Laser eye surgery: expert advice and what you need to know now

Laser eye surgery could transform your eyesight, so you don't need to wear glasses or contact lenses.

But it's not without risk, and some companies can overhype the benefits without being upfront about the potential pitfalls.

Costs can also vary considerably from one provider to another, so we've pulled together laser eye surgery costs from all the big providers, to help you choose the best laser eye surgery for you.

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How much does laser eye surgery cost?

We've gathered starting prices from 13 providers in the UK to give you a sense of the costs you might face when getting laser eye surgery.

Starting prices range from £595 to as much as £2,593 per eye across the clinics we looked at, with higher prices usually reserved for complex prescriptions or Wavefront, which is personalised eye-mapping technology (sometimes also called iDesign or Intralase).

Be aware that the price you pay may differ from the lowest advertised price, and all prices listed here are starting prices.

For example, Optical Express advertises costs from £595 per eye, but the small print says that less than a quarter (23.4%) of individual eyes had a prescription that qualified for surgery at this price. In other words, those with a simpler prescription.

Extra laser eye surgery costs and what to ask

Look out for additional consultation fees and deposits, and ask the clinic in what circumstances they're refundable.

The Royal College of Ophthalmologists recommends you ask about aftercare and what's included in the cost before committing. You should also ask who will perform the surgery, where it will be carried out, and how long after surgery the clinic will continue to support you.

Importantly, make sure you know what will happen if anything doesn't go according to plan, and who will pay if additional corrective surgery is needed.

If you need to spread the cost of your surgery, many clinics offer finance options that allow you to pay in instalments. At some clinics, you can make an appointment to discuss finance options and whether they're suitable for you, before you book your surgery consultation.

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Can you get laser eye surgery on the NHS?

You can't get laser eye surgery on the NHS if you’re getting it purely to stop wearing glasses. However, if you have a medical condition that’s causing loss of vision, you might qualify for free NHS treatment. 

These conditions include glaucoma, diabetic retinopathy and some cornea diseases. Check the NHS laser eye surgery guide for more details.

How does laser eye surgery work?

There are different types of laser eye surgery and the right type for you will depend on your eyes and your lifestyle.

Lasik surgery

In Lasik surgery, your cornea is cut using a mechanical blade or infrared laser, a laser then sculpts the surface underneath.

This can be less painful than Lasek (see below) and heals more quickly, unless there are complications. People often return to work the day after surgery. 

Lasik is less suitable if you have a thin cornea, as it leaves less tissue if retreatment is needed.

Lasek surgery

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

It’s generally more uncomfortable and slow-healing after surgery (you can expect to be off work for a week), but it's better if you have thin corneas, as it doesn't waste precious tissue.

The lack of a flap in the eye can also mean less chance of an injury, such as a fingernail snagging the edge, which may be especially useful if you're involved in sports, for example, where this is potentially more of a risk.

ReLex Smile surgery

This process reshapes your cornea using an infrared laser, which creates a small disc inside the cornea of your numbed eye. The surgeon then removes this disc through a small incision. 

There's no need to cut a flap, as with Lasik, which again means you can go back to normal activities more quickly. 

Smile procedures should cause minimal discomfort, and your vision should be restored rapidly. But it isn't suitable for people with a thinner cornea or with higher prescriptions.

It's worth noting that recovery can be a little slower, and retreatment (if needed) can be more tricky.

Are you awake for laser eye surgery?

You need to be fully conscious during laser eye surgery, but the surgeon will apply anaesthetic drops into your eye so you won't be able to feel anything.

If you feel especially anxious, you should express your worries to your surgeon who will be able to reassure you and make any adjustments to help put you at ease.

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How to choose a laser eye surgery company

One of the main decisions to make is whether you want to go to one of the bigger chains, a small chain, or an independent clinic.

The larger chains, unsurprisingly, tend to offer lower prices, whereas hospitals, smaller chains and individual clinics tend to be at the pricier end.

Professor Bruce Allan, consultant ophthalmic surgeon and Professor of Anterior Segment and Refractive Surgery at University College London says: ‘One thing I think is important is you should be in the hands of a surgeon who’s offering all of the main options, so that they don’t have a conflict when one type of procedure might suit you better than another, and they can explain all of the options clearly.

‘That way, you don’t feel pressured into doing something or are given a hard sell in any way.’

How to find the best laser eye surgeon

You can ask your surgeon directly how many operations they've done and their success rate.

They should be straightforward with you and explain their experience clearly. If you feel they are being evasive or you're not happy with what they tell you, you should look elsewhere.

Professor Allan explains: 'What's important is whether a surgeon is coming over clearly to you and you feel confident in their care. Go where you’re most comfortable. Whether you’re looking for a surgeon, a plumber, or a lawyer, you need to find someone you feel confident in.'

It's also worth looking for surgeons with qualifications specifically in laser eye surgery, for example FRCOphth and CertLRS certifications. These will be displayed by a surgeon's name on their website or in the clinic itself.

Who is a candidate for laser eye surgery?

