It is an extraordinary privilege to be able to deliver modern laser eye surgery. I’ve seen it evolve to where we are now, which is using all laser technology for all components of the procedure. The laser eye surgery success rate is very high. Such that the risk of infection is minuscule, the outcomes are extraordinarily accurate, and the chance of having any significant problem afterwards are really small. To the point where if you’re someone who wears contact lenses, for example, you’ve already embraced the concept of a small risk for an enhancement in lifestyle and convenience. Moreover, you’ve accepted an ongoing risk of contact lens-related infection.

As we get older, all of us get slightly drier eyes, and the quality of your tear film is incredibly important for safe contact lens wear. By definition, people who wear contact lenses over time not only are they accepting an ongoing risk of contact lens-related infection, but that risk is going up as time goes on their tear film quality declines.

Whereas with laser eye surgery, everything we use, everything that touches the eye is single use sterile disposable. It’s a one-off event, and certainly, with SMILE, small incision laser eye surgery, the surface is healed within two or three hours, and the patient’s defences are back up. So the chances of getting an infection at that time are incredibly small. We’re covering it with strong antibiotics as well immediately after the surgery. Once we’ve got the patient through that, they can enjoy great quality vision, independence from spectacles, and no contact lenses.

How we monitor the laser eye surgery success rate

If we consider LASIK laser eye surgery for short-sightedness correction and SMILE laser eye surgery for short-sightedness correction, we have audited our own figures of laser eye surgery success rate over the last four years we found that we’ve had no patients with two or more lines of loss spectacle corrected vision and we have a two percent enhancement rate.

Let me explain this. Best corrected vision is the very best sharpness of vision that we can achieve for a patient with any kind of lens. It’s how far we can push them down the chart. There is variation. We’re not all wired the same. The most some patients can achieve is the 20/20 vision line. The 6th vision line. While we talked about that as a good level of vision, it’s an average. Many patients can achieve a line or even two lines better and sharper than that, as long as they’ve got an appropriate lens in front of them. This is common when considering the laser eye surgery success rate.

When we perform laser eye surgery for somebody, what we’re after is really a quality vision without wearing spectacles. Ideally what we want to achieve is the very same level of sharpness that they can achieve in their spectacles before surgery, but they’re achieving that without the spectacles afterwards. We and the patient would accept a slightly lower bar of very good vision with a small correction. I’m an example of that. I have a small amount of short-sightedness in my left eye. If I compare the vision of each eye, I can see a line better with my right than my left, but if I put an appropriate lens in front of my left eye, I can unlock all the sharpness.

At the very least, we will accept for our cases is they got the 20/20 vision line, but if I put in that tiny correction, which the patient doesn’t need and they don’t want, I can get all the vision back. If we can’t achieve that lost line, we’re always working to eliminate them and what we’ve been able to achieve is no patients with two lines and only two percent of patients losing one line. As a quantum of vision, we’re really holding onto it for people. Then we have to write enhancements. I was just mentioning we may have some patients who have a small amount of the defocus remaining after the laser eye surgery and for most patients, it’s a normal amount of the defocus that you might find in someone like me who’s got good vision without spectacles. But for some patients, because we’re all unique, they’ll heal in such a way that we’re just a bit too far off for them to be delighted with the surgery, and I want them to be delighted.

For argument’s sake, let’s say they started as a minus six prescription short-sighted patient, three months after surgery they are minus 0.75 in each eye. They’ll have good vision, they’ll be able to wake up in the morning and make a cup of tea and see what they’re doing, they probably with both eyes open would even be at the driving standard, but it will be slightly blurry. It’ll feel like the benefit from a pair of specs. But we don’t want that.

So once we’re happy that the prescription is stable and it isn’t moving, then we will offer those patients an enhancement, and it’s very straightforward. They would return to the laser. With LASIK we would just surgically find the edge of the flap and lift it up, do a tiny ablation, it’s incredibly accurate because it’s such a small amount that we’re correcting and also the patient’s flap is in place. We measure the eye with a flap as opposed to the virgin eye before the initial treatment. This is incredibly accurate, and it can secure that last bit of sharpness that the patient is after.