The National Institute for Health and Clinical Excellence (NICE) - May 2006
NICE Issues Guidance on Laser Eye Surgery for Treating Refractive Errors
The National Institute for Health and Clinical Excellence (NICE) has issued guidance on photorefractive (laser) eye surgery for the treatment of refractive errors (short and long-sightedness) to determine whether it is safe enough and works well enough for use. The guidance does not recommend that laser eye surgery should be offered to patients routinely on the NHS, as for most people eye problems can easily be corrected by wearing spectacles or contact lenses.
In summary the guidance states:
1) Current evidence suggests that laser eye surgery is safe enough and works well enough for use in appropriately selected patients.
2) Clinicians wishing to undertake laser eye surgery should ensure that patients understand the benefits and potential risks of the procedure.
3) Risks include failure to achieve the expected improvement in unaided vision, development of new visual disturbances, corneal infection, and flap complications. These risks should be weighed against the risks and any possible inconvenience of wearing spectacles or contact lenses.
4) Clinicians should audit and review clinical outcomes of all patients who have laser eye surgery. Further research will be useful and clinicians are encouraged to collect longer-term follow-up data.
5) Clinicians should have adequate training before performing these procedures.
The Royal College of Opthalmologists
The Royal College of Opthalmologists (RCO) has produced standards for laser refractive surgery. The guidance covers the three most common types of laser eye surgery (laser in situ keratomileusis [LASIK], photorefractive keratotectomy [PRK] and laser epithelial keratomileusis [LASEK]) and updates and replaces guidance on LASIK issued in December 2004. www.rcophth.ac.uk/docs/publications/published-guidelines/RefractiveSurgeryStandardsDec2004.pdf
Professor Bruce Campbell
Chairman of the Interventional Procedures Advisory Committee, Professor Bruce Campbell says, "We hope today's guidance will help to reassure people thinking of having laser eye surgery either on the NHS or privately. It is still important that patients discuss fully with the surgeon the possible risks and benefits of having laser surgery in their particular case. They need to weigh the risks of the procedure carefully against the inconvenience and possible risks of wearing spectacles or contact lenses. We are not saying that laser eye surgery should be offered to patients routinely on the NHS, because most people's eye problems can easily be corrected by wearing spectacles or contact lenses."