To be suitable for eye surgery, you have to be over 18, with a stable eye prescription (no change greater than 0.5 units or dioptres) in the past two years.

Eye clinics have different criteria, which may depend on the surgeon’s expertise and the laser being used. You might well find that clinics are more cautious if one of these applies to you:

• a significant prescription (over +10.00D of myopia or short sight, over +4.00D of hyperopia or long sight, and over + or -6.00D of astigmatism)
• Type 1 diabetes
• existing medical dry eyes
• you're over 50 or have early cataracts 

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 that you might not know about, such as having corneas that are too thin for surgery.

How long does laser eye surgery last?

Laser eye surgery will permanently change the shape of your eye, but that doesn’t mean you’ll see clearly forever. 

Most people’s vision gets worse as they age, and laser eye surgery won’t stop this from happening. 

You could also still develop cornea issues after laser eye surgery, perhaps requiring further treatment. 

Is laser eye surgery safe?

Laser eye surgery and lens replacement surgery are generally very safe and the majority of people will do well, with any problems likely to be short-term.

However, some people do experience longer-term and more serious problems and it's important that the risks are explained to you by your surgeon before you commit to treatment.

The risks of laser eye surgery

• Dry eye – This is common after surgery and usually clears up, but it can persist in the longer term and be very debilitating.
• Infection – Usually due to bacteria under the flap caused by the laser, but it's rare – the risk of developing an infection after surgery is around 1 in 4,000. It's usually picked up quickly and treated successfully with antibiotics.
• Cornea problems – Scarring after an infection, abnormal healing or an unstable corneal shape (corneal ectasia) can – in the rare worst-case scenario – lead to a damaged block of tissue in the cornea, meaning that a corneal transplant is needed.
• Worsened vision – A small proportion of people don't see as well without glasses or contact lenses following surgery as they did with their spectacles or contact lenses before surgery. In up to 5% of cases, the patient can be left with some long or short-sightedness and will need glasses or further surgery. For an even smaller group, this can't be corrected.
• Night glare – Some patients can experience a glare or halo effect around lights when driving at night, or increased flare from oncoming headlights. These problems are usually mild and last for a few months, but very occasionally, problems are permanent and can affect an activity such as driving. 
• Under or over-correction – It's difficult to know exactly how your eyes will heal, so a small number of patients will require additional treatment to achieve the desired correction.

How long does it take to recover from laser eye surgery?

The time it takes to recover from laser eye surgery depends in part on the type of surgery you have.

If you have Lasik or ReLex Smile surgery, you can be back to most normal activities as soon as the following day. With Lasek, you'll need four or five days of complete rest.

You'll be especially sensitive to light, so it's best to avoid screens as much as possible in the first couple of days after surgery. Also, avoid using make-up or other chemicals near your eyes.

You should be able to drive a few days after surgery if you had Lasik or ReLex, and a week or two after Lasek.

Whichever surgery you've had, you won't be completely healed straight away, and you'll need to avoid certain activities like intense exercising for a few weeks.

Your doctor will advise you on when you can resume specific activities, and it's best to wait until they've cleared you to do so.

Your rights when booking laser eye surgery

Be cautious of pressure-selling tactics that book the same day without allowing adequate time for research.

Limited-time special offers, such as two-for-one deals or discounts, should not rush you into deciding on your procedure.

If you sign up but want to cancel, many clinics offer the cooling-off period recommended by the General Medical Council. 

Check the terms and conditions to find out if this is the case and how long it lasts before you sign up for surgery, as you’re unlikely to be offered your money back after any cooling-off period has ended.

What questions should I ask my laser eye surgeon?

You should have an initial consultation with the operating surgeon, who can advise you on the specific procedure you will undergo.

• How much will it cost? Ask for all of the costs involved in the procedure, as well as how long after the surgery you're covered for free additional treatment.
• What are my treatment options? You should set out your aim for your possible treatment so the surgeon can explain what options you have and their limitations.
• What will the procedure involve? You can ask how long the procedure will take and whether you'll need any repeat surgery in the future.
• What are the risks and complications of the procedure? You can ask the surgeon what the most common complications are and how they'd be resolved.
• What should I expect after the surgery? You'll likely need some level of follow-up care after your surgery, so you should find out who will be dealing with this and where.

The Royal College of Ophthalmologists has a series of resources available for patients on their website, to help you see what you should expect from laser eye surgery, as well as a glossary of some of the jargon you might run into.

What happens if something goes wrong?

In the unlikely event of complications, you should contact your doctor straight away.

The symptoms of complications could be increasing pain, light sensitivity, redness, blurred vision, or an injury to the eye, followed by pain, blurred vision, or watering.

Even if you are not experiencing any discomfort and your eyes feel like they're healing well, you should attend all of your review appointments in case there are any issues you haven't noticed.

If you're unhappy with your treatment, you can complain to the Optical Consumer Complaints Service (OCCS) on their website if the clinic is registered by the General Optical Council (this would be displayed at the bottom of their website).

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