UK Surgery

[c0g]

Hi,

I'm trying to find some information about surgery in the UK. I've been to OpticalExpress and have another meeting with UltraLase coming up. I have average cornea thickness and my prescription is about -6 in both eyes with some astigmatism. From research and talking to the optometrist at OE, my ideal operation would be custom Wavefront LASEK- I do martial arts and am quite paranoid about the flap and am happy to deal with pain/poor vision for a few days.

It seems that we're not supposed to mention surgeon names here, however I've seen on previous posts that posters got PM'd certain information on request- is this possible? OE has agreed to let me email the surgeon an adapted list of your 50 questions, which I consider to be the minimum level of contact required before agreeing.

Thanks,
Tom

[c0g]

I'm also interested in P-IOL implants. What is the disadvantage to these besides cost? How do those disadvtanges compare to LASEK? I'm 21 and my prescription has been stable for 2 years (at least).

[LasikExpert]

It's good that you are looking at different providers, however both the providers you mentioned may be well described as Lasik "mills". You should also consider a more "boutique" Lasik doctor. At lease for comparison. If you are in London there is a clinic whose chief surgeon has published more than 250 medical articles and personally designed many of the features of the Karl Zeiss Meditec MEL 80 excimer laser. You should be sure to see that level of surgeon too.

Using a surface ablation technique like PRK, LASEK, or Epi-Lasik is undoubtedly wise due to the higher than normal probability of trauma to the eyes. Don't even consider P-IOLs. They cause endothelium cell loss in the best of circumstances and would destroy the underside of the cornea with a strong impact. You can expect the same long-term outcome between the three surface ablation techniques. I personally think LASEK and Epi-Lasik are so much expensive luggage and would just go straight to PRK.

Using the 50 Tough Questions For Your Lasik Doctor will help guide you to selection of the best available Lasik surgeon. Unfortunately none of the doctors certified by our organization are practicing in the UK.

[c0g]

I have a consultation coming up with advanced vision care, and a surgeon from Moorefields. I think I know which clinic you're referring to (similar acronym to AVC?) so I'll look into talking to them as well.

With PRK vs LASEK, I believe the difference is LASEK folds the epithelium back and PRK straight up skins the eye. Are there greater risks of long term clouding/other bad things with PRK? I recall reading a report of a study saying that there isn't, but I might be imagining.

Thanks for your input on P-IOLs. One clinic I've been speaking to told me when asked that they're the future of refractive surgery- in 5 years everyone would be having them. Should this ring alarm bells?

Thanks very much for your help.

[LasikExpert]

With PRK vs LASEK, I believe the difference is LASEK folds the epithelium back and PRK straight up skins the eye. Are there greater risks of long term clouding/other bad things with PRK? I recall reading a report of a study saying that there isn't, but I might be imagining.

PRK has a tendency to cause corneal haze when attempting to remove too much tissue. Normal healthy corneas with less than about 6.00 diopters of attempted correction would not haze. Over 6.00 diopters of correction and the probability of haze increases exponentially. When everyone switched to Lasik, the concern about haze was all but forgotten. The Lasik flap fools the cornea into not realizing it has had surgery and the wound response is muted. The problem was that Lasik had its limitations too.

In an attempt to have surface ablation and a flap, LASEK was developed. With LASEK the epithelium is slid out of the way, the laser energy is applied, and then the epithelium is slid back over the treatment area to act as a bandage. The problem is that all of the epithelium cells are mortally wounded in the process. They will die, slough off, and be replaced. This process provided a less even and slightly longer vision recovery period. Just removing the epithelium encourages the unbridled growth of the replacement cells.

The original problem of corneal haze has been addressed in three ways; the newer lasers are less traumatic on the cornea, the use of Mitomycin C during surgery to change the healing response, and the discovery that taking 500mg of vitamin C twice a day twice a day for a week before PRK, LASEK, or Epi-Lasik and at least two weeks after surgery significantly reduces the incidence of corneal haze. Read the portion of our article on corneal haze prevention.

Thanks for your input on P-IOLs. One clinic I've been speaking to told me when asked that they're the future of refractive surgery- in 5 years everyone would be having them. Should this ring alarm bells?

It was eight years ago that our organization testified of our concerns with the P-IOL to the US Food and Drug Administration. P-IOLs are very limited in their application.

Thanks very much for your help.

Glad to be of service.

[broken850]

You may need to travel for this evaluation. Also, if you decide on P-IOLs, you may want to select a surgeon who does a lot of cataracts as the surgical skills or P-IOL are closer related to cataract lens surgery than Lasik or PRK