Laser Eye Surgery – LASIK
Your eyesight is precious. Under Miss Saw’s care you can expect:
- An experienced, world- renowned Moorfields Eye Hospital consultant surgeon (2010 – 2015) currently in the top of her field. Unlike other LASIK surgeons who are not experienced in non-LASIK surgery, she routinely carries out complex corneal surgery, and LASIK surgery under her care is enhanced by this unique expertise.
- The safety of your eyes is our priority. Impressive attention to detail and consistently world class care, with a reputation for excellence and innovation in eye surgery. Continuity of care is paramount to Miss Saw and you will see her at every visit.
- Tailored, custom-planned treatments, where time is taken with a very thorough examination and testing of the cornea and focusing elements of the eye. Her aim is to give patients the best possible vision, no matter how complex or unusual their condition.
- The world’s safest, fastest and most technologically advanced lasers. At the world-leading specialist centre of excellence, Advanced Vision Care in Harley Street London, Miss Saw carries out ‘iLASIK’, the safest all-laser bladeless wavefront-optimised LASIK surgery using the AMO Intralase Femtosecond Laser for flap creation, and the German Zyoptix Technolas Perfect Vision Excimer laser with sophisticated eye tracking and bespoke personalised Wavefront-guided treatment.
- A dedicated team of expert optometrists, eye care professionals and clinic coordinators selected to work with Miss Saw, who are all passionate about excellence in safety and customer service.
Valerie did her medical training at the University of Sydney, where she received the University Medal for coming first place on the Honours list. She has been trained at the highest level in complex corneal and cataract surgery, having spent over 4 years in advanced specialisation at Moorfields Eye Hospital. Due to her experience she is able to offer a choice of treatments and customise these to the patient’s individual situation.
Since 2011 Ms Saw has been a Council Member of the British Society of Refractive Surgery (BSRS), and she is currently the Treasurer of the BSRS. She is also a member of the American, European and UK and Ireland Societies of Refractive Surgery (ASCRS, ESCRS, UKISCRS), the Association for Research in Vision and Ophthalmology (ARVO), the American Academy of Ophthalmology (AAO), the Medical Contact Lens and Ocular Surface Association (MCLOSA) and the UK Bowman Corneal Club. She is a member of International Sjogren’s Syndrome Registry Review Panel (SICCA) and medical advisor for the Dry Eyes Medical website.
Having a skilled and expert surgeon
Who uses the safest, most precise and technologically advanced laser
Who carefully selects the right patients for laser vision surgery
Sometimes it may be better to continue with contact lenses or glasses. Miss Saw’s unique expertise with dry eyeand contact lens problems means that she can optimize the health of your eyes, and relieve the symptoms which led you to consider laser surgery in the first place.
Who optimises the ocular surface in preparation for laser eye surgery
Who teaches patients about how to care for their eyes after the procedure
Your safety is paramount. Miss Saw leaves no stone unturned when caring for your eyes.
🎛 Advanced Technology
The iLASIK femtosecond laser has the fastest cutting speed of any currently available laser, taking only 13 seconds to cut a LASIK flap. The German Zyoptix Technolas Perfect Vision laser gives customized wavefront treatments with outstanding 20/20 vision results.
Book a consultation with Miss Saw, to find the best procedure for your eyes.
How will I know if I am suitable for laser vision surgery?
Laser eye surgery works best for the following range of glasses prescriptions:
Short sight (myopia) -1.00 to -10.00D
Long sight (hypermetropia) +1.00 to +4.00D
Astigmatism up to +/-5.00D
The only way to evaluate whether you are suitable for laser surgery is by attending a consultation, where Miss Saw and her team will carry out a series of detailed eye tests and scans to evaluate the health of your corneas and eyes.
If Miss Saw feels that your eyes are not suitable for laser vision correction surgery, she will advise you about the most appropriate non-laser corrective surgery, for example implantable contact lenses (ICL) or intraocular implant surgery with refractive lens exchange. Book a consultation with Miss Saw, to find the best procedure for your eyes.
What is LASIK? What is the difference between LASIK and LASEK?
