Excimer Laser - British Society for Refractive Surgery

Refractive surgery survey
2
008 saw marked
growth in the number
of refractive surgery
clinics in the UK, the
largest increase since
our surveys began. But
when last year’s survey was published,
the economic downturn and recession
that followed had already begun to
take effect. Almost all clinics said the
economy was likely to have the most
significant influence on the market in
the year to come.
Reports of falling demand came first
from the US where, by early 2008,
Lasik providers were feeling the pinch.
As the year ended, one of the largest in
the US, LCA-Vision, said the number of
procedures at its LasikPlus group was
down by a half on the previous year.
If the economic prospects remained
gloomy for most of 2009, there was
better news from a clinical standpoint,
with the publication of research
released the previous year by the
American Society of Cataract and
Refractive Surgeons. Analysis of 19
studies from 13 countries involving
2,198 subjects who had Lasik from
1988 to 2008 found that 95 per cent of
patients were satisfied with the results.1
Satisfaction rates differed little
between countries and were slightly
higher for surgeries performed
between 1995 and 2000 (96 per
cent) than after 2001 (94 per cent).
The authors estimated 16.3 million
Lasik surgeries had been performed
worldwide to date and about 1 million
were done annually in the US.
Less encouraging was adverse media
coverage for the sector’s business
practices on both sides of the Atlantic.
In the UK, the April issue of consumer
magazine Which? claimed that
high-street laser eye clinics were giving
unsatisfactory advice about the risks
of surgery and pressurising customers
into more expensive treatment options.
Which? said that more than half the
18 clinics visited by its undercover
researchers gave unsatisfactory
advice and had played down the level
and possible duration of risks and
complications.
Optimax and Optical Express
advertised surgery from £790 for
both eyes, but the lowest price offered
to Which? was £1,090. Premium
treatments were heavily promoted and
discounts up to £200 were offered,
it said. Lasik providers dismissed the
findings as misleading and questioned
Which?’s methodology, but the findings
were widely reported in the lay media.
Meanwhile, in the US, the Food
and Drug Administration issued a
24 | Optician | 27.11.09
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Trends in refractive
surgery in the UK 2009
Economic recession made for uncomfortable times for the refractive
surgery sector this year, but new clinics are still opening.
Alison Ewbank reports on the findings of Optician’s ninth annual
survey of clinics in the UK and Ireland
Corneal collagen cross-linking for the treatment of keratoconus is becoming more widely used
Key findings of 2009 survey
● Growth in the number of clinics has slowed this
year − the survey identified 138 locations in the UK
compared to 128 in 2008, an increase of 8 per cent
compared to a 22 per cent rise last year
● All three major groups either opened or acquired new
sites and private clinics and hospital-based sites also
expanded
● The three major groups between them now have 81
locations in the UK
● A total of 22 clinics were identified in Ireland, where
the groups have increased their presence and at least
one clinic has closed
● Lasik is still the most common treatment provided,
followed by Lasek
● Average charges for Lasik increased slightly this year
and still vary widely
● Increased uptake of wavefront and femtosecond
lasers, and more demand for IOLs were the main
trends in treatments
● Corneal collagen cross-linking for keratoconus is
among other procedures becoming more widely used
● Reputation/ experience of the surgeon/ clinic is the
key factor to consider when choosing a clinic but price
is seen as more important than last year
● The economy may continue to have a major effect on
the market in 2010
similar warning and urged Lasik
doctors, clinics and others promoting
refractive treatments to make sure
their advertisements told consumers
about the possible risks of the surgery.
The US regulator wrote to providers,
calling for promotional materials to be
‘truthful, properly substantiated and
not misleading’.
2009 has been a quieter year for
mergers and acquisitions in the sector,
although Ultralase became the largest
provider in Ireland following its
€3m acquisition of Eye Laser Ireland,
taking over clinics in Cork, Dublin and
Limerick from the struggling company.
In a spirit of cooperation, Optical
Express revealed its working practices
to its competitors in a supplement
to the Journal of Refractive Surgery,
published in July. Articles detailed
the company’s research outcomes,
satisfaction rates and patient selection
methods.
Medical director for Optical Express,
Steve Schallhorn, told Optician that
continuous quality improvement of the
industry was important for the growth
of the refractive surgery market by
encouraging satisfied patients to
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Refractive surgery survey
The clinics
This year, 138 clinics were identified
in the UK, 10 more than in 2008,
representing an increase of 8 per cent
opticianonline.net
24-30Lasersurvey 25
140
128
120
Number of clinics
The survey
Now in its ninth year, Optician’s annual
survey of laser eye clinics provides
a snapshot of developments in the
market. This year the survey was again
conducted jointly with the British
Society for Refractive Surgery and
supported by the Eye Laser Association.
