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Photorefractive laser eye surgery for the correction of refractive error

1. Introduction

NHS Lancashire and South Cumbria ICB regularly reviews its clinical policies to ensure they reflect the latest evidence-based guidance and best practice. This is a rolling programme and sometimes results in changes being made to the policies.

We are currently reviewing the Photorefractive laser eye surgery for the correction of refractive error policy and would welcome your views on the proposed changes.

Visual refractive error is a common eye condition. It causes what people see to become blurred and often become what is known as short-sighted, long-sighted or astigmatism. 

It is usually treated using glasses or contact lenses. 

Photorefractive surgery (PRS), is also known as laser eye surgery. The procedure uses lasers to remove part of the cornea (part of the eye) that then grows back correcting the issue. 

The policy aims to manage inappropriate referral and procedure activity in line with evidence-based best practice.

Currently, NHS Lancashire & South Cumbria ICB does not fund the procedure.

The current policy can be found at: https://www.healthierlsc.co.uk/application/files/1916/7576/5522/LSCICB_Clin08_Policy_for_Photorefractive_Surgery_for_the_Correction_of_Refractive_Error_v1.2.pdf

The new policy says the ICB will still not routinely fund the procedure but allows one exception. It will be allowed for people who have a refractive error caused by other eye surgery or after a cornea transplant IF the problem is not solved by using glasses or contact lenses. 

Overall, this should mean that more people are able to have the surgery but still only when it is absolutely necessary.

You can read the full new wording below:

New wording in full:

1.     The ICB does not routinely commission photorefractive surgery for the correction of refractive error  

 

An additional exclusion should be added as follows: 

Patients who have a refractive error arising from non-refractive ophthalmic surgery or corneal transplantation, and whose refractive error cannot be corrected by the use of glasses or contact lenses, are excluded from this policy. 

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Question 1.

What is the first part of your postcode? This helps us check we have heard from people all over Lancashire and South Cumbria.

- Required.
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Question 2.

Do you or someone you are responding for have a condition / require treatment that is covered by the policy?

- Required.
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Question 3.

The proposed policy will mean potentially more people would be able to get laser eye treatment because of the added exclusion criteria. Do you consider this to be an appropriate use of NHS resources?

- Required.
This is required
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Question 4.

Are the exclusion criteria clear about which patients are included in the policy and which are not?

- Required.
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Question 5.

To what extent do you agree with the clinical circumstances identified within the exclusion criteria as justifying NHS‑funded photorefractive treatment?

- Required.
Question 6.

Are there any potential risks, unintended consequences, or equity issues commissioners should consider as a result of expanding access through the addition of the exclusion criteria? 

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Question 7.

Do you think the reasons for the policy change are reasonable?

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This is required
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Question 8.

Do you think the criteria for access are clear and understandable?

- Required.
This is required
Question 9.

Do you think the policy disadvantages any individuals or groups? Please explain.

Question 10.

Does the policy provide enough information to allow a clinician to discuss a patient’s eligibility for treatment?

This is required
Question 11.

 Do you agree or disagree with the policy change?

Question 12.

Is there anything else you would like to tell us about the policy or the proposed policy change?

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