Impartial Advice on Laser Eye Surgery

[968]

13m said:

I was referring to consultants in the medical sector.

As for reputation, it's much harder to obtain reviews about consultant performance than it is of a retail operation, such is the opacity of medical performance data and the proliferation of review websites. You could be a bloody awful surgeon and it would be quite difficult for anyone to find out about it. A large operation trading under business name is far more susceptible to public patient feedback.

As for optoms and surgeons in the retail outfits being targeted and clock watching: I cannot speak about anyone but Optical Express, but I can assure you that none of the medical staff ever applied any pressure or tried to persuade me one way or another. The business has separate sales staff, but even after agreeing to the surgery the checks and balances were in place to make sure that I was happy with my decision.

I saw absolutely no hint of clock watching by the surgeon, in fact quite the opposite.

For what it's worth, I think what you are doing here is very useful, in terms of advising people what options are available for their given prescription. However, I think you'd do yourself and everyone else a favour by not scaremongering about retail operations that appear to be making improved eyesight more accessible to the general public. Talk your own book by all means, but don't attempt to diminish others, particularly on bases that are almost certainly untrue and about which I suspect you have little knowledge.

Edited by 13m on Wednesday 30th September 18:02

Thanks, however, I have a great deal of inside knowledge of a number of these organisations as I know a number of surgeons who've worked for them and currently work with them and they totally contradict what you've written. Indeed I've been approached by more than one company for my services and they positively encourage and incentivise their surgeons to sell procedures to patients because that's how their paid, I declined their offers as frankly they put patient safety behind their profits and knowingly were encouraging patients to have treatments that were not necessarily the best option, hence my negative views about them, which is not scaremongering any more than your rather inaccurate views of private consultants are. Anyhow this is a quite pointless discussion. You have your opinion and I have mine and readers can make their own minds up.

[968]

Mad March Taffy said:

I keep seeing £2,500 per eye - I must need to get my sight checked!




Many thanks for this infor - really helpful and as least I now know which questions to ask - appreciated

No problem. Any further questions, please ask or pm

[Sonic]

968 said:

You have your opinion and I have mine and readers can make their own minds up.

I've been advised by quite a few friends to look at eye surgery as it's been life-changing for them.

Any advice is much appreciated.

My current prescription is the following -

R -1.25 -2.00 175
L -0.75 -2.25 170

With only the right astigmatism having shifted from 5 to 175 since 2013.

I also have type 1 diabetes which may be a complicating factor in any procedure?

Many thanks!

[Richyvrlimited]

Can I join in?

I'm mid 30's, been wearing soft contact lenses since I was 16. I'm quite long sighted, my contact lensees are +6.0 in both eyes, but that's more for convenience as both eyes are slightly different with an astigmatism in one eye.

I don't know my glasses prescription off the top of my head.

I did go for a consultation 10 years ago for laser surgery but was rejected due to my prescription strength, I was offered a consultation for permanent contact implants, but after tests couldn't have those due to my pupils being too large? (something was too big it was too long ago to remember).

I would genuinely be much happier if I could end up with a much lower prescription, presently my current glasses have very thick and heavy lenses, having to wear low prescription glasses, (and contacts for sport), wouldn't bother me if they didn't make me look like Mr Magoo! Obviously glasses free would be ideal, but I'm realistic that it might not be possible.

Any advice would be most welcome

[dave_s13]

Bookmarked. My Mrs is off for a consultation tomorrow at optical express in Leeds so I'll post back her stats and see what the learned folk of ph think.

[tumble dryer]

dave_s13 said:

Bookmarked. My Mrs is off for a consultation tomorrow at optical express in Leeds so I'll post back her stats and see what the learned folk of ph think.

Google is your friend.

[RobM77]

Richyvrlimited said:

Can I join in?

I'm mid 30's, been wearing soft contact lenses since I was 16. I'm quite long sighted, my contact lensees are +6.0 in both eyes, but that's more for convenience as both eyes are slightly different with an astigmatism in one eye.

I don't know my glasses prescription off the top of my head.

I did go for a consultation 10 years ago for laser surgery but was rejected due to my prescription strength, I was offered a consultation for permanent contact implants, but after tests couldn't have those due to my pupils being too large? (something was too big it was too long ago to remember).

I would genuinely be much happier if I could end up with a much lower prescription, presently my current glasses have very thick and heavy lenses, having to wear low prescription glasses, (and contacts for sport), wouldn't bother me if they didn't make me look like Mr Magoo! Obviously glasses free would be ideal, but I'm realistic that it might not be possible.

