The short answer. For most people with a stable prescription and healthy corneas, yes. Over 95 in 100 patients in published studies are satisfied with the result and patients often describe the surgery as “life changing.” The correction is long lasting, and sight threatening complications are rare. The only way to know if it is worth it for your eyes is a proper assessment. For some people another option suits them better, and I will always say so.
I perform laser eye surgery at Moorfields Private Eye Hospital, and I have had laser vision correction myself. Patients ask me this question at almost every consultation. Below is how I answer it, with the published evidence.
Will it work?
Over 95% of patients are satisfied, and many describe the surgery as “life changing.”
The published evidence here is strong and consistent. A world literature review by Solomon and colleagues in 2009, pooling 19 studies and 2,198 LASIK patients, found 95.4% were satisfied, with the range across individual studies running from 87.2% to 100%. A larger review by Sandoval and colleagues in 2016, covering 97 studies and 67,893 eyes treated between 2008 and 2015, found that 90.9% of eyes landed within half a dioptre of their target and 99.5% could see better than 6/12 without glasses, with only 1 to 2 in 100 patients dissatisfied. And in the FDA’s PROWL studies (Eydelman and colleagues, 2017), in which 574 patients answered validated questionnaires, just 1 to 2% were dissatisfied with the surgery and 1 to 4% with their vision.
Most of this evidence is for LASIK. Surface laser (PRK, of which TransPRK is the modern form) gives similar results at one year, with a slower and less comfortable recovery (Shortt et al., 2013). Vision after SMILE typically takes longer to settle than after LASIK.
Satisfied does not mean symptom free, which is why the next question matters more.
Is it safe?
Safety is usually the first concern, and a fair one. In brief it is a low risk procedure, not a zero risk procedure. Laser eye surgery is now among the most studied elective surgeries in medicine and permanent serious loss of vision is rare. That said, no procedure is entirely without risk. The Royal College of Ophthalmologists also sets clear standards for how the procedure should be carried out. Results depend heavily on a careful assessment beforehand and an experienced surgeon. This is why I map each eye in detail and only recommend surgery when I am confident it is the right choice for that patient.
Remember there is a difference between side effects that are common and temporary, and complications that are rare and serious.
Common and usually temporary. Almost every patient will experience some dry eye symptoms, and some glare or halos around lights at night, for the first few months. In the PROWL studies, 43% to 46% of patients who had no visual symptoms before surgery noticed at least one new symptom at three months. About 28% of those with no dry eye symptoms beforehand had some at three months (Eydelman et al., 2017). Visual symptoms were common before surgery too, and across the whole group they became less common afterwards.
Rare and serious. In the 2016 review, 0.61% of eyes (about 6/1000) lost two or more lines of best-corrected vision on the chart (Sandoval et al., 2016). This review article was published over a decade ago and laser eye surgery technology has improved since then. The complications surgeons worry about most are infection and ectasia, a progressive weakening and bulging of the cornea. The main risk factors for ectasia are an abnormal corneal shape, a thin cornea, younger age and a high prescription (Randleman et al., 2008). That is why the scans at your consultation decide whether you should have laser at all. The Royal College of Ophthalmologists information on laser vision correction estimates that “less than 1 in 5000 patients require a corneal transplant to restore vision after laser surgery.”
Compared with contact lenses. Contact lenses carry a small risk of corneal infection every year you wear them. Surgery carries it once. A 2017 meta-analysis found the risk was similar after one year of daily soft lens wear and after LASIK, and estimated about three times as many infections with daily lenses over five years (Masters et al., 2017). Both risks are small.
What lowers the risk. Careful selection, an experienced surgeon and reliable aftercare. The Royal College of Ophthalmologists publishes Professional Standards for Refractive Surgery and awards the Certificate in Laser Refractive Surgery (CertLRS), which I hold.
Will it last?
This is where much of the value sits. The reshaping of the cornea (the clear window at the front of the eye) is permanent, and for most people the correction stays stable for many years. In that sense, the results are designed to last.