As in previous years,2 a database of
clinics providing refractive treatments
on the premises was compiled using
various sources including websites
such as www.lasik-eyes.co.uk and
www.lasereyesurgery.ie.
The survey was conducted in
September and October 2009 by
independent market research company
NSM Research via email and post,
and was also sent to individual BSRS
members. Each clinic was also asked
to identify any new clinics opening
in their town, city or surrounding
area over the past year and report
any change in ownership or business
arrangements.
To encourage clinics to respond, this
year’s survey was again simple and
easy to complete. We omitted questions
considered commercially sensitive,
such as the number of treatments
carried out, which clinics are reluctant
to divulge. Some clinics and groups
make claims on their websites for
numbers of treatments. Optical Express
describes itself as ‘Europe’s number
one provider of laser eye surgery’ and
says its surgeons have a combined
experience of over 600,000 procedures,
although this presumably reflects their
experience outside the group as well
as in clinics overseas. This is the same
figure that appeared on its website this
time last year.
Ultralase, the UK’s longest
established provider, quotes ‘over
100,000 people’ having chosen
Ultralase laser eye surgery. Last year
it said it had carried out more than
175,500 treatments to date. Optimax
states its surgeons have performed
over ‘300,000 procedures since 1991’
compared with last year’s quoted
‘250,000 laser procedures’.
Figure 1 Number of clinics in the UK, 2001-09
100
80
80
60
92
95
92
95
138
105
47
40
20
0
2001 2002 2003 2004 2005 2006 2007 2008 2009
Base: all clinics identified each year
Figure 2 Types of premises occupied
50
Premises occupied (%)
recommend the procedure to friends.
Citing the US as an example of how
big the UK laser surgery market could
become, he said: ‘In the US the laser
market is more mature, [the surgery] is
more common, well-known and more
accepted. In the UK, it’s probably just a
matter of time for attitudes to change.’
47%
40
32%
30
20
16%
10
0
5%
Private
clinic
Optical
practice
Private
hospital
NHS
hospital
Base: All respondents who answered the question
Figure 3 Single or a group of clinics
Group
82%
Single
18%
Base: All respondents who answered question
(Figure 1). From 2003 to 2006 there
was little or no growth in the number
of clinics in the UK but last year the
number of sites increased dramatically,
by 22 per cent. When our first survey
was conducted in 2001 only 47 sites
were identified, a third of this year’s
total.
New clinics opened in Ireland last
year taking the total to at least 23. This
year there were changes in ownership,
at least one clinic closed down and no
new clinics were identified.
In all, completed surveys were
received for 117 UK clinics by the
cut-off date, a response rate of 84 per
cent (2008: 81 per cent). This year,
only eight clinics in Ireland took part.
Results discussed here are therefore for
the UK unless otherwise stated.
In terms of type of premises, just
under half of our UK sample (47 per
cent) say they are private clinics (Figure
2), similar to last year, and almost
one in three (32 per cent) describe
their locations as optical practices,
again similar to last year’s breakdown.
Sixteen per cent of clinics responding
are located in private hospitals, a slight
increase on 2008 (13 per cent), and only
5 per cent in NHS hospitals, a similar
proportion to last year (4 per cent).
As in previous surveys, our sample is
biased towards groups of clinics. More
than eight out of 10 clinics responding
this year are part of a group (82 per
cent, Figure 3), the same proportion as
last year, compared to an estimated 76
per cent of all 138 clinics identified.
Hospital-based clinics are again poor
responders; whereas 21 per cent of our
sample is based in hospitals (NHS or
private), these make up an estimated 27
per cent of all clinics. Caution should
therefore be exercised in extrapolating
the results to the total market.
A key trend last year was expansion
among two of the three major groups
in the UK, but 2009 showed much
more modest growth in this sector.
These three companies between them
now operate in 81 locations, six more
than last year, and account for nearly
six out of 10 clinics.
UK-based groups have continued
to move into the Irish market,
traditionally dominated by private
hospital-based facilities, with Ultralase
acquiring the three Eye Laser Ireland
clinics. Optical Express has two
treatment centres in Ireland.
Last year, three new clinics opened
in the Dublin area, where there were
at least 12 centres offering refractive
surgery compared with a reported four
clinics in 2002. This year has seen no
such expansion and one company, the
Orbit Laser Eye Clinic, ceased trading
in November 2008.
In the UK, Optical Express is the
largest group, with three new locations
taking the total to 38. Among new
openings this year for the Glasgowbased company were Newcastle Metro
Centre, Princes Street in Edinburgh,
and Kingston-upon Thames, Surrey.
In 2009, the company opened 10 new
sites, several of them in shopping
mall locations. Most of its clinics are
located in optical practices but two in
the UK and one in Ireland do not retail
spectacles or contact lenses.