Any advice would be most welcome

I find that surprising. I was lasered in 2007 and went from over 6 myopic (sorry, I can't remember my exact prescription) with an astigmatism of around 3, to 6/4. I now enjoy daily life without glasses annoying me and all my sports and hobbies have become *so* much easier!

[Buster73]

968 , are you based at Sunderland E.I. by any chance. ?

[NorthDave]

To throw my opinion in (as a punter who has been through the process) - I went to the Manchester Royal Eye Hospital. The process was great and reassuringly expensive. They deal with the aftermath of when high street chains get in wrong too.

I can't recommend them highly enough. It must be approaching 10 years since I had mine done and have had no problems, only benefits, since.

[13m]

NorthDave said:

To throw my opinion in (as a punter who has been through the process) - I went to the Manchester Royal Eye Hospital. The process was great and reassuringly expensive. They deal with the aftermath of when high street chains get in wrong too.

I can't recommend them highly enough. It must be approaching 10 years since I had mine done and have had no problems, only benefits, since.

Which is misleading isn't it, because it implies that high street chains get it wrong more often than hospitals - which I doubt it the case.

I've had better results with commercial operations than I have with consultants, in respect of private treatment. The RLE surgery I had at one such chain has been extremely successful and the post-op support on a whole different level from any hospital or consultant I've used.

[NorthDave]

13m said:

Which is misleading isn't it, because it implies that high street chains get it wrong more often than hospitals - which I doubt it the case.

I've had better results with commercial operations than I have with consultants, in respect of private treatment. The RLE surgery I had at one such chain has been extremely successful and the post-op support on a whole different level from any hospital or consultant I've used.

I wouldn't say it's misleading? When the high street chains get it wrong - as I guess everyone does from time to time - they go to somewhere like the Royal Eye Hospital. When I was making my choice I took this to mean they had more experience dealing with issues.

Ultimately I guess everyone makes their own decision. I've only been through the process once. I cant see a comparison for a different service yet your post reads like you have done this a few times?

[13m]

NorthDave said:

13m said:

Which is misleading isn't it, because it implies that high street chains get it wrong more often than hospitals - which I doubt it the case.

I've had better results with commercial operations than I have with consultants, in respect of private treatment. The RLE surgery I had at one such chain has been extremely successful and the post-op support on a whole different level from any hospital or consultant I've used.

I wouldn't say it's misleading? When the high street chains get it wrong - as I guess everyone does from time to time - they go to somewhere like the Royal Eye Hospital. When I was making my choice I took this to mean they had more experience dealing with issues.

Ultimately I guess everyone makes their own decision. I've only been through the process once. I cant see a comparison for a different service yet your post reads like you have done this a few times?

Eye surgery only once, but other procedures via consultant surgeons and commercial outfits. The former have been okay if somewhat arrogant quite often, without justification in a lot of cases. Also follow-up is lousy, whereas I have found it to be generally good with commercial operators.

Commercial operators live or die on their reputation whereas it is far easier for a consultant to be mediocre and still get work. If all else fails there's always his bread and butter NHS job to fall back on.

[968]

13m said:

Eye surgery only once, but other procedures via consultant surgeons and commercial outfits. The former have been okay if somewhat arrogant quite often, without justification in a lot of cases. Also follow-up is lousy, whereas I have found it to be generally good with commercial operators.

Commercial operators live or die on their reputation whereas it is far easier for a consultant to be mediocre and still get work. If all else fails there's always his bread and butter NHS job to fall back on.

Actually the total opposite is true. Individual consultants live by their reputation and are not able to hide behind the corporate governance of an enormous multinational.

The follow ups ironically aren't carried out by the operating surgeon, but by optometrists trained by these operators to reduce the surgeons time away from theatre. However, this is due to change with new guidance from the GMC, though the multinationals are trying to challenge this.

The point about seeing a specific consultant, in particular one who is a corneal and refractive surgeon, is that they are able to deal with the complications that can occur from refractive surgery. In addition, they can offer the full range of management options available for a given patient, rather than just recommending one procedure. I regularly see patients in their 60s being offered and treated with LASIK and LASEK which is wholly inappropriate and evidence that the surgeon has no idea about the range of procedures available and offered the patient completely incorrect options.

Most surgery is routine, but it does go wrong, as I've seen on many occasions and when it does, these outfits usually dump their complications on the nearest corneal specialist within the NHS to deal with. I'm a surgeon myself (though not refractive, but a retinal one) and would not go anywhere apart from my local corneal/refractive surgical colleague for such a procedure.

[RobM77]

968 said:

13m said:

Eye surgery only once, but other procedures via consultant surgeons and commercial outfits. The former have been okay if somewhat arrogant quite often, without justification in a lot of cases. Also follow-up is lousy, whereas I have found it to be generally good with commercial operators.

