Your ophthalmologist will ensure that your eyes are healthy by first performing a thorough eye exam. He or she will evaluate:
- Pupil size
- Refractive errors including myopia, hyperopia, and astigmatism
- Corneal shape and thickness
- Screen for other eye conditions
The curvature of the front surface of the eye will be measured with an instrument called a corneal topographer.
Evaluation of the tear film on the eyes’ surface may call for treatment, as a precaution, to minimize the development of dry eyes after the surgery.
Your eye doctor also initiates questions regarding your general health history as well as any medications you are taking, to determine if you are a suitable candidate for LASIK. If it is determined that you are not a candidate for LASIK, then we may be able to consider PRK (Photorefractive Keratectomy) as an option.
Contact lenses should not be worn for two weeks before your evaluation, and before the LASIK procedure. This is necessary because contact lens wear can temporarily alter the natural shape of your cornea. This period of time will depend on the type of lens that you wear.
Before the surgery begins, you will receive numbing eye drops to prevent any discomfort during the procedure. You may also be given medication for relaxation.
You are positioned under the laser; an instrument called a lid speculum is used to help keep your eyes open wide.
First making a mark with a marker on the cornea, the surgeon then begins by creating a very thin superficial flap in your cornea with a femtosecond laser. A suction ring is then applied to the front of your eye to prevent eye movements or loss of contact that could affect flap quality.
After the corneal flap is created, the surgeon then uses a computer to adjust the excimer laser, a type of ultraviolet laser, according to your prescription. After the corneal flap is created, the surgeon uses a different laser, called an excimer laser, to alter the shape of the cornea according to your prescription.
The doctor may ask you to look at a light for a short period of time while watching your eye through a microscope while the laser sends pulses of light to your cornea.
Painlessly reshaping the cornea, the laser emits a steady clicking while it operates. You will not feel pain but may experience pressure on your eye.
At the end of the surgery with the laser ablation reshaping the cornea, the flap is then laid back to cover the cornea where the tissue was removed. This flap will seal the cornea while it heals after the surgery.
LASIK is performed separately for each eye and each procedure takes about five minutes. Both eyes are typically performed on the same day.
There will be no bandages; stitches are not required. Immediately after the surgery, you may feel some burning or itching; at that time the surgeon will have you rest for a while. Right after the surgery things may be somewhat blurry, but clarity should improve by the following morning.
There will be a brief post-operative exam; then you can have someone drive you home. You will not be able to drive until the doctor confirms, the next day, that your uncorrected vision meets the legal requirements for driving.
Within the following days, your eyes should stabilize and continue to improve. Although you may be able to go to work the next day, some doctors advise that you take at least one day to rest. It is important to follow any instructions given by the doctor as well as take any prescribed medications.
The day after the surgery, you will be returning to see the eye doctor or the surgeon who performed your LASIK surgery. Visual acuity will be measured to ensure that you meet the requirements for driving without contact lenses or glasses. Many states require acuity of 20/40 or better than that.
In the few days after surgery, avoid rubbing your eyes as dislocation of the corneal flap could occur before it has fully healed.
What to Expect Long Term
A majority of patients electing to have LASIK result in 20/20 vision following the recovery period. There is the possibility that you might need to wear glasses or contacts after the surgery, but the prescription will be much lower than previously. Results are long-lasting and typically remain stable until other age-related changes occur such as cataract formation or presbyopia.
Those with sensitivity to sunlight after LASIK might want eyeglasses with photochromic lenses. This will reduce the occurrence of photophobia and make vision clearer and more comfortable.
What are Some Possible Problems?
Generally considered safe, LASIK complications can still occur in a small number of cases. These include:
- Night glare, such as halos
- Dry eyes
- Dislocation of the flap in the setting of trauma or contact sports
- Follow-up touch-up
Once you are in your 40’s you may still need to wear reading glasses, due to presbyopia, normal age-related vision loss.
It is important to discuss all concerns with your surgeon or eye doctor before you have LASIK surgery done.
Find out whether you are a candidate for this surgery and if it can improve the quality of your life with improved vision.
Not a Candidate for LASIK?
PRK (Photorefractive Keratectomy)
PRK is a type of laser refractive surgery that is used for the correction of myopia, hyperopia and astigmatism. PRK works by reshaping the cornea using the excimer laser after the epithelium is removed from the center of the cornea. (Unlike LASIK). This outer corneal layer is able to repair itself, which is the reason why the recovery period is a bit longer than a LASIK procedure. The outcomes of PRK are equivalent to LASIK. In fact, most patients that undergo this procedure result in seeing 20/20 or better after the recovery period!
PRK is a great alternative for patients who previously went through a LASIK procedure, have a naturally thin cornea or for those with risk of high-impact or traumatic activity (Military, Karate, etc). We are happy to discuss these options with you and help determine the best fit for you!
Refractive Lens Exchange (RLE)
This outpatient procedure replaces the clear, natural lens of the eye with an artificial IOL (Intraocular Lens) to correct your refractive error. The procedure is similar to cataract surgery, and typically for patients over the age of 40, especially those developing presbyopia that may not qualify for laser vision correction.