Clearer vision of the future

ONLY DAYS had passed since I had undergone laser eye surgery in a bid to rid myself of spectacles forever, but already I could read the headlines bright and clear: "Laser Eye Surgery is ‘too risky’ for the NHS;" "Safety Fears Stop Laser Eye Op;" not to mention a high- profile doctor’s statement that "my worry is that so many eye surgeons wear glasses..."

As I settled down to study the newspaper reports I hoped I had not made a terrible mistake with that most precious of gifts - my sight.

The reports were sparked by the National Institute for Clinical Excellence (NICE), which advises the Government on whether new techniques and drugs should be made available on the NHS.

NICE concluded that laser-assisted in-situ keratomileusis - aka Lasik - should not be offered on the NHS because its long-term safety remains uncertain, and current evidence on the treatment "does not justify its widespread use."

I heaved a sigh of relief. Yes, I had just undergone laser eye surgery, but I had not opted for Lasik - instead I had chosen Lasek, the user-friendly term for Laser epithelial keratomileusis.

Tests on my eyes showed that both Lasik and Lasek were likely to have worked for me, and it was only after thorough and sensitive counselling by my practitioners that I opted for Lasek - a decision I came to just ten minutes before surgery began.

Only a few weeks have passed since I had my eyes "done" but I believe it was the right thing for me. Having worn spectacles since I was 16, I had suffered 22 years of lenses fogging up on cold winter nights and sighing at the racks of stylish sunglasses I couldn’t wear.

So, faced with the opportunity to try out eye laser surgery free of charge, I was not about to say no.

My initial consultation at Optical Express lasted two hours but as my designated counsellor, Cat, explained, when it comes to your eyes, you can not be too careful.

It soon became obvious that whatever I was about to undergo I would be going into it with my eyes wide open, if you will excuse the pun. Cat sat me down and explained all about laser eye surgery, its pros and cons, and encouraged me to ask questions.

Patients hoping to throw away their spectacles have a choice between Lasek and Lasik.

With Lasek, the cells at the front of the eye - the epithelium - are loosened and then gently pushed to one side while a laser reshapes the cornea to allow light to focus on the retina. Lasek can be successful in correcting mild to moderate short sight and astigmatism, which is caused by an abnormally shaped cornea and causes the distortion of images.

With Lasik, a thin, circular flap is created in the cornea allowing the laser to work on the deeper parts of the eye. This procedure can help patients with long sight, short sight and astigmatism.

Lasik offers the "wow" factor of allowing patients to see clearly almost straight away, while the final results with Lasek can take a few days longer, although you can notice a difference immediately.

This consultation included a series of tests. As well as the standard prescription eye test, I underwent examinations for retinal problems and glaucoma, as well as having the thickness and dilation of my cornea measured.

This corneal test can be key to deciding whether a patient should have Lasek or Lasik.

If your cornea is too thin, you can not have laser treatment at all. If it is thin or flat, Lasek is the only option. I had the choice of either treatment.

Pupil dilation is also a key consideration in whether to have laser surgery. If your pupil dilates too much, it can cause problems with night vision - the much-reported haloes around lights, for example.

This was a major concern for me - I often have to drive in the dark and would not jeopardise that. If I had been a borderline case, I don’t think I would have opted for the surgery at all.

My optometrist, Raymond, told me that Lasek runs less risks because it does not create a flap. He also informed me - and this was the deciding factor for me - that in a few years’ time, an optician would still be able to tell if I had opted for Lasik and its flap, but the same optician would be unable to tell if I had undergone Lasek.

Nevertheless, it was only ten minutes before the operation that I decided that I would opt for Lasek. My surgeon, Mr Eve, who inspired all the confidence and awe a good surgeon should, commented: "That’s a wise choice for you," which put my mind at ease even more.

First my eyes were totally anaesthetised and my eyelids were held open with a speculum. Then, while I focused on a small blinking red light as if my life depended on it, alcohol solution was put into my right eye for exactly 40 seconds to loosen the cells. Next - and this part was slightly uncomfortable - the cells were gently pushed out of the way to allow the laser to do its bit. Eighteen seconds for the first eye, 17 for the left. Then the cells were pushed back into place, a clear contact lens placed over them, and that was that. It took eight minutes for each eye, and every procedure was explained to me along the way. After the right eye was done, I had no fear about the procedure being repeated on the left.

An explanation about follow-up treatment - which included eyedrops, antibiotics and anti-inflammatories - and a cup of coffee later and I was in a taxi home, wearing dark glasses to protect my light-sensitive eyes.

Two hours later I was very, very sore. But I knew this was going to happen and had been given more of the anaesthetic to help numb the pain. But just a couple of hours later, I was out of my bed, wrapped up in my Jackie O glasses, and occasionally opening my eyes to watch TV. And then it hit me: I was watching TV without prescription lenses for the first time since I was 16.

Now, a few weeks on, I have better than 20-20 vision. The regime of eye drops continues, but is abating, and I don’t have to return to the opticians for another month. It hasn’t all been plain sailing. I was given a list of dos and don’ts and the don’ts include going to the gym and wearing eye make-up for a week (although Mr Eve prefers two weeks). My eyes also felt dry for a while, which caused some discomfort. I also felt the need to dash back to see Raymond when I felt a strange sensation in my right eye. "These are your eyes", Raymond told me when I apologised, "and they’re too important to be left to chance." My eye was fine, it transpired, simply healing.

Would I do it again? Yes. But I would advise anyone interested to ensure they were as well informed as I was, especially in light of the recent headlines. I’m glad I had Lasek - but my friends who had Lasik don’t regret it either.

Elizabeth Carr-Ellis underwent Laser Eyes Surgery courtesy of Optical Express. For further details contact 08702 20 20 20. Prices start from 600 per eye.