There is one honest caveat. Laser surgery corrects your prescription as it is today, but it cannot pause the natural ageing of the eye. Also, everyone will develop presbyopia (the age related need for reading glasses) in their 40s or 50s, and cataracts can still form later in life, just as they would anyway. Neither is a fault of the surgery, and both can be treated in their own right when the time comes.
Surface laser, 20 years on. The cornea had not changed. Prescriptions had drifted by half a dioptre on average, almost all of it in people treated before 40 (O’Brart et al., 2014).
LASIK, 10 years on. With 1990s lasers, 73% to 88% of eyes were still within 1 dioptre of target (Alió et al., 2008; Alió et al., 2009).
SMILE, 10 years on. Average drift was about a third of a dioptre or less in three studies (Blum et al., 2019; Xia et al., 2024; Zhao et al., 2024).
Does the money add up?
Laser eye surgery is a significant one off investment, so it is natural to focus on that figure. It helps, though, to set it against what you already spend. Glasses, prescription sunglasses, contact lenses, solutions and replacements add up quietly over the years, and they never stop. Spread across the years of clear vision that follow after laser eye surgery, many patients find the comparison closer than they expected.
For most, though, the real value is not purely financial. It is waking up and seeing the clock, swimming or playing sport without a compromise, and no longer planning around lenses and cases. That everyday freedom is what a lot of my patients tell me made it worth it for them. Many describe it as “life-changing” and wish they had done it sooner.
To put rough figures on it: if you spend around £250 a year on glasses, replacing them every couple of years, it would take roughly 24 years of that spending to match the cost of laser eye surgery. If instead you wear daily contact lenses with a back-up pair of glasses, at around £570 a year, it would take about 10 years. Everyone’s numbers are different, but set against a lifetime the gap is usually smaller than people assume.
What changes day to day?
Money is rarely why people do it. I had LASIK laser vision correction myself in 2018. The procedure was painfree and easier than a visit to the dentist for a checkup. I remember waking up the next day and seeing the London skyline for the first time without glasses or contact lenses. Eight years later it is just as clear.
These are what patients often mention to me at their three month visit:
- reading the alarm clock without reaching for glasses
- swimming and seeing the far end of the pool
- running or cycling in the rain
- packing for a trip without lenses, solution and a spare pair
- getting to the end of the day without dry, tired contact lens eyes
Most patients’ only regret was not having it done sooner.
When I advise against it
Being honest about when laser eye surgery might not be worth it matters as much as the positives. Laser eye surgery is not right for everyone. If your cornea is too thin, your prescription is still changing, or you have certain eye conditions, the risks can outweigh the benefits and in that case I will say so plainly.
That does not always mean vision correction is off the table. Alternatives such as ICL (Implantable Collamer Lens) or lens replacement (refractive lens exchange) can suit people who are not ideal laser candidates, and they correct many of the same prescriptions. And if you have astigmatism, or you are weighing up which laser procedure is right for you, that is all part of the same conversation.
There are some clear situations where I will advise caution or a different route. If you are under 21, or your prescription has moved by more than half a dioptre in the last two years, I would wait, ideally until you are at least 21, and always until your prescription is stable. If your scans show corneas that are thin or irregular in shape, LASIK is not the answer; surface laser or an implantable contact lens (ICL) may be safer, and sometimes the right advice is no surgery at all. For higher prescriptions, above about -7.00 dioptres of short sight, +6.00 of long sight or 6.00 of astigmatism, an ICL or lens exchange is usually the better operation. If you have significant dry eye, I would treat that first and then reassess, and an ICL may suit you better.
If you are over 50 and mainly want to be free of reading glasses, refractive lens exchange, which replaces the lens that has aged rather than reshaping the cornea, may be the better option; where the natural lens is still healthy, laser eye surgery is generally the best choice, with an ICL as an alternative. If your prescription is mild and you are comfortable in glasses, I would often say keep them, as the benefit may not justify the cost or the small risk. And if what you want is perfect night vision with no glasses for life, no operation can promise that, and I would not operate.