Commercial operators live or die on their reputation whereas it is far easier for a consultant to be mediocre and still get work. If all else fails there's always his bread and butter NHS job to fall back on.

Actually the total opposite is true. Individual consultants live by their reputation and are not able to hide behind the corporate governance of an enormous multinational.

The follow ups ironically aren't carried out by the operating surgeon, but by optometrists trained by these operators to reduce the surgeons time away from theatre. However, this is due to change with new guidance from the GMC, though the multinationals are trying to challenge this.

The point about seeing a specific consultant, in particular one who is a corneal and refractive surgeon, is that they are able to deal with the complications that can occur from refractive surgery. In addition, they can offer the full range of management options available for a given patient, rather than just recommending one procedure. I regularly see patients in their 60s being offered and treated with LASIK and LASEK which is wholly inappropriate and evidence that the surgeon has no idea about the range of procedures available and offered the patient completely incorrect options.

Most surgery is routine, but it does go wrong, as I've seen on many occasions and when it does, these outfits usually dump their complications on the nearest corneal specialist within the NHS to deal with. I'm a surgeon myself (though not refractive, but a retinal one) and would not go anywhere apart from my local corneal/refractive surgical colleague for such a procedure.

This is precisely why I chose an individual surgeon with a reputation and history that I could check to 'laser' my eyes. Having someone operate on my number one sense wasn't something I undertook lightly. I arrived at the initial consultation with a long list of questions, which were all answered fully and knowledgeably, and I then saw the same guy for a pre-op check, the op itself and quite a number of follow ups (from memory it was roughly 1 week, 2 weeks, a month, six month and a year). Of the horror stories and stats I had read, most seemed to occur during post-operative care (much of it caused by the patient!) and it re-assure me greatly that I could call the surgeon's secretary directly at any point and speak to the surgeon and/or see him asap if necessary.

[13m]

RobM77 said:

I could call the surgeon's secretary directly at any point and speak to the surgeon and/or see him asap if necessary.

That's the nub of the problem. When I've had a procedure with a consultant surgeon, 99% of the time any follow-up concerns have been dealt with by his secretary. If she didn't know the answer, she'd ask the surgeon when she next saw him and drop me an email; which may or may not have provided the answer. On the one occasion I did get a surgeon to see me again regarding what turned out to be a cock-up on his part, he behaved like it was a massive inconvenience.

Aftercare with commercial outfits has tended to be far, far better. To give you an example, when I had RLE surgery with Optical Express I had a couple of concerns in the early days. I called them and was told an optom would see me immediately. I.e. within an hour.

A few weeks ago (this is >2.5 years after surgery), I had a query regarding the impact of a blepharoplasty upon the RLE surgery they'd performed. Again, I was invited in to see an optom, who checked me over and made contact with the surgeon. Within 12 hours she'd come back to me by phone and followed up by email. All of this without charge.

This is entirely different from the service I've had from consultant surgeons who seem to feel that their responsibility ends once the last suture is in. Any follow-up appointments have a lead time and are priced at £150-£250 (for 15 minutes typically) thank you very much.

[RobM77]

13m said:

RobM77 said:

I could call the surgeon's secretary directly at any point and speak to the surgeon and/or see him asap if necessary.

That's the nub of the problem. When I've had a procedure with a consultant surgeon, 99% of the time any follow-up concerns have been dealt with by his secretary. If she didn't know the answer, she'd ask the surgeon when she next saw him and drop me an email; which may or may not have provided the answer. On the one occasion I did get a surgeon to see me again regarding what turned out to be a cock-up on his part, he behaved like it was a massive inconvenience.

Aftercare with commercial outfits has tended to be far, far better. To give you an example, when I had RLE surgery with Optical Express I had a couple of concerns in the early days. I called them and was told an optom would see me immediately. I.e. within an hour.

A few weeks ago (this is >2.5 years after surgery), I had a query regarding the impact of a blepharoplasty upon the RLE surgery they'd performed. Again, I was invited in to see an optom, who checked me over and made contact with the surgeon. Within 12 hours she'd come back to me by phone and followed up by email. All of this without charge.

This is entirely different from the service I've had from consultant surgeons who seem to feel that their responsibility ends once the last suture is in. Any follow-up appointments have a lead time and are priced at £150-£250 (for 15 minutes typically) thank you very much.

