• Home
  • Daniel Gore Ophthalmologist

Call now

Email Us

Initial consultation

Laser Eye Surgery

Keratoconus (CXL)

ICL Implants

Refractive lens exchange

Cataract Surgery

PTK

Therapeutic Laser Treatments (PTK)

For corneal scarring or injury or to prevent recurrent erosions

PhotoTherapeutic Keratectomy is a type of laser eye surgery used for a range of problems affecting the superficial layers of the cornea. PTK uses the same excimer laser as in LASIK, LASEK or TransPRK. Instead of reshaping the cornea to correct your vision, PTK can remove scars, opacities or treats painful recurrent erosions. If you already wear glasses or contact lenses and need to have a therapeutic laser treatment you could correct your vision simultaneously. As an alternative to PTK, PhotoRefractive Keratectomy (or LASEK) can, in most cases, correct short-sightedness (including astigmatism). For recurrent erosion symptoms, freshening up the top base layer is achieved during the same treatment. This additional treatment can be done with no additional risk. PTK treatment is normally covered by insurers; PRK/LASEK is not covered.

Recurrent Corneal Erosion

The surface (epithelium) skin layer of the eye is only secure if it is ‘stuck down’ to its base layer. After a corneal abrasion or scratch, sometimes the new cell layer doesn’t stick properly. Since this layer has lots of nerve endings, the slightest disruption can cause intense pain as it moves and becomes unstable. This commonly occurs at night or the early morning when your eyelid sticks to the surface of the eyeball. PTK works by freshening up the base layer so that a new sheet of epithelial cells sticks down properly.

Superficial corneal scarring

If you have had a previous injury or infection in the eye, sometimes residual scarring can affect your vision. This is particularly problematic if any scarring is covering all or part of the pupil. Phototherapeutic keratectomy (PTK) uses laser to remove all or part of a scar to help improve your vision.

FREQUENTLY ASKED QUESTIONS

No. Anaesthetic drops are used to numb the eye so that no pain is felt during the procedure. If you are really nervous, a sedative in the form of a tablet can be given to help you stay relaxed.

For recurrent corneal erosions, Mr Gore’s standard protocol removes just 15 microns, less than 3% of the central corneal thickness. This is based on recent clinical trial evidence from the University of Hamburg showing success rates of 90% with a single treatment. To remove scars from the front layers of the cornea, the depth of the PTK treatment is programmed based on high-definition scans taken as part of your consultation.

Yes. Initially your vision will be blurred, before beginning to recover during the first week. Depending on the underlying reason for PTK treatment ,it can sometimes take a few weeks for the vision to fully stabilise. You will need to wear a ‘bandage’ soft contact lens for at least one week to support the new epithelial cell layer as it heals. This lens stays in day and night (no need for you to remove it), before being removed by Mr Gore’s team in the clinic. One advantage of modern laser technology is that the ablation profile is refractively neutral – this means that it is very unlikely that your spectacle or contact lens prescription will change. Similarly, if you don’t currently require spectacles, PTK is unlikely to change that.

Overall, laser eye surgery is very safe. The risk of a serious complication (e.g. infection, scarring) requiring a corneal transplant to restore vision is approximately 1 in 5,000. This compares with the risk of a serious corneal infection due to the wearing of contact lenses of approximately 1 in 3,000 per year.

Yes. As an alternative to PTK, PhotoRefractive Keratectomy or LASEK can, in most cases, correct short-sightedness (including astigmatism). For recurrent erosion symptoms, freshening up the top base layer is achieved during the same treatment. The risks of the treatment (either PTK or PRK) are the same. PTK treatment is normally covered by insurers; PRK/LASEK is not covered.

Rarely. The success rate for recurrent erosion treatment are approximately 90%. PTK for corneal dystrophies sometimes need to be repeated if the original opacities re-occur.

Make an appointment today

Call Us

Email us

Opening hours: Monday - Friday 8am - 6pm

Continue reading

What Are Cookies

As is common practice with almost all professional websites this site uses cookies, which are tiny files that are downloaded to your computer, to improve your experience. Cookies can be deleted at any time by you by simply clearing all your browser history. We do not store your cookies on our site. This page describes what information they gather, how we use it and why we sometimes need to store these cookies. We will also share how you can prevent these cookies from being stored however this may downgrade or 'break' certain elements of the sites functionality.

For more general information on cookies see the Wikipedia article on HTTP Cookies.

How We Use Cookies

We use cookies for a variety of reasons detailed below. Unfortunately in most cases there are no industry standard options for disabling cookies without completely disabling the functionality and features they add to this site. It is recommended that you leave on all cookies if you are not sure whether you need them or not in case they are used to provide a service that you use.