Changes within the group include
a move from the Salford Quays site to
the private Bridgewater Hospital in
Manchester. The former Strand site in
central London is now a consultation
clinic and no longer carries out
treatments.
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Refractive surgery survey
Treatments
As in the past four surveys, almost
all (99 per cent) of the clinics that
responded carry out the most common
treatment, Lasik, and a similarly high
proportion (97 per cent) offer Lasek
(Figure 4).
In 2002, when our surveys began,
only 2 per cent of clinics in our sample
were offering any treatment other
than PRK, Lasik or Lasek. In recent
years there has been a growing trend
towards more invasive procedures,
traditionally the preserve of hospitalbased clinics, as new treatments
emerged and the groups have
expanded the range they offer.
Since the high-street groups usually
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24-30Lasersurvey 26
confine these procedures to a small
number of their clinics or outsource
surgery to other providers, this year we
asked groups to indicate how many of
their clinics provided each treatment.
The result is a more realistic picture of
the types of procedure provided by our
sample.
About half of respondents carry
out photorefractive keratectomy
(PRK) and one in three offers cataract
surgery. Similar proportions offer
clear lens extraction (32 per cent) or
phakic intraocular lenses (IOLs). Less
commonly provided are conductive
keratoplasty (CK), EpiLasik and Intacs.
This year, clinics listed a range of
‘other’ procedures, highlighting, in
particular, the use of corneal collagen
cross-linking (CCL) for the treatment
of keratoconus but also a continuing
trend towards oculoplastic, cosmetic
surgery and general ophthalmic
surgery, mainly, although not
exclusively, among the single clinics
and hospitals.
The Optegra Hospital in Guildford,
Surrey says it covers every major
discipline within ophthalmics apart
from paediatrics, and was the first clinic
in Europe to use the Lipshitz macular
implant (LMI). It also offers the Visual
Impaired Person Lens (VIP LOI).
Of the major groups, Optical Express
offers PRK, Lasik and Lasek in all 36
of its ‘laser eye clinics’ in the UK. It
also operates five ‘IOL centres’ carrying
Figure 4 Types of treatments offered
99%
Lasik
97%
Lasek
PRK
51%
Cataracts
Clear lens
extraction
Phakic IOLs
33%
32%
29%
CK
26%
EpiLasik
Intacs
23%
15%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Base: All 117 respondents who answered the question
100
80
Figure 5 Proportion who have
invested in femtosecond
67%
85%
87%
2008
2009
73%
60
(%)
Optical Express has two treatment
clinics in Ireland, in Dublin and
Newbridge, Co Kildare, although
last year it said it would be opening
in Cork and Galway. The company
lists 17 locations in mainland Europe
(in Holland, France, Germany and
Croatia) and one in the US.
Ultralase, the UK’s second largest
group, acquired the London Centre for
Refractive Surgery in Harley Street
to take its total number of treatment
centres to 23. It also has ‘consulting
rooms’ in Brighton, Exeter, Norwich
and Sheffield.
Ultralase now has four sites in
Ireland; its Cork clinic at the Shanakiel
Hospital was transferred to the former
Eye Laser Ireland site. The company
has one clinic, in Edinburgh, located
in a branch of Dollond & Aitchison
following a partnership and referral
agreement between the two companies
in 2007.
The third major group, Londonbased Optimax, lists 20 locations,
having opened two new clinics since
last year, in Nottingham and Milton
Keynes.
Among the other groups, Accuvision
opened a third clinic, in Wetherby,
north of Leeds, and the Birkdale
Clinic added a fourth site, in London’s
Hammersmith Hospital. Grange Eye
Consultants now operates in five
locations, adding a London clinic to
Chandlers Ford, Havant, Oxford and
Taunton.
Of the single clinics, the Centre
for Vision at the Manchester Royal
Eye Hospital and the London Vision
Centre, now in Harley Street, both
moved into new premises this year.
Among new locations was the
Nuffield Health Exeter Hospital,
which in February became the latest
in the private health group to offer
refractive surgery.
40
20
0
2006
2007
Base: All respondents who answered the question
out intraocular procedures, three of
which share a location with laser vision
correction. One Optical Express clinic
offers CK.
Among ‘other treatments’ it lists
are CCL, wet AMD treatment,
oculoplastics and corneal inlays, some
of which are carried out at its Harley
Street clinic. In 2006, Optical Express
offered only two treatments: Lasik and
Lasek.
Optimax continues to carry out Lasik,
Lasek and EpiLasik at all its locations,
while three clinics offer CK and Intacs
and one provides CCL. CLE, phakic
IOLs and cataract surgery take place in
sub-contracted operating theatres.
Ultralase carries out Lasik, Lasek
and CK in all its clinics and intraocular
procedures on the premises in three
locations.
