I said goodbye to my jam-jar specs and hello to 20/20 vision
00:07 GMT, 25 March 2012
Corrective eye surgery is now an option for patients with very short sight thanks to a laser so accurate it could write a word on a grain of sand.
Although 100,000 Britons undergo surgery for short sight every year, it is estimated that half a million others have been deemed unsuitable because their lens prescription is too high or they suffer from dry eyes, a condition that can be made even worse by the procedure.
If a patient’s vision is deteriorating and considered ‘unstable’, this would also have once precluded them from having laser eye surgery.
Teenager Mischa Hunt is delighted by the results of her laser operation
Mischa Hunt, 19, a student at Aston University, fits that description – but has become the youngest patient in Britain to benefit from the new procedure.
She says: ‘I’ve been wearing glasses since I was eight and needed a new prescription virtually every six months since then because my eyes were worsening.
‘I also suffer from dry eyes, which meant I couldn’t wear contact lenses regularly or for long periods. I was constantly trying to blink as there weren’t sufficient tears.’
When she approached Vision Express last year to ask about laser eye surgery, she was told she wasn’t suitable. At that stage, her prescription was minus-ten and getting worse.
Mischa was also told that the more her eyes deteriorated, the less likely it would be that corrective surgery would give her 20/20 vision, and that her cornea might not be thick enough for surgery.
About ten to 15 per cent of people enquiring about laser eye surgery are turned away because they have dry eyes
As an image-conscious teenager, Mischa eventually persuaded her parents to buy her expensive, thin-lensed designer glasses rather than the ‘jam-jar’ spectacles she once needed.
Then, last May, her mother, Joanna, 49, a hairdresser from Bourne End, Buckinghamshire, read about the London Vision Clinic, which offered a solution for Mischa, and she had the new procedure last summer with Dr Dan Reinstein.
He explained that while he might not be able to give her perfect vision, her prescription would be about minus-one after the procedure.
In those with correct vision, light rays are focused clearly on to the retina at the back of the eye by the cornea lens at the front. In those with long or short sight, the cornea is misshapen so that images are focused either in front or behind the retina, causing the brain to interpret them as blurred.
Laser eye surgery changes the shape of the cornea so that a patient can see without the need of glasses or contact lenses.
Traditional laser eye surgery involves cutting a flap in the cornea’s surface and opening a hole through which excess corneal tissue can be evaporated by the surgeon. This changes the lens’s shape and corrects the patient’s vision.
One limitation of this approach is that the cornea needs to be sufficiently thick to remain structurally sound after the front flap is cut. It is for this reason that those with prescriptions of more than minus-ten who have thinner corneas are told they are not suitable for the surgery.
The other limitation of traditional surgery is that in cutting open the flap, nerves that control the production of tears are also severed, making the eyes dry. Those already with insufficient tear production are advised against the surgery as it could make their existing condition unbearable.
About ten to 15 per cent of people enquiring about laser eye surgery are turned away because they have dry eyes.
How the surgery works
In the ReLEx procedure, instead of cutting a flap in the cornea, a protective contact lens-like cap is placed over the cornea. An ultra-precise laser then cuts away a circle of tissue beneath the surface of the cornea without damaging the top layer. The same laser cuts a tiny hole through which the circle of tissue is pulled out.
Patients are advised to keep their eyes closed for the next few hours, but within 12 hours their vision is noticeably clearer and within 24 to 48 hours it is almost perfect.
It can take four to six weeks for the eyes to settle, during which patients can experience seeing halos around lights, and are advised not to drive. Mischa says: ‘It was all over in less than ten minutes and I was pain-free. For the first couple of days my sight was a little fuzzy, but every morning it was slightly better and within a week it was perfect. I had to wear plastic cups over my eyes at night for two weeks to stop me rubbing them, and apply eye drops every 15 minutes for the first two days to speed the healing process, but now I’m completely free of glasses or contact lenses.
‘I’ve been back for follow-up checks to make sure everything has healed properly – Dr Reinstein has actually left me very slightly long-sighted in case my eyes slip back. I was sitting at the back of a lecture theatre recently and thought how amazing it was that I could see every detail at the front of the room. It feels like a miracle.’
Professor William Ayliffe, Consultant Ophthalmologist at the Lister Hospital in London, who specialises in corneal and cataract surgery, says: ‘What ReLEx surgery can achieve is wonderful. It doesn’t affect the corneal nerves and rehabilitation is fast, with almost no discomfort.
‘The downside is cost and access, as it’s a strictly patented procedure with a very small number of the precise lasers in use, but I’m sure that will change. In my opinion, it will change the way corrective laser eye surgery is carried out.’
lThe ReLEx procedure costs 6,300 at the London Vision Clinic.