Disabling Cookies

You can prevent the setting of cookies by adjusting the settings on your browser (see your browser Help for how to do this). Be aware that disabling cookies will affect the functionality of this and many other websites that you visit. Disabling cookies will usually result in also disabling certain functionality and features of the this site. Therefore it is recommended that you do not disable cookies.

 

The Cookies We Set

Third Party Cookies

In some special cases we also use cookies provided by trusted third parties. The following section details which third party cookies you might encounter through this site.

This site uses Google Analytics which is one of the most widespread and trusted analytics solution on the web for helping us to understand how you use the site and ways that we can improve your experience. These cookies may track things such as how long you spend on the site and the pages that you visit so we can continue to produce engaging content.

For more information on Google Analytics cookies, see the official Google Analytics page.

The Google AdSense service we use to serve advertising uses a DoubleClick cookie to serve more relevant ads across the web and limit the number of times that a given ad is shown to you.

For more information on Google AdSense see the official Google AdSense privacy FAQ.

More Information

Hopefully that has clarified things for you and as was previously mentioned if there is something that you aren't sure whether you need or not it's usually safer to leave cookies enabled in case it does interact with one of the features you use on our site.

However if you are still looking for more information then you can contact us through one of our preferred contact methods. This Cookies Policy was created with the help of the CookiePolicyGenerator.com

Email us using the links above if you need further information.

9-11 Bath Street London EC1V 9LF

From Old Street Tube: Exit Subway 4 (Moorfields Eye Hospital) and follow the green line on the pavement to Moorfields Eye Hospital. Follow the line to the entrance of the hospital, but do not enter. Instead, walk to the end of the road (Cayton Street) and turn right onto Bath Street. The entrance is on your right.

Moorfields Private Moorfields Eye Hospital Francis Cumberlege Wing / Refractive Laser Suite 4th Floor 162 City Road London EC1V 2PD

Call us at 0207 566 2803

Online Contact Form

Email us any time.Bookings line open from 8 am - 6 pm

Call Us

Email Us

How to find us

Moorfields Private Eye Hospital is located in the City of London, a few minutes' walk from Old Street Underground station on the Northern Line, with several bus routes also serving the area. On street parking is limited; however public/metered parking is available a short walk away. Find out how to contact us or get directions using the buttons below. Directions are available from Citymapper and Google Maps.

From Old Street Tube: Exit Subway 4 (Moorfields Eye Hospital) and follow the green line on the pavement to Moorfields Eye Hospital. Follow the line to the entrance of the hospital, but do not enter. Instead, walk to the end of the road (Cayton Street) and turn right onto Bath Street. The entrance is on your right.

Get here with City Mapper

Get here with Google Maps

Continue reading

0% Finance options

Moorfields Private Eye Hospital offers interest free finance payment plans to help you spread the cost of treatment. Please note that you must be a UK resident and that financing is only available for laser refractive procedures such as LASIK or LASEK. Finance is available over 6 or 12 months.

Example payment plan

This example is based on LASIK to both eyes performed by Daniel Gore with repayments over 12 months

Total cost of bilateral LASIK                    £4,470

10% Deposit                                                £447

Balance remaining                                     £4,023

12 month repayment schedule                £335.25 per month

< back to Prices

Make an appointment today

Call Us

Email Us

Opening Hours: Monday - Friday 8am - 6pm

Continue reading

Call now

Email Us

Initial consultation

Laser Eye Surgery

Keratoconus (CXL)

ICL Implants

Refractive lens exchange

Cataract Surgery

PTK

Refractive Lens Exchange (RLE) / Cataract Surgery

RLE / Cataract surgery using the very latest advanced monofocal, toric and multifocal lenses

The lens inside your eye may need to be replaced if it becomes cloudy (a cataract), or if your eyes are not suitable for laser vision correction. In both cases, a replacement lens is implanted. Intraocular lenses can also correct short-sightedness, long-sightedness and astigmatism.

Which lenses do we use?

Lens choice is one of the most important decision in cataract surgery. Mr Gore uses only the very latest lenses to provide you with the vision that you need every day. During your consultation, he will discuss with you which option would be most suited to your particular requirements.

Mr Gore uses both the Zeiss AT LISA and PhysIOL FineVision toric trifocal lenses.

A standard (monofocal) lens implant will correct your distance vision as clearly as possible. Many people have some astigmatism as well, when means the cornea at the front of the eye is slightly oval in shape. A toric monofocal lens will be required to treat astigmatism to provide properly focused vision. Many patients with monofocal lens implants benefit from monovision where the focus in one eye is brought within an arm’s length such that with both eyes open you have a spread of focus (far and near). This helps to improve intermediate and near vision (particularly computer use), but glasses will likely still be required to read comfortably. One in 3 (33%) patients do not need reading glasses at all with monofocal monovision lens surgery.Multifocal lenses can provide a far greater range of focus. Trifocal lenses target near, intermediate and distance vision. Four in 5 (80%) of patients will be spectacle-free with trifocal lenses; the remaining 1 in 5 (20%) may require reading glasses for some tasks. The potential downside of trifocal lenses is a comprise in the quality of distance vision as well as optical side effects (glare and haloes), particularly at night.

