after surgery. There are alternative procedures, such as Presbyond, available for those over the age of 40.

Unstable Vision: Candidates should have stable vision for at least one to two years before undergoing laser eye surgery. Rapid changes in vision can make it challenging to determine the appropriate correction.

Certain Eye Conditions: Some eye conditions, such as keratoconus, severe dry eye, glaucoma, and retinal issues, can make laser surgery less suitable or even risky.

Pregnancy and Nursing: Hormonal changes during pregnancy and nursing can affect vision stability, making it advisable to wait until hormonal fluctuations have stabilised before considering laser eye surgery.

Autoimmune Disorders and Medications: Certain autoimmune disorders and medications that affect the immune system can impact the healing process and increase the risk of complications.

While all surgical procedures carry a very slight degree of risk, laser eye surgery is an extremely safe, common and effective procedure ­– with over 40 million patients worldwide who have had corrective eye surgery!

• See clearly without the need for glasses or contacts
• Significant cost savings on glasses & lenses
• 10 – 15-minute treatment, with no pain or discomfort
• Back to work within 48 hours

By Author: Amir Hamid

Mr. Amir Hamid is our Medical Director for Vision Correction and an expert refractive surgeon, based in London. Medically reviewed on: Thursday 28th September 2023.