Surgical Vision Correction – The Outcomes of Laser Eye Surgery and Intraocular Lens Procedures

Abstract

Introduction
Each year, hundreds of thousands of patients in the UK undergo Laser Eye Surgery or Intraocular Lens (IOL) surgery.1,2 While Laser Eye Surgery primarily focuses on improving uncorrected distance vision, IOL surgery can additionally enhance intermediate and near vision, often as part of cataract treatment. This thesis analyses the safety & efficacy of Laser Eye Surgery, otherwise known as Laser Vision Correction (LVC) and Refractive Lens Exchange (RLE) otherwise known as Lens Replacement Surgery, conducted as part of my tenure at Optical Express across the UK, Ireland, and Europe.

Methods
Safety and efficacy were investigated using extensive clinical data and patient-reported outcomes (PROs). Safety metrics included complication rates and visual acuity changes, while efficacy metrics span visual acuity at different distances, quality of vision, quality of life, and satisfaction. The analyses are retrospective, based on large datasets extracted from electronic medical records, covering varied patient cohorts by refractive range, age, and comorbidities. Sample sizes ranged from hundreds to tens of thousands, across different LVC procedures / IOL designs (as applicable). A comprehensive adverse event analysis across tens of thousands of consecutive cases is included.

Results
Laser and IOL surgery were found to be safe, predictable & effective for eligible patients. Studies demonstrated that LASIK provides excellent safety and efficacy, even in complex cases such as those with controlled systemic health conditions. Advancements in wavefront technologies have further enhanced outcomes. Further, presbyopia-correcting IOLs provide functional vision across all distances (far, intermediate and near) & can be performed safely in younger & older patients. However, low residual astigmatism can affect post-RLE visual acuity & satisfaction. Adverse events analyses revealed a low risk of sight-threatening complications for both procedures.

Conclusions
This work confirms that surgical vision correction is safe & effective across a wide range of patients, refractive & general health conditions, shaping best practices within the global ophthalmic community. Although retrospective analyses have limitations, the large datasets help identify areas of focus to further enhance outcomes. The findings have been widely shared with clinicians internationally, supporting informed decision-making for both professionals and patients.

Date of Award	2025
Original language	English
Awarding Institution	Glasgow Caledonian University
Supervisor	Niall Strang (Supervisor) & Gunter Loffler (Supervisor)