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NEW Refractive Surgery Standards and patient information improve quality of care and help patients make informed choices

4 April 2017

Surgery to correct refractive errors, using lasers or implants, to provide freedom from glasses or contact lenses is increasingly popular. Over 100,000 refractive surgery procedures (laser vision correction surgery) are undertaken every year in the UK and implant based alternatives are now widely available. Results are generally very good, but concerns have been raised by patient and consumer groups regarding inconsistent patient information and quality of care.

Recognising these concerns, The Royal College of Ophthalmologists brought together experienced refractive surgeons and ophthalmologists from across the public and private sectors. The Refractive Surgery Standards Working Group (RSSWG) have developed new patient information leaflets and professional standards for refractive surgeons to improve patient safety and quality of care. The RSSWG collaborated and consulted widely with patients and those organisations working in the sector.

The Professional Standards for Refractive Surgery April 2017, aimed at surgeons and other medical professionals, provide clear guidance on the level of experience and knowledge refractive surgeons should have, as well as the environment for performing surgery safely, good communication and teamwork, continuity of care, and maintaining trust.

Mr Bruce Allan, Fellow of The Royal College of Ophthalmologists and Chair of the RSSWG said, ‘In the right setting, refractive surgery is safe and highly effective. The Professional Standards guidance provides a great framework, raising consistent standards of care, for refractive surgeons to work with. I would strongly recommend that surgeons review the standards against their own working practices for the benefit of their patients and the clinics they work in.’

Charlie Massey, Chief Executive of the General Medical Council said, ‘These new standards will play a very important role in helping to protect patients seeking this type of eye surgery. They build on the guidance we published last year which made it very clear that doctors involved in all aspects of the cosmetic industry have a responsibility to provide the best possible care. Patients have a right to expect safe and consistent standards, and this will help achieve that.’

New patient information leaflets on the common refractive surgery procedures offer patients balanced and independent advice, based on the results of clinical trials, on the risks and benefits of refractive surgery to help patients make the right choices. Additionally, a Surgery Checklist acts as a quick reference guide helping patients cover important questions with their surgeon before agreeing to go ahead with treatment.

Mr Allan continued, ‘The standardised patient information leaflets will raise the general public’s awareness and help them to balance the risks of surgery with the risks of contact lens wear.  So, anyone considering refractive surgery, will be able to attend their surgery consultation with a good understanding of procedure choices.’

Because refractive surgery is performed largely in the private sector patients can be influenced by advertising and promotional offers. The RSSWG has also produced new Advertising and Marketing Standards which offers guidance for organisations to review against their own advertising and marketing methods; and to comply with the Advertising Standards Authority recommendations and their Committees of Advertising Practice (CAP) codes of advertising.

Following on from the work of the RSSWG, eye surgeons are working towards a national database to provide accurate, up to date information on the results of refractive surgery in the UK and patient satisfaction levels.

The Royal College of Ophthalmologists encourages all eye surgeons to work in accordance with the new standards ensuring that they are upheld by the clinics they work in.  The new standards are expected to be implemented by 1 June 2017.

Notes to Editors

Refractive surgery is functional rather than cosmetic. But, like cosmetic surgery, it is not covered by the NHS or private medical insurance. The scope of RSSWG’s work follows recommendations in:

The new guidance from the RSSWG includes:

  • Professional Standards for Refractive Surgeons: recommendations on standards expected of surgeons and other medical professionals who are responsible for the care and well-being of patients
  • Advertising and Marketing Standards: recommending ethical marketing methods and information that is not misleading
  • Patient information: clear information on the risks and benefits of each type of procedure. These are: Laser Vision Correction, Refractive Lens Exchange, Phakic Intraocular Lens Implantation
  • Checklist: an easy to follow checklist for patients to be used in consultation with their surgeon

What is refractive surgery?
Refractive surgery is surgery performed with specialised lasers or lens implants. It is also referred to as ‘vision correction surgery’ or ‘laser refractive surgery’. The aim is to reduce dependence on spectacles and contact lenses. Excimer and femtosecond lasers are used reshape the front of the cornea – the transparent front of the eye wall. Alternatively, lens implants are placed within the eye either in addition to the natural lens or to replace it. Different techniques are used to correct short sight (myopia), long sight (hyperopia) astigmatism (irregular defocus) and presbyopia (age related loss of reading vision).

How is the laser refractive surgery industry regulated?
Organisations providing laser eye surgery will soon be subject to inspections by the CQC.
All surgeons must be registered with the GMC. Marketing and Advertising methods and communications must comply with the guidance from the ASA and the new recommendations from The Royal College of Ophthalmologists

What is the role of The Royal College of Ophthalmologists and the RSSWG?
The Royal College of Ophthalmologists is responsible for setting professional standards for eye surgeons in the UK.  The RCOphth is not a regulatory body but we are leading in the field of providing a framework for refractive surgery standards and patient care through the RSSWG. Read more about Standards, Regulation and Legislation.