Of the smaller groups, Accuvision
offers PRK and Lasik at all three of
its clinics, and also the ‘all laser’ transepithelial surface treatment which it
says has superseded EpiLasik in its
clinics. The company says that this
‘no touch’ procedure is used to treat
patients with thin corneas, or those
who play contact sports, requires no
cutting of the cornea and healing times
are reduced compared with Lasek.
Accuvision clinics also offer CCL
and the Accuwave topography-guided
treatment for keratoconus vision
rehabilitation, while IOL surgery is
carried out off premises.
We asked our sample whether
there had been a trend towards any
treatment or treatments in their clinics.
The most marked changes again this
year are increased uptake of wavefront
and use of Intralase, but others
note more demand for IOLs and, in
particular, CLE.
Two clinics, Aston University Day
Hospital and Nuffield Health, The
Grosvenor Chester, report an increase
in Lasek
Lasik, while
Kirkwood
% over
of treatments
offered
Fyfe in Aberdeen found this trend was
reversed.
In Ireland, the single and hospitalbased sites tend to offer a wider range
of treatments than the groups. Dublin’s
Wellington Eye Clinic, the longest
established, offers all those listed in our
survey other than EpiLasik and Intacs,
plus CCL. The Roseville clinic in
Dublin provides all but CK and Intacs.
The Wellington noticed more requests
for lens surgery this year, and also
increasing demand for CCL.
Technology
Almost all our UK sample has now
invested in wavefront technology; only
two have not done so. This year 87 per
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Refractive surgery survey
Figure 6a Lasik treatment charges per eye
Figure 6b Treatment charges per eye
£1,400
£1,100
£1,090
£1,059 £1,049
Average charges (£)
£1,016
£1,000
£957
£900
£951
£925
£916
£860
Average charges (£)
£1,200
£1,326
£1,200
£1,000
£1,063
£951
£800
£600
£400
£200
0
Lasik
£800
Wavefront
guided Lasik
Femtosecond
Lasik
Base: All respondents who offered each treatment
£700
£600
2001
2002
2003
2004
2005
2006
2007
2008
2009
Base: All respondents who offered each treatment
cent of our sample has femtosecond
lasers, a slightly higher proportion than
last year (85 per cent) and a further
two clinics plan to invest in the next 12
months (Figure 5).
This year, we again asked clinics
to specify what technology they
acquired over the past 12 months
and their intended investment in the
year to come. Femtosecond, CCL and
diagnostic equipment were the main
areas of recent investment.
Among the major groups, Ultralase
has invested in CCL, aspheric
wavefront and diagnostics and now
plans to add IntraCOR, intrastromal
correction for presbyopia. Optical
Express provides a long list of recent
investments in equipment including
Pentacam topographers, Visante
ocular coherence tomography (OCT),
Zeiss IOL Master and Cirrus Retinal
OCT. In the coming year it would be
investing further in these technologies
as it opened more clinics and upgraded
its current centres.
Smaller groups and single clinics
generally have less ambitious plans.
Several say they made no investment
in equipment this year and that none is
planned in the next 12 months.
In Ireland, the Wellington has taken
on the Allegro BioGraph, allowing it to
perform ray tracing surgery, which it
describes as one of the most significant
developments this year for the clinic
and for the market as a whole.
Charges
2008 saw average charges for Lasik,
the most common treatment, falling
back below the £1,000 mark. This year
the average charge clinics quote for
Lasik is slightly higher again, at £951
per eye compared with £916 last year
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24-30Lasersurvey 27
(Figure 6a). In fact the cost of Lasik has
remained relatively static across our
nine surveys, despite fluctuations from
year to year, the exception being 2005,
when the average price fell to £860.
As ever, these average prices mask
wide variations in charges between
clinics. Optical Express quotes ‘from
£395’ for Lasik, the same as the last
three years and lowest of our sample.
Ultralase now quotes £1,395, £50
more than last year, and more than
three times the price quoted by Optical
Express. Its website states ‘Laser eye
surgery could save you a fortune
compared to glasses or contact lenses’,
linking through to an online calculator
to enter the annual costs of each
and your age. Ultralase then emails
a cost comparison. Optimax did not
supply prices this year but its website
homepage states ‘prices from £395’.
Average prices among our sample
are higher for wavefront-guided Lasik
and femtosecond Lasik, at £1,326
and £1,063 respectively (Figure 6b).
Wavefront prices start ‘from £750’ per
eye at Accuvision and femtosecond
treatments ‘from £695’ at Optical
Express. The London Vision Clinic in
Harley Street is the most expensive of
those respondents supplying prices, at
£2,300 per eye for Lasik, wavefront
Lasik and femtosecond Lasik.
Charges for treatments other than
Lasik also vary widely. The highest
quoted costs for any procedures are
£3,150 for IOLs at Ultralase and £2,900
for premium IOLs at the Yorkshire Eye
Clinic. Cataract surgery is generally in
the £1,500 to £2,500 range, depending
on the type of implant used.