Crumbs - a lot of assumptions there on things I haven't described yet. Firstly, neither of us can expect to speak to the surgeon immediately when he phone, obviously, so we need to decide what the next best thing is. The surgeon's secretary in my case had worked closely with the surgeon for years and it was her you spoke to, so the triage in that respect was much better than it would be in a commercial operation. I can't see how it could be better? Secondly, if you needed to see the surgeon, the response time for an appointment would be just as good if not better than you describe above. Thirdly, with regard to your last paragraph, obviously there are good and bad consultants - follow ups for me were all booked in on day one and came at no extra charge.

[968]

13m said:

That's the nub of the problem. When I've had a procedure with a consultant surgeon, 99% of the time any follow-up concerns have been dealt with by his secretary. If she didn't know the answer, she'd ask the surgeon when she next saw him and drop me an email; which may or may not have provided the answer. On the one occasion I did get a surgeon to see me again regarding what turned out to be a cock-up on his part, he behaved like it was a massive inconvenience.

Aftercare with commercial outfits has tended to be far, far better. To give you an example, when I had RLE surgery with Optical Express I had a couple of concerns in the early days. I called them and was told an optom would see me immediately. I.e. within an hour.

A few weeks ago (this is >2.5 years after surgery), I had a query regarding the impact of a blepharoplasty upon the RLE surgery they'd performed. Again, I was invited in to see an optom, who checked me over and made contact with the surgeon. Within 12 hours she'd come back to me by phone and followed up by email. All of this without charge.

This is entirely different from the service I've had from consultant surgeons who seem to feel that their responsibility ends once the last suture is in. Any follow-up appointments have a lead time and are priced at £150-£250 (for 15 minutes typically) thank you very much.

Again, that is simply not true.

Follow ups are a part of the price the patient pays and are packaged within that price. Most surgeons will provide free follow ups if there's a problem also. Optoms are not trained to deal with the complications so yet they will see you but will then have to defer to the surgeon, who may or may not be within the UK to deal with the complication. This is precisely why the GMC are clamping down on this practice so that large companies cannot get out of their responsibilities to the patient by palming off the follow up onto another staff member who will not be trained to deal with these issues.

[13m]

RobM77 said:

The surgeon's secretary in my case had worked closely with the surgeon for years and it was her you spoke to, so the triage in that respect was much better than it would be in a commercial operation. I can't see how it could be better?

Was your surgeon's secretary medically trained then? I very much doubt it, beyond at best being trained as a medical secretary.

RobM77 said:

Secondly, if you needed to see the surgeon, the response time for an appointment would be just as good if not better than you describe above.

What less than an hour? I doubt that.

RobM77 said:

Thirdly, with regard to your last paragraph, obviously there are good and bad consultants - follow ups for me were all booked in on day one and came at no extra charge.

Well the last two experiences I had were with two of the leading consultants in their fields in this area. One of them is one of the leading consultants in the UK in his field. So arguably, in that sense at least, they are "good consultants".

[968]

13m said:

Well the last two experiences I had were with two of the leading consultants in their fields in this area. One of them is one of the leading consultants in the UK in his field. So arguably, in that sense at least, they are "good consultants".

No they clearly are not, as they don't provide a good service to their private patients. I would not consider what you've described, if accurate, satisfactory. With regards to messages passed to me, I'd rather see the patient myself than outsource it to someone else who may or may not be permanent staff and may or may not be trained adequately in the complex procedures/equipment I use or need to use. Your experience is highly anecdotal n= 2, hence why the regulations are changing to tighten up this area because there have been so many complaints and poor service from under regulated multinationals who can sometimes sacrifice patient safety for profit.

[RobM77]

13m said:

RobM77 said:

The surgeon's secretary in my case had worked closely with the surgeon for years and it was her you spoke to, so the triage in that respect was much better than it would be in a commercial operation. I can't see how it could be better?

Was your surgeon's secretary medically trained then? I very much doubt it, beyond at best being trained as a medical secretary.

RobM77 said:

Secondly, if you needed to see the surgeon, the response time for an appointment would be just as good if not better than you describe above.

What less than an hour? I doubt that.

RobM77 said:

Thirdly, with regard to your last paragraph, obviously there are good and bad consultants - follow ups for me were all booked in on day one and came at no extra charge.

Well the last two experiences I had were with two of the leading consultants in their fields in this area. One of them is one of the leading consultants in the UK in his field. So arguably, in that sense at least, they are "good consultants".

The person answering the phone in a commercial operation won't be medically trained either. With regard to consultants being "leading", naturally that depends what they're leading in: research, operations, customer service etc - obviously the latter is not necessarily connected to the former two. For customer service and quality of aftercare, this is much down to individual surgeons and clinics and will obviously be part of your research.

Bear in mind that my eyes were lasered some time ago (2007). What we all need to do is to research the options available to us at the time and make a decision on what we find. I was hugely impressed with the service I received.