Mr Gore uses the Zeiss AT LARA EDoF lens.

Extended Depth of Focus (EDoF) is the next generation technology in multifocal lens design. EDoF lenses let you see clearly at far and intermediate distances. They provide greater spectacle independence than monofocal lenses, while inducing less visual side effects compared to trifocal lenses. This balance of increased spectacle independence and less visual phenomena is particularly attractive to patients with an active lifestyle, who wish to be spectacle-free for most of their daily activities but are more sensitive to halos and glare. EDoF lenses are a particularly good option for patients who have had prior laser eye surgery. Adjusting the focusing of EDoF lenses with the non-dominant eye slightly near-sighted (mini-monovision) can further improves reading vision. This means that with both eyes open, you have the advantages of both monofocal and multifocal IOLs: greater freedom from glasses and fewer side effects.

Try the simulator

A picture speaks a thousand words, or in this case, a simulator from lens manufacturer Zeiss. This useful tool will explain some of the differences and limitations of the various lens designs. Although the simulator discusses cataract, the same principles apply to RLE surgery with the same lenses being available for both types of surgery. Click here to visit the simulator now.

More information on Cataract Surgery

Although RLE and Cataract surgery are effectively the same operation, the reason for each is quite different. RLE is used in cases where laser surgery is not suitable or possible, while Cataract surgery is performed when the natural lens in the eye becomes cloudy. Hover over and click the images below for more information about all the lens types that Mr Gore uses. Lots of information about life after Cataracts is available here, with more available in person at your consultation.

Click for more information

Click for more information

Click for more information

Private medical insurance

If you have health insurance, it is likely that not all fees (including premium lens implants) will be covered under your policy. Follow-up appointments are covered if you have outpatient cover. YAG laser capsulotomy is usually covered. For further details, please check with your insurer before your initial consultation if possible.

Additional information and frequently asked questions about about RLE/Cataract surgery are available below.

FREQUENTLY ASKED QUESTIONS

Information on prices for all of our procedures can be found on our Prices pages.

RLE / Cataract surgery is performed as a day-case procedure, typically lasting 15 minutes. You will go home with a protective shield over the eye which you can remove the following morning.

No, there is no pain during the procedure. Anaesthetic drops are used to completely numb the eye before the beginning of the procedure. Sedation can additionally be given intravenously to help you stay relaxed during the operation. General anaesthetic is very rarely necessary.

Overall, RLE/Cataract surgery is very safe. Complications rarely occur, with a serious problem such as an infection or bleeding in the eye affecting approximately 1 in 1000 patients. 1 in 100 patients may require a second operation - this could include repositioning or exchange of the lens, clearing lens fragments from the back of the eye or repairing a retinal detachment. 1 in 5 patients may develop posterior capsule opacification (PCO) - a thickened membrane behind the new lens that can develop months or years after the operation. This can cause the vision to become blurred again and may require a quick out-patient laser procedure (YAG laser capsulotomy) to restore clarity. The experience and expertise of your surgeon is the most important factor in minimising the risk of complications during your treatment. Daniel Gore has an excellent safety record: His PCR (posterior capsular rupture) rate, the key index for safety in RLE & cataract surgery, is 0.5 %*, compared with 1.5% national average and the Royal College of Ophthalmologist's benchmark of 2.0%. *(correct as of 2018)

Your vision is likely to be better the following day, although it will continue to improve in the days following the operation. The eye may be sore and sensitive to light for the first 48 hours. Strict compliance with the drops typically ensures any discomfort settles early on. You may return to work when you feel able (often after the first few days). You may drive once you meet the DVLA standard - reading a number plate at 20.5 meters (approximately 26 paces).

Lens implants are designed to be permanent. It is important to remember that regular eye health checks with your optician are recommended for all adults, regardless of lens implant surgery. Up to 1 in 5 patients may notice their vision deteriorating months or years after cataract/lens exchange surgery due to the natural thickening of a membrane behind the lens. This is called posterior capsule opacification (PCO), and is normally treated successfully with a simple laser procedure in the clinic.

Make an appointment today

Call Us

Email us

Opening hours: Monday - Friday 8am - 6pm

Continue reading


Copyright © Daniel Gore 2019
Website design & build by Marcello Leucci

Contact Us        |        Cookies