Last year, for the first time, we asked
for the average total charge per patient
for all treatments carried out. Many
again decline to respond to this question
or answered ‘varies’. Of those that did
reply, costs given ranged from £1,500
to £4,600 per patient, reflecting the
different types of procedure on offer.
The website www.lasik-eyes.co.uk
shows an ‘average surgery price’ for
each clinic it lists. The site currently
gives average surgery prices for 13
clinics or groups, ranging from £1,585
at Optimax to £4,922 at Viewpoint
Vision in Manchester. The figures
for Optical Express and Ultralase
are £2,366 and £3,286 respectively.
Perhaps more useful is the ‘price paid’
against each clinic review posted up by
patients, which provides a guide to the
actual cost of specific treatments.
Promotions
Among the groups in particular,
easy-payment options, interest-free
credit and price guarantees are
again common. Ultralase states on
its website, ‘Our prices are totally
transparent with no hidden extras’. It
offers visitors to its website the chance
to win ‘laser surgery worth over
£4,500’ (compared to ‘over £3,800’
last year) in a monthly prize draw.
Optical Express also has a monthly
prize draw for free treatment and an
‘Ambassador Referral Programme’,
while Optimax offers a ‘Price match
promise’ and corporate discount
scheme.
In Ireland, charges for all procedures
have tended to be slightly higher
than in the UK. However, increased
competition, the arrival of high-street
clinics and aggressive marketing saw
lower prices emerging in 2008. This
year Optical Express quotes from €595
per eye for Lasik, unchanged from last
year, which at current exchange rates is
about £525.
Of the single clinics, the Wellington
charges €2,050 per eye (£1,800),
the same as last year, for Lasik and
the same fee for Lasek and PRK.
Wavefront-guided Lasik costs €2,200
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Refractive surgery survey
(£1,935) and it charges €1,500 (£1,320)
for CCL and CLE (plus theatre costs).
Choosing a clinic
We asked our sample to name the
single most important factor for
patients to consider when choosing a
clinic. Most cite more than one factor
but the reputation and/or experience
of the surgeon or clinic is again the
most common, followed by personal
recommendation.
Not surprisingly given the economic
climate, price is cited more often
this year. Other factors are: quality
of surgery or technology; location;
accurate data reporting; a clean, safe
environment; and the opportunity to
meet the surgeon prior to treatment.
For Ultralase, other than knowing
somebody who has been treated,
surgeon experience and qualification
(Royal College of Ophthalmologists
certification and visual outcomes)
are the most important factors. On
its website it states that all Ultralase
surgeons are certified by the RCO
and ‘99.9 per cent of its patients have
reached driving standard or better’.
Celebrity endorsement continues to
be a feature of marketing for refractive
surgery but companies are increasingly
using patient testimonials to promote
and advertise their offering. Several
also include patient forums on their
websites. Online information in general
is more comprehensive than it has
been in the past, allowing prospective
patients to be better informed before
choosing a clinic.
Significant developments
New and improved treatments
and technology are considered the
most significant developments for
individual clinics over the past year.
Our sample mentions advances in
presbyopic correction, premium and
toric IOLs and keratoconus treatment,
among other advances.
Of the major groups, Optical
Express points to the introduction of a
patient electronic questionnaire (PEQ)
as being significant for the company,
and Ultralase singles out bilateral
wavefront-guided treatments.
But for other companies, business
developments are more significant,
such as the introduction of interest-free
finance and extended credit facilities, or
winning back major insurers. Among
the groups, only Optimax concedes that
it has been harder to get patients this
year and there has been more pressure
on prices. More competition from
more clinics opening in 2008 has had a
knock-on effect this year, it says.
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Asked specifically about the effects
of the economic recession on their
business, more companies reveal the
commercial pressures they have faced.
Most say that the market as a whole is
down and volumes reduced. One NHS
hospital-based clinic says that referrals
for laser correction are down by 30 per
cent on 2008. Patients are asking for
‘deals’ as the high-street clinics are now
offering up to 50 per cent off published
treatment prices, says another.
In Ireland, hard hit by recession and
rising unemployment, there is some
evidence of a larger drop in volumes.
One clinic says its business is 60 per
cent down on 2008, and others report
demand for laser treatments has
softened and downward pressure on
prices. But not all report a downturn in
demand. Despite increased competition,
Optimax say the recession has not had
a great deal of effect on its business,
although it has worked harder for the
same results. Volumes at Ultralase were
’fairly flat but with higher revenues’
this year. Others say the recession has
had very little or no effect.
Two single clinics – Hillsborough
Private Clinic in Northern Ireland
and Focus Laser Vision in London’s
Wimpole Street – buck the trend by
reporting growth of 20 per cent and as
much as 79 per cent respectively.
