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Last Updated: Friday, 17 December, 2004, 11:16 GMT
Should laser eye sugery be offered on NHS?
Woman having an eye test

The NHS has been told that it should not be using laser eye surgery as a matter of routine.

The National Institute for Clinical Excellence says more needs to be known about the long term effects of the procedure before it's offered to NHS patients.

NICE says there would need to be evidence that laser surgery was very safe before it could be offered as a routine alternative to glasses and contact lenses.

Doctors providing the treatment defended its record and said they were disappointed with the findings.

Have you had laser eye surgery? Do we know enough about its long term effects? Should it be offered to NHS patients?

This debate is now closed. Read a selection of your comments below.


The following comments reflect the balance of comments received so far:

The risks were explained beforehand
Roger Harrison, Bridgnorth, Shropshire
I have had laser eye surgery done (in South Africa) and have never been happier. The risks were explained beforehand and with modern technology and professional specialists undertaking the operation I think this warning is just another attempt by the Government to try and save money for the NHS.
Roger Harrison, Bridgnorth, Shropshire

True, laser eye surgery is well established now but it is not entirely without serious risks. Would I have it myself or recommend it for my partner? Most certainly NOT. You only need to go to an ophthalmic convention to see how many ophthalmologists wear glasses!!
An ophthalmologist, Leeds

There is no need for the NHS to underwrite the safety of the procedure, since the risks are well known, and it would be elective. NHS buying power could reduce the cost to a level where it is the cheapest alternative for long term vision correction for 90% of spec wearers.
Philip, Exeter

I am considering it. From a cost point of view, I'm sure a short treatment will be much cheaper in the long run, than producing a pair of glasses, and replacing them yearly due to changes in fashion and for wear and tear reasons.
Paul Sealey, Cannock, England

I can change my glasses indefinitely
Danny, Kendal, England
Eyes change. In a few years time they will probably need more treatment. I can change my glasses indefinitely, how many times can you have your eyes burned by laser?
Danny, Kendal, England

Laser surgery is not currently advanced enough to fix my eyes, but as soon as it is, I shall be paying for it to be done. It's simple economics as a new pair of glasses typically cost me around 500 so long term I will save. The NHS would have come to the same conclusion, except for the fact that they no longer provide any financial support for those of us who wear glasses.
Paul Johnson, Horsham, UK

Surely the NHS is supposed to be there for essential health needs?? Laser surgery does nothing that a pair of glasses can't do far more easily and cheaply. Why do we keep trying to expand the range of services the NHS offers and then complain when the basics are underfunded??
John R. Smith, UK

Could this save money for the NHS in the long term? People with laser corrected vision won't need glasses again, so maybe a once off expense will save recurring expenses over the years.
Martin, England, UK

The NHS does not currently pay for anything towards my eye care...I pay for the test, the lenses and the frames. Would it not be better to provide at least some contribution towards the costs of spectacle wearers before considering offering a more radical and probably more expensive solution?
Martin Hilton, Leicester, UK

Why are people going on about cosmetic treatments?
Nigel, UK

The NHS currently provides breast enlargements and tummy tucks, free of charge, to women and in the latter some men, who know how to play the system. Ask any operating department nurse. So why are people going on about cosmetic treatments? Some forms of myopia do not allow the use of off the shelf contact lenses and wearing glasses can restrict your lifestyle in many ways.
Nigel, UK

Apart from possible health considerations, my view on whether it should be offered rests on the question of how necessary it is? Can a person get by with contacts or specs, and could the money that would be used for enhanced vision then go to help someone keep his/her life? In an ideal world, we'd have everything on the NHS, but it's not ideal, and we don't have the money.
Andy Armitage, Hebron, Whitland, West Wales

Definitely not. When I considered it the surgeon said he wouldn't have it done to himself, as the long term effects were unclear.
Michael Montagu, London

Laser eye surgery hasn't been around long enough to evaluate the long-term effects - what happens 20, 30, 40, 50 years after surgery. I've been very short-sighted since childhood: I wear contact lenses or glasses, and don't feel myself in any way 'impaired'. I would not wish to risk my eyes in unnecessary surgery which might have consequences in old age.
Doc M, Glasgow, Scotland, UK

Laser eye surgery is offered FREE in Brazil (a developing country), why not the U.K.?
Tony Blackburn, Congleton UK/ Sao Paulo Brazil

Surely in the long run this is actually cheaper?
Gareth Roberts, Edinburgh

What about the assistance the government gives people to pay for their glasses? Surely in the long run this is actually cheaper?
Gareth Roberts, Edinburgh

We cannot afford to keep expanding the range of non-essential treatments available on the NHS. Added to this, just wait for the lawsuits from people who are dissatisfied with the free treatment they receive.
Will Ford, Cardiff UK