In LASEK, no flap is created. This procedure is recommended for patients in the military or those who play contact sports, because of the absence of a flap which could potentially be disturbed following an injury to the eye. It can be recommended in patients with thin corneas and those with a high prescription, and in certain corneal abnormalities such as mild keratoconus. In LASEK, the skin or epithelium on the surface of the cornea is removed after using dilute alcohol to make the epithelium loose, then the excimer laser reshapes the cornea. It is possible to do this with no-touch LASEK (transepithelial LASEK), where the laser removes the surface epithelium on the cornea.
For prescriptions of -6D or less, outcomesare identical for LASIK and LASEK (Manche 2011).
Both procedures are safe and highly effective, with over 99% of patients achieving driving standard vision or better after 1 treatment. Most patients are able to return to work within a few days after LASIK. With LASEK the visual recovery is slower, and it can takes 10-14 days for the vision to recover fully.
What is wavefront LASIK and wavefront LASEK?
Wavefront technology accurately maps the way light is focused by an individual eye. Having wavefront optimized and wavefront guided treatment ensures that the treatment is customized to your individual eye aberrations, and also ensures that aberrations are not induced after the laser procedure.
Current wavefront optimised and guided laser treatments do not produce better vision than spectacles and contact lenses, but they have two benefits over non-wavefront laser eye treatments:
Wavefront treatments are less likely to result in surgically induced increases in higher order aberrations (i.e. the corneal shape produced by a wavefront guided treatment is closer to the ideal natural shape of the eye).
Wavefront surgery is less likely to cause night vision problems or a reduction in other elements of visual performance. Night vision can improve in patients after wavefront-optimised treatment.
What results should I expect after having laser vision surgery?
Realistic expectations are important. Laser eye surgery is highly effective in reducing spectacle dependence. Over 99% of patients in the range treated by us are able to see to driving standard or better without glasses, after one treatment. Results are similar for both LASIK and LASEK patients.
Common side effects, such as mild dryness or light scatter during night driving, normally resolve within 6-9 months of treatment.
What alternative eye treatments are possible?
For glasses prescriptions outside the recommended range within with laser eye surgery works best, or for some individuals with very dry eyes who are not suitable for laser vision correction surgery, intraocular implant surgery is usually the best option.
In young patients, an implantable contact lens (VisianICL) is the best choice. In older patients (above the age of 45-50), implanting an intraocular implant that corrects the focus of your eye in an operation identical to modern key-hole cataract surgery, called refractive lens exchange (RLE) works very well.
If we find that you are not suitable for laser eye surgery, Miss Saw will explain the most appropriate alternative procedure to you, and give you comprehensive information about it.
How do I prepare for the consultation appointment?
- If you wear contact lenses, please remember to leave your contact lenses out before the consultation, for the following durations:
- Daily disposable soft lenses – at least 3 days
- Weekly/fortnightly/monthly soft lenses – at least 7 days
- Gas permeable lenses – at least 2 weeks
- Hard lenses – 4 weeks (or change to daily disposables, wear them for 3 weeks & leave them out for 1 week prior to the appointment)
Continuous contact lens wear can lead to temporary changes in the shape of your cornea, so it is important to leave contact lenses out prior to the consultation to ensure that the eye tests we perform are accurate. After the consultation, soft contact lenses can be used again, but they should be stopped 1-2 days prior to laser eye surgery. Hard contact lenses must be stopped 2 weeks before laser eye surgery. For RLE/cataract or ICL surgery, all types of lenses can be used until the day of the surgery.
- Bring a record of all your spectacle prescriptions over the last 2 years if possible. Laser eye surgery is normally postponed until the spectacle prescription is stable. Small variations in your prescription are normal, but if there has been a significant change over the last 2 years, we would normally wait 12 months before proceeding with surgery to ensure that there is no progressive change. Learn more about understanding your prescription.
- You should allow a full two hours for your consultation.
- Your pupils will be dilated at the initial consultation. This will make your vision blurry and your eyes sensitive to bright light for a few hours. Bring sunglasses and avoid driving or biking to your appointment.
- Read the literature we send you and bring any questions you may have, to your consultation with Valerie.
What happens during the consultation appointment?