Prospects for 2010
As in 2008, the economy is expected
to dominate the market in the coming
year. Most clinics say that the recession,
whether ending or otherwise, and lack
of consumer confidence is likely to
have the most significant influence on
the market in 2010.
Despite continuing uncertainty about
the economy, several companies plan
to expand in the coming year. Optegra
is developing a 15,000sq ft site in the
Solent area as well as a further location
in Manchester. Optimax says it will add
‘about two clinics a year on average’
and Ultralase will be opening more
consulting rooms as well as offering
more presbyopic surgical solutions.
Optical Express, the provider that
has grown most dramatically in
recent years, describes its plans for the
coming year as ‘more consolidation
of our position as European leader in
refractive surgery’.
Last year all but one of our Irish
respondents predicted that the
economy would be the key factor
in market prospects in the next 12
months. This year, the Roseville Eye
Clinic summed up the feelings of
many in the sector, saying ‘an end to
people’s perceptions of the recession’
would have the single most significant
effect in the year to come.
Conclusions
2009 has been a more difficult year
for the refractive surgery market in
the UK and Ireland. Following a year
which saw the number of clinics
increase substantially, we identified
10 new clinics this year in the UK and
none in Ireland where at least one
clinic is no longer offering treatments.
The major groups and private health
care providers are again responsible for
most of the new locations, although
some single clinics are either expanding
or have invested in new premises. In
both countries there have been changes
of ownership among existing clinics.
Lasik and Lasek remain the most
commonly offered treatments but
the trend towards a wider range of
procedures continues. This year clinics
have invested further in femtosecond
lasers and almost all either use this
technology or plan to do so in future.
Corneal collagen cross-linking and
diagnostic equipment have also seen
growth and investment.
Average prices for Lasik increased
slightly this year but are still below
£1,000 per eye although there are wide
differences in cost for all treatments
and the figures clinics quote may not
reflect the actual price the patient pays.
Economic recession and lack of
consumer confidence, coupled with
increasing competition from new
clinics opening up, has impacted the
market in the past year and is likely to
have the most significant influence in
the next 12 months.
To celebrate the 20th anniversary of
Lasik, the European Society of Cataract
and Refractive Surgeons has designated
2010 as the European Year of Lasik.
It will be interesting to see what
prospects are in store for the sector as it
celebrates this milestone. ●
Acknowledgements
Data were collected and analysed independently
by NSM Research for Optician. Thanks to the
BSRS for input to the questionnaire and helping
to distribute it, the Eye Laser Association for
supporting the survey and to all the clinics that
responded this year – contact details are listed in
the directory on pages 29-30.
References
1 Solomon KD, Fernández de Castro LE,
Sandoval HP et al. Lasik world literature
review: quality of life and satisfaction.
Ophthalmol, 2009;116:4 691-701.
2 Ewbank A. Trends in refractive surgery in the
UK 2008. Optician, 2008;236:6180 21-26.
opticianonline.net
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Refractive surgery survey
Directory of clinics that took part in the survey
● Accuvision Laser Eye Clinics
● Focus Laser Vision
● Midland Eye Institute
www.accuvision.co.uk
0845 000 2020
20-22 Wimpole St
London W1G 8GQ
0845 5000 500
www.focusclinics.com
50 Lode Lane
Solihull B91 2AW
0121 711 2020
www.midlandeye.co.uk
