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Laser eye surgery - best and worst companies

What you need to know about laser treatment

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What you need to know about laser treatment

The promise of freedom from glasses or contact lenses is  tempting, and laser eye surgery is big business. But is it right for you?

In our investigation, we sent researchers undercover to 18 high street laser eye clinics, including market leaders Optical Express and Optimax. The results revealed that some are not upfront when telling you about potential risks. 

We've combined these insights with advice from our expert panel - which included a consultant ophthalmologist/laser eye surgeon - to help you make the right decision.

Optical Express was the worst performer in our undercover investigation. We also surveyed Which? members who have had laser eye surgery, asking them to rate their provider, so you can find out which are the best and worst laser eye surgery companies according to patients who have actually had the surgery. 

Laser eye-surgery myths busted

When we sent our undercover researchers on 18 visits to high street clinics, they used hidden recorders to capture what they were told. Below you can see some of the sales patter, and what our experts think you should really be considering when you hear it.

Myths busted
Quote Our experts says
'You are definitely going to get a better vision [sic] than you get with your glasses or contact lenses...'
[Optical Express]
A false promise: a very small proportion of people don't see as well as they did with glasses before surgery. In about 1 in 200 eyes, this can't be corrected with specs because the eye's optical quality has been reduced.
'...because with this laser 99.3% of patients achieve 20/20 [vision].'
[Optical Express]
What you want to know is, is this true for your particular eyes? Ask for statistics to be for your individual prescription.
'The next day you'll have 20/20 vision and no need for glasses'
[Optical Express]
A vital fact is missing: even if your eyes are fully corrected for distance vision, most people need reading glasses when they reach 45-50 years old.
'it's more like a procedure, it's not ...erm...that much surgical involved... [it's] something like a Botox injection...'
[Optical Express]
Unrealistic. Sales staff may avoid using words such as 'surgery', 'cut' or 'blade', but, unlike Botox, Lasik and Lasek are operations, and you should consider complications and risks as well as benefits.
'My husband had treatment about two years ago now and he had like a highest prescription [sic] that the surgeon had ever treated...'
[Optimax]
On visits, we heard staff refer to a surprising number of relatives. While it may be comforting to hear this and true, don't let it influence your decision.

Are you suitable for laser eye surgery?

Only the detailed eye scans carried out at a laser eye surgery clinic (more detailed than those you normally get at the optician) would reveal problematic issues. Eye clinics have different criteria, which may depend on the surgeon’s expertise and the laser being used. 

Conditions where caution may be exercised include a significant (high) prescription, type 1 (insulin-dependent) diabetes and existing dry eyes.

There's nothing better than a recommendation from someone who's been there before. We've asked Which? members who've had laser eye surgery to rate their clinic to reveal the best and worst laser eye surgery companies.

What are the different types of laser eye surgery?

The laser eye (refractive) surgery we're talking about is to correct vision such as short sight, rather than - for example - sealing the leaking blood vessels in the retina that can happen as a result of diabetic retinopathy, or making a small hole in your iris to allow fluid to flow freely around it (for people with acute glaucoma). 

The main types of laser treatment are Lasik and Lasek (PRK, the forerunner of Lasek, is rarely performed these days), and ReLex Smile.

Lasik (laser-assisted in-situ keratomileusis)

The cornea is cut by a mechanical blade or infrared laser, creating and then lifting a precise flap of tissue. The surface underneath is sculpted using a different (excimer) laser, and the flap then adheres without stitches. It usually causes minimal pain and vision recovers quickly.

95% of people have Lasik, which can be less painful than Lasek, and heals more quickly. Lasik is less suitable for those with thin corneas as - for example -  it leaves less tissue if re-treatment is needed.

Lasek (laser epithelial keratomileusis)

Lasek uses dilute alcohol to soften and roll back a thin flap of the cornea to do the excimer laser treatment.

It’s generally more uncomfortable and slow-healing after surgery, but better for thin corneas as it spares the tissue.

ReLex SMILE (Small Incision Lenticule Extraction)
To re-shape the cornea, an infrared (femtosecond) laser creates a small disc [lenticule] of tissue inside the intact cornea of your numbed eye.  The surgeon then removes the lenticule  from inside the cornea through a small incision measuring a few millimetres, using a minimally invasive procedure.  The surgeon doesn't need to cut a flap (as with LASIK), and the surface corneal layer remains intact.

As with a LASIK procedure, you should experience minimum discomfort and rapid restoration of vision after a SMILE procedure.  It can be suitable for patients with a thinner cornea (something you'll find out after initial eye testing) who are not eligible for a LASIK procedure.

Intraocular lenses (refractive lens surgery)

This is an increasingly common alternative to laser eye surgery. Some patients have their eye lens replaced by a synthetic one, or have an additional lens inserted to change the eye’s power (prescription). Lens replacement is effectively the same as a cataract operation.

It's an alternative where laser eye surgery isn’t possible, and is often suggested for older people or those with early cataracts (it wouldn't be worth having laser eye surgery if it was likely you'd need the lens replaced in the near future anyway). But it's more expensive than laser eye surgery such as Lasik, as it’s a more complex procedure.

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