During the consultation Miss Saw and her team will perform several diagnostic tests including:
- A careful glasses test (refraction), evaluation of ocular dominance, binocular fusion and eye muscle control.
- Detailed scanning of the eye, using state-of-the-art equipment specifically designed to firstly assess the suitability of your cornea for laser eye surgery, and secondly to capture precise wavefrontmeasurements and ocular rotation pictures that will be used to program the laser with data that’s unique to you.
- Miss Saw will then do a comprehensive examination of your eyes, including an eye pressure check, examination of the back of your eye (the retina) and evaluation of the health of the surface of your eyes, blink reflex and eyelids, and the tear film.
- Miss Saw will explain the results of the eye tests and her examination findings to you. She will then discuss the options for sight correction which are most appropriate for your eyes. Miss Saw will perform all the surgical procedures.
What happens on the day of surgery?
Laser vision correction surgery typically takes around 10-20 minutes for treatment of both eyes. Some waiting time prior to surgery is usual, and further time is required for post-operative checks and to go through your aftercare instructions. Most patients spend approximately 1-1.5 hours in the surgery facility.
What happens immediately after surgery?
After the surgery, it is like looking through a watery fog and you experience soft focus. You are able to see enough to walk around without assistance, but the vision is not clear. Relatively clear vision normally returns within just a few hours of LASIK treatment. Patients typically see at driving standard after 24-48 hours following LASIK surgery and after 7-10 days followingLASEK surgery. Remember to follow the aftercare instructions we give you. These are provided to you when you schedule your surgery.
When can I drive after surgery?
It is usually safe to drive short distances 24 hours after LASIK surgery. However, you must wait until Miss Saw has given you the all-clear to do so, at your first post-op check-up (this is the day after your surgery). Even after being given clearance, you must only drive once you feel safe to do so.
When can I wear makeup?
You can apply make-up to your face 48 hours after surgery. However, you should avoid eye-makeup for seven days.
Are the results permanent?
Long-term follow-up studies have demonstrated that once the shape of your cornea is changed to correct your vision, the change is permanent. Of course, your eye is a living organ and alters over the years, just as the rest of your body does. Everyone’s eyes change, to some degree, even if they have never needed glasses.
As your eyes get older, the first change you may notice if you have had laser corneal surgery aiming for a full distance prescription correction in both eyes (that is, good distance vision in both eyes without glasses), is natural presbyopia, which commonly starts around the mid to late 40s. This is due to weakening of the focusing muscle for reading inside our eyes. Your distance vision will not be affected by presbyopia. Only your reading vision. Wearing reading glasses will help with this.
If you are already noticing symptoms of presbyopia, at your laser eye surgery consultation Miss Saw will evaluate whether you would be a suitable candidate for laser blended vision/ micro-monovision, which can significantly reduce, or even eliminate, the need for reading glasses in older patients.
As your eyes get older still, the only change that could alter the distance prescription of your eyes after laser eye surgery is the development of cataract, that is, thickening of the natural crystalline lens inside your eyes. The natural crystalline lens develops more and more layers each year we get older. This thickening can alter your distance prescription. Cataract is a treatable condition and modern femtosecond laser cataract surgery ensures that the procedure is safer and more predictable.
Could I go blind?
With today’s technology, your chance of going blind from laser eye surgery with an expert surgeon is almost too small to measure – estimatedto be around 1 in 5 million. In fact, laser eye surgery is even safer than wearing contact lenses – which few would think are unsafe!
What are the risks of laser vision surgery?
Laser eye surgery, like any surgical procedure, is associated with an element of risk. The relative risk of laser eye surgery is extremely low when compared to the relative benefits, and compared to wearing contact lenses. In the hands of an expert surgeon using the best technology, the chances of even just a small compromise to the vision is in the order of 1 in 1,000.
Most problems are minor, and usually occur within the first month after surgery. Almost all complications can be corrected safely without affecting the final visual result. Additional consultations and treatments may be required. The risk of long-term loss of corneal shape stability (keratectasia) after LASIK has recently been estimated at less than 1 in 1000 by NICE (the National Institute for Health and Clinical Excellence). Current patient selection strategies further reduce this risk. The risk for keratectasia after LASEK is negligible.