● Grange Eye Consultants
● Nuffield Health Hospital
www.grangeeyeconsultants.com
08456 520354
Brentwood
Shenfield Rd
Brentwood CM15 8EH
01277 695695
www.nuffieldhospitals.org.uk
3 The Courtyard
707 Warwick Rd
Solihull B91 3DA
08700 20 2000
42-48 New Kings Rd
London SW6 4LS
020 7736 2020
1 Cromwell Park
York Road
Wetherby LS12 7SU
0845 000 2020
● Advance Vision Care
77 Harley St
London W1G 8QN
0870 7559800
www.advancevisioncare.co.uk
● Aston University Day Hospital
Aston University
Aston Triangle
Birmingham B4 7ET
0121 204 3800
www.astonacademy.co.uk
Nuffield Health Wessex Hospital
Winchester Rd
Chandlers Ford SP53 2DW
● Nuffield Health Plymouth
Spire Portsmouth Hospital
Bartons Road
Havant PO9 5NP
Oxford Eye Laser Centre
Radcliffe Infirmary, Headley Way
Oxford OX3 9DU
Somerset Nuffield Hospital,
Nuffield Health Taunton Hospital
Staplegrove Elm, Taunton TA2 6AN
Hospital Derriford Rd
Plymouth PL6 8BG
01752 704255
www.nuffieldhospitals.org.uk
● Nuffield Health The Grosvenor
Chester Wrexham Rd
Chester CH4 7QP
01244 342460
www.youreyesurgery.co.uk
● Nuffield Hospital Warwickshire
BMI: The Kings Oak Hospital
Chase Farm (North Side)
The Ridgeway, Enfield EN2 8SD
The Chase, Old Milverton Lane
Leamington Spa CV32 6RW
01926 427971
www.nuffieldhospitals.org.uk
Unit 23A, Bristol Cabot Centre
Bristol BS1 3BH
32 Donegall Place
Belfast BT1 5BB
40 Union St
Aberdeen AB10 1BD
Unit L40
Lower Thames Walk
Bluewater DA9 9SJ
58 High St
Inverness IV1 1JE
112 Briggate
Leeds LS1 6BL
36 Lister Gate
Nottingham NGI 7DD
7- 8 Queen St
Oxford OX1 1EJ
127 High St
Cheltenham GL50 1EX
155-156 High St
Uxbridge UB8 1JY
● Guy’s and St Thomas’ NHS
● Birkdale Clinic
www.birkdaleclinic.co.uk
0800 1958 779
Prem House
2 Park Road
Liverpool L22 3XF
Clifton Lane
Rotherham S65 2AJ
The Triangle
5-17 Hammersmith Grove
London W6 0LG
● C Steven Bailey
99 Harley St
London W1G 6AQ
07973 691727
www.csbailey.com
● Cathedral Eye Clinic
York St, University of Ulster
Belfast BT15 1ED
02890 322020
www.cathedraleye.com
● Face & Eye
2 Gibwood Road
Northenden
Manchester M22 4BT
08458 332233
www.faceandeye.co.uk
opticianonline.net
24-30Lasersurvey 29
Foundation Trust
Department of Ophthalmology
London SE1 7EH
01702 586656
www.davidobrart.co.uk
● Optegra Eye Care
10 Alan Turing Rd
Surrey Research Park
Guildford GU2 7YF
01483 903100
www.optegra.com
22 Harley St
London W1G 9AP
Bridgewater Hospital
120 Princess Rd
Manchester M15 5AT
● Hillsborough Private Clinic
2 Main St, Hillsborough,
Co Down BT26 2AE
028 9268 8899
www.hillsboroughprivateclinic.com
● Kirkwood Fyfe Laser Ltd
12 Victoria St, Aberdeen AB10 1XB
01224 643999
www.kirkwoodfyfe.com
● Optical Express
www.opticalexpress.com
08702 202020
Barlow House,
Minshull St
Manchester M1 3DZ
50 Broad St
Reading RG1 2AA
● LaserSight Essex
Phoenix Hospital, 15 Fairfax Drive,
Westcliff On Sea SS0 9AG
01702 608900
www.lasersightessex.co.uk
41 High St
Birmingham B4 7SL
24 Northumberland Rd
Newcastle-upon-Tyne NE1 8JF
● London Vision Clinic
138 Harley St
London W1G 7LA
020 7224 1005
www.londonvisionclinic.com
13 Silbury Arcade Centre
The Centre
Milton Keynes MK9 3AG
39-41 Petty Cury
Cambridge CB2 3NB
46-48 Queen St
Cardiff CF10 2GQ
1 Haymarket
Norwich NR2 1QD
96 High St
Dundee DD1 1SD
Unit LR21, The Mall
Cribbs Causeway
Bristol BS34 5GF
55 Peel Ave
Trafford Centre
Manchester M17 8BN
● Manchester Royal Eye Hospital
219-229 Shaftesbury Avenue
London WC2H 8EL
30, The Gallery
Meadowhall Shopping Centre
Sheffield S9 1EP
Oxford Rd, Manchester M13 9WL
0161 276 5198
www.centreforvision.co.uk
44 West Quay
Southampton SO14 7EG
Unit 27, St Stephens
Shopping Centre, Hull HU1 3UA
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Refractive surgery survey
Unit 16, Lakeside Shopping Centre
West Thurrock, RM20 2ZF
16-17 Kings Park Rd
Southampton SO15 2AT
Unit 5C, Victoria Plaza
Oxford St
Bolton BL1 1RD