I wear lenses or glasses but I would never think that the NHS should provide this. We do not know about its long term effects and there are alternatives.
Tracey, Norwich, England

I haven't had laser eye surgery and although I would probably take it if it were offered on the NHS I don't believe that it should be. Laser eye surgery is more of a cosmetic than a health issue and if it could open the door to other cosmetic treatments becoming available and were would we draw the line?
George, Nairobi, Kenya

I think it should be offered on the NHS, I wear glasses and am going to pay to have the treatment because wearing glasses constantly has left permanent scarring on the side of my nose. I seem to be allergic to them whatever I try and constantly come up in a rash.
Jenny, Herts

This is just another NICE way of limiting ordinary people's access to effective treatment. It's cynical and means that hundreds of thousands of people will be deprived of an easy way of improving their quality of life.
Ron Bracey, Chichester, UK

No. Unless it is to prevent imminent blindness
Graeme, England

No. Unless it is to prevent imminent blindness. This is cosmetic surgery. Glasses are widely available, and NHS subsidised for those who need it. Contact lenses are available for the vain. There is no need to burden the NHS budgets for a "nice to have" procedure.
Graeme, England

To Graeme, England - contact lenses are not only for the vain. Try working outdoors in the rain, or in a steamy kitchen in glasses. Try playing contact sports. Also note that some visual problems can only be corrected by contact lenses - paid for by the wearer. Don't be so quick to put people down as vain. Also please note that NHS glasses are not subsidised for all who need them, only those who the system deems worthy. The lenses alone in a cheap pair of glasses cost what I used to earn in two weeks as a student but being over 18 I wasn't entitled to help.
Fiona, Dumbarton

Graeme, I take it you've never had to wear glasses...?
SP, London

It should be available, they offer help for patients who suffer from hearing loss why not? They pin back children's ears on the NHS why not laser eye surgery? My husband has subsidised lenses from the NHS over the years it will be cheaper for them to fork out for the laser eye surgery than to keep paying for glasses.
Keryn Irving, Glasgow

I can see that the NHS doesn't want to be sued
Anna Hornsey, London, UK

Tricky question. I have a hearing loss and the NHS provided me with surgery and a free hearing aid to correct it. Yet my contact lenses for my short sightedness cost me over 200 a year. If laser eye surgery was free on the NHS I would definitely go for it - but I can see that the NHS doesn't want to be sued in the future by people whose sight is damaged by surgery.
Anna Hornsey, London, UK

These findings appear to be ignorant of the fact that laser eye surgery has been available for years. Some high street opticians can even arrange for this to be done. What is the real issue here?
Andy Bird, Cheshire, UK

I am an eye surgeon, and feel safety is well proven. I suspect it is the fear of potential litigation costs that is the real problem here.
An ophthalmologist, Cheltenham

I had laser surgery 3 years ago as an alternative to purchasing another pair of glasses to replace a broken pair. The cost was approx 500 but a pair of designer glasses was 250 and would inevitably need replacing. I opted for the older but more medically proven treatment and I was forewarned that it would be a painful recovery. Painful is only a mild definition of the healing process! Now 3 years later I would put it down as one of the very best decisions I have ever made and feel that its benefits should be offered to those not fortunate enough to be able to go private.
Doug, London UK

Perhaps the problem is that everyone wants an instant fix, so are opting for the more invasive Lasik surgery. PRK has been done for many years, and is cheaper. However, not on the NHS unless clinically necessary, I feel.
Sue Roberts, Bristol

If the NICE decision is based purely on safety then fair enough. If, however it is based on economic considerations then all new techniques may go the same way. Then, if we want to feel better, it won't be long before we're back to leeches, magic potions and Cliff Richard Christmas records.
Josephine Peat, London, England

If corrective surgery would improve genetically defective vision, it should be a right; after all, if treatment for the self-inflicted injuries caused by smoking, drinking and overeating are freely available, it would be discriminatory to refuse to provide it.
Anon, UK

I had laser surgery over a year ago and it was the best decision I have ever made
Carl, Liverpool, UK

I had laser surgery over a year ago after speaking with a colleague who'd had the same operation a couple of years earlier, and it was the best decision I have ever made. From being myopic, I now have 20-20 vision. I was made aware of potential side effects - one being the halo effect which I got with contact lenses anyway, but so far hasn't been a problem post surgery - and the fact that my eyesight will deteriorate naturally as part of ageing, but at least 10 years of not having to wear glasses or contact lenses makes it all worthwhile.
Carl, Liverpool, UK

The NHS should only offer basic treatments. If anyone wants gold-plated or cosmetic treatment they should pay for it themselves.
Andrew, London UK




SEE ALSO:
Routine NHS laser ops ruled out
15 Dec 04 |  Health
Safety fears over laser surgery
29 Aug 04 |  Health
Laser eye surgery complaints up
26 May 03 |  Health


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