What about SMILE laser surgery?
Unlike LASIK and LASEK, with which we have over 20 years of experience, the long term outcomes of SMILE laser surgery are not clear, and at present the evidence for a definite benefit of SMILE laser compared to LASIK or LASEK has not been confirmed by independent studies.
Currently SMILE is only approved to correct myopia (short sight) and astigmatism, in patients with suitable thickness corneas. Visual recovery after SMILE is slower than after LASIK. If retreatment is needed after SMILE, LASIK or LASEK surgery must be carried out. Although Miss Saw was able to offer this treatment at Moorfields Eye Hospital in the past, currently Miss Saw’s practice at Advanced Vision Care does not offer SMILE. However it may be offered in time, if clear evidence for its benefits over LASIK or LASEK is demonstrated.
Do I need to prepare for treatment?
Yes. If you are a contact lens wearer, leave your contact lenses out prior to your treatment day for 1-2 days (remember it is at the time of your first assessment that you need to remove them for longer – see before)
Remove all traces of eye make-up, perfume and aftershave. You should avoid wearing eye make-up for one week afterwards.
Remember to bring sunglasses on the day of surgery. They will protect your eyes from wind and your eyes will be sensitive to light after the procedure.
Does it hurt?
The surgery itself is not painful. You will feel touching around the eye, cold fluid on the eye’s surface, and some pressure on the eye at various stages during the surgery, but anaesthetic drops administered prior to surgery are highly effective in minimising any discomfort. You may have some discomfort or irritation for up to 24 hours after the surgery, but this is usually relieved with artificial tears (which we provide).Some people feel a little discomfort as their eyes are healing, so we provide pain relief eye-drops to use where necessary
When can I get back to work?
If you have LASIK, you can usually go back to work 1-2 days after surgery. But keep your eyes well lubricated with artificial tears (this is especially important if you’re using a computer, as looking at a screen can dry your eyes), and remember to Blink regularly.
If you have LASEK/PRK treatment, the recovery time is a little longer: you should plan to return to work after 7-10 days.
Miss Saw carries out laser eye surgery on Tuesdays and Thursdays.
What if I blink during surgery?
Blinking is not a problem. Your eyelashes will be gently taped out of the way and a gentle eyelid clip is used to keep the eyelids open. Miss Saw will ask you to look up at the fixation light during the surgery. The eye not being operated on will be covered.
You can help the surgery to proceed quickly and accurately by gazing directly up at the fixation light throughout the procedure, but involuntary eye movement is not a problem. The wavefrontoptimisedexcimer laser system Miss Saw uses has a sophisticated eye-tracking mechanism that follows eye movements during treatment. Any movement outside the safe range will cause the laser to stop automatically. Miss Saw will be looking at your eyes through an operating microscope throughout and can override the laser’s automatic cut-out to stop and start the treatment as often as necessary.
Why choose Miss Saw as your surgeon?
Valerie Saw is an experienced, world-renowned Moorfields Eye Hospital surgeon (2010 – 2015) in the top of her field in both the NHS and privately. Unlike other LASIK surgeons who are not experienced in non-LASIK surgery, she routinely carries out complex corneal and cataract surgery, and LASIK surgery under her care is enhanced by this unique expertise.
She is the only female listed in the top 10 laser eye surgeons in the UK*. Valerie has performed thousands of eye surgeries and her results are second to none. With a reputation for providing the highest quality care, she is one of a specially selected group of Examiners for the Royal College of Ophthalmologists UK Certificate in Refractive Surgery. She is also a longstanding invited surgeon and advisor on the Council of the British Society of Refractive Surgery.
The safety of your eyes is paramount. Valerie and her dedicated Moorfields Eye Hospital-trained team of professionals are passionate about providing world class care. Her practice has a consistent track record of excellence and safety. She is often referred complex cases, and it’s no coincidence that patients seek her help when things don’t go well elsewhere.
Why compromise on anything less? Your eyesight is precious. There are many laser eye surgeons but few who have years of expertise and experience in both dry eye and laser eye surgery like Miss Saw.
* according to Clinic Compare UK.