18 Lloyds Ave
Ipswich IP1 3HD
131 Fenwick Rd
Giffnock G46 6JB
69A South John St
Liverpool L1 8BU
Unit B5, Silverburn
Shopping Centre, Pollok
Glasgow G53 6EQ
16/18 Clarence St, The Cloisters
Kingston-upon-Thames
KT1 1NX
171-173 Charles St
Leicester LE1 1LA
172 Lincoln Rd
Peterborough PE1 2NW
108A Friar St
Reading RG1 1EP
Nightingale House
Hesselwood Country Office Park
Hessle HU13 0QF
428 Lisburn Rd
Belfast BT9 6GR
● Spire Leicester Hospital Eye
Laser Clinic
Gartree Rd, Oadby
Leicester, LE2 2FF
0116 265 3021
www.spirehealth.com/leicester
● Ultralase
www.ultralase.com
0113 200 2115
14 Highfield Rd
Edgbaston
Birmingham B15 3DU
7 Derryvolgie Ave,
Belfast BT9 6FL
15 Harley St, London W1 9QQ
20/20 Optical Store
216-217 Tottenham Court Rd
London W1T 7PT
6th floor Airedale House,
77-85 Albion Street
Leeds LS1 5AW
Havell House, 62-66 Queens Rd
Reading RG1 4AZ
3 Albion Place, Off Galena Rd
London W6 0QT
● Vision Surgery & Research
1 Vicars Lane
Chester CH1 1QX
60/62 Cameron Walk
Metro Centre
Newcastle NE11 9YR
179 Church Rd
Brighton BN3 2AB
33 Princes St
Edinburgh EH2 2BY
2 Mosely St
Newcastle NE11 1DG
Unit 2121
Westfield London Shopping Centre
London W12 7GF
2 Golden Square
Aberdeen AB10 1RD
7 St John St, Manchester M3 4DN
26-28 Heathcoat St
Hockley Village
Nottingham NG1 3AA
St Nicholas Building, St Nicholas St
Newcastle upon Tyne
NE1 1RF
Brooklyn House
311 Avebury Boulevard, The Hub
Milton Keynes MK9 2GA
10 Elmdale Rd, Tyndalls Park,
Clifton, Bristol BS8 1SL
Marlborough House,
Victoria Rd South
Chelmsford CM1 1LN
Centre
11 Ferriby High Rd, North Ferriby
East Yorkshire HU14 3LD
01482 339515
www.visionsurgery.co.uk
● Yorkshire Eye Hospital
Unit 55B, Eden Centre
High Wycombe HP11 2HW
U83, Upper Mall
Merry Hill Shopping Centre
Brierley Hill, West Midlands
DY5 1SS
Elmdon House
116 London Rd
Guildford GU1 1TN
937 Harrogate Rd, Apperley
Bridge, Bradford BD10 0RD
0845 456 2021
www.yorkshireeyehospital.co.uk
CLINICS IN IRELAND
● Optical Express
24 Windsor Place
Cardiff CF10 3BY
2A Wellington Rd, Dublin 4
8-9 Upper Marlborough Rd
St Albans AL1 3UR
Unit 10, Whitewater Shopping
Centre, Newbridge, Co Kildare
Sentinel Building, 103 Waterloo St
Glasgow G2 7BW
● Roseville Expert Eye Laser
● Optimax Laser Eye Clinic
www.optimax.co.uk
08456 889555
96 Bristol Rd
Birmingham B5 7XJ
128 Finchley Rd
London NW3 5HT
147 The Headrow
Leeds LS1 5RB
3 Water St
Liverpool L2 ORD
18 Charing Cross Mansions
Glasgow G3 6UJ
1 Albert Square
Manchester M2 3FU
● Sheffield Vision Centre
Royal Hallamshire Hospital
Glossop Rd, Sheffield S10 2JF
0500 400 222
www.sheffieldvisioncentre.co.uk
● Site for Eyes
Sunderland Eye Infirmary
Queen Alexander Rd
Sunderland SR2 9HP
0191 5699165
www.site-for-eyes.co.uk
● St James’s Laser Vision
St James’s University Hospital
Beckett St
Leeds LS9 7TF
0113 206 6856
www.stjameslaservision.co.uk
Tower Building, 4 George’s
Dock Gates, Liverpool L3 1QA
● Ultralase
Waterfront House, Waterfront Plaza
Station St, Nottingham NG2 3AJ
Model Farm Rd, Cork
61 London Rd
Edinburgh EH7 6AA
The Atrium Maritana Gate, Canada
St, Waterford, Co Waterford
The Gate House, Maris Lane,
Trumpington, Cambridge CB2 9LG
Dundrum Eye Clinic,
Rockfield Medical Campus, Dublin
2nd Floor Colman House
King Street, Maidstone ME14 1JE
O’Connell St, Limerick
● Wellington Eye Clinic
● St Paul’s Eye Unit Excimer
13 Clare St
Bristol BS1 1XH
103 High St
Croydon CR0 1QG
30 | Optician | 27.11.09
24-30Lasersurvey 30
Laser Service Royal Liverpool
University Hospital
Liverpool L7 8XP
0151 706 3996
www.rlbuht.nhs.uk
Clinic
1 Hyde Park, Terenure, Dublin 6
+353 1 4929298
Kingswood House, The Avenue
Cliftonville, Northampton NN1 5BT
Avenue House, 37-38 The Avenue
Southampton SO17 1XN
Suite 36, Beacon Mall
Beacon Court, Sandyford
Dublin 18
+353 1 2930470
www.wellingtoneyeclinic.com
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