Questions to ask any surgeon
Two clinics can quote similar prices for very different care, so there are six questions worth asking any surgeon, and you should ask them of me too.
First, who will assess you, operate on you and see you afterwards? I do all three: you see me at the first consultation, on the day of surgery and at every follow-up. Second, which procedures do they offer? I offer LASIK, TransPRK and SMILE Pro, plus ICL and refractive lens exchange, so the recommendation is never limited by what is available. Third, do they hold the Royal College‘s Certificate in Laser Refractive Surgery? I do, alongside FRCOphth, PhD and FWCRS. Fourth, what exactly does the price include? In my case, the surgery, hospital fee, drops and three months of follow-up. Fifth, what happens if you need a top-up treatment? With me it is included within five years for short-sighted corrections. And sixth, who do you call if you are worried at night or at the weekend? Me, as my patients have my mobile number for emergencies after surgery.
I see private patients only at Moorfields Private, part of Moorfields Eye Hospital. If you need an anaesthetist or another eye specialist, they are part of the same hospital.
So, is laser eye surgery worth it?
If your prescription is stable, your scans are normal, and glasses or contact lenses get in the way of your life, the evidence says yes. Over 95 in every 100 patients are satisfied, less than 6/1000 eyes lose two or more lines on the chart, and the correction is long-lasting.
If any of those three conditions is missing, the answer may be no, or it may be a different operation.
The only way to know which group you are in is to have your eyes measured. A consultation with me costs £195 including all scans. You do not need a referral, and appointments are usually available within one to two weeks. Book a consultation or call 020 7100 5468.
About Mr Alex Day
Mr Alex Day FRCOphth PhD CertLRS FWCRS is a Consultant Ophthalmic Surgeon at Moorfields Private, specialising in laser eye surgery (LASIK and SMILE), cataract surgery and Implantable Collamer Lens (ICL) surgery. Based in London, he is the author of over 70 peer-reviewed publications and is widely regarded as the surgeon of choice for medical practitioners and their families seeking vision correction in London. To arrange a consultation, visit www.alexday.co.uk.
References
Solomon KD, et al. LASIK world literature review: quality of life and patient satisfaction. Ophthalmology. 2009;116(4):691-701. doi:10.1016/j.ophtha.2008.12.037
Sandoval HP, et al. Modern laser in situ keratomileusis outcomes. J Cataract Refract Surg. 2016;42(8):1224-34. doi:10.1016/j.jcrs.2016.07.012
Eydelman M, et al. Symptoms and satisfaction of patients in the PROWL studies. JAMA Ophthalmol. 2017;135(1):13-22. doi:10.1001/jamaophthalmol.2016.4587
Shortt AJ, Allan BDS, Evans JR. LASIK versus PRK for myopia. Cochrane Database Syst Rev. 2013;(1):CD005135. doi:10.1002/14651858.CD005135.pub3
Randleman JB, et al. Risk assessment for ectasia after corneal refractive surgery. Ophthalmology. 2008;115(1):37-50. doi:10.1016/j.ophtha.2007.03.073
Masters J, Kocak M, Waite A. Risk for microbial keratitis: comparative meta-analysis of contact lens wearers and post-LASIK patients. J Cataract Refract Surg. 2017;43(1):67-73. doi:10.1016/j.jcrs.2016.10.022
Blum M, et al. 10-year results of small incision lenticule extraction. J Refract Surg. 2019;35(10):618-623. doi:10.3928/1081597X-20190826-02
Alió JL, et al. Ten-year follow-up of LASIK for myopia of up to -10 diopters. Am J Ophthalmol. 2008;145(1):46-54. doi:10.1016/j.ajo.2007.09.010
The Royal College of Ophthalmologists. Professional Standards for Refractive Surgery. 2024.
