LASIK is the most commonly performed refractive surgery procedure. You may hear people calling it "LASIX," but the name is actually short for "laser-assisted in situ keratomileusis."
Why is it so popular? LASIK has advantages over other procedures, including a relative lack of pain afterward and the fact that good vision is usually achieved by the very next day.
An instrument called a microkeratome is used in LASIK eye surgery to create a thin, circular flap in the cornea. Another, newer way of making the flap is with a laser.
The surgeon folds the flap back out of the way, and then removes some corneal tissue underneath using an excimer laser. The excimer laser uses a cool ultraviolet light beam to precisely remove ("ablate") very tiny bits of tissue from the cornea to reshape it. When the cornea is reshaped in the right way, it works better to focus light into the eye and onto the retina, providing clearer vision than before. The flap is then laid back in place, covering the area where the corneal tissue was removed.
Both nearsighted and farsighted people can benefit from the LASIK procedure. With nearsighted people, the goal is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. While this is not widely recognized by consumers, excimer lasers also can correct astigmatism by smoothing an irregular cornea into a more normal shape.
In order to decide whether you're a good candidate for LASIK, your eye doctor will examine your eyes to determine their health, what kind of vision correction you need, and how much laser ablation is required.
Also, a corneal topographer is usually used; this device photographs your eye and creates a kind of "map" of your cornea. With new wavefront technology associated with custom LASIK, you also are likely to undergo a wavefront analysis that sends light waves through the eye to provide an even more precise map of aberrations affecting your vision.
Finally, the doctor will find out from you any health problems you have or medications you take. Some health conditions will disqualify you altogether for LASIK, but others may just postpone the procedure until a later date.
Your doctor will probably ask you to follow a few simple directions leading up to your LASIK eye surgery, including:
If you currently wear contact lenses, you will likely be asked not to wear them for two to four weeks prior to your procedure. Contact lenses can change the shape of your corneas, so you'll want to keep them out long enough for your corneas to assume their natural shape.
Keep your eyes free of debris. Your doctor may ask you to avoid using creams, make-up, or perfumes at least a day in advance of the procedure.
Your doctor may recommend that you wash the area surrounding your eyes with a mild cleanser (such as baby shampoo) for a few days prior to the procedure.
LASIK is an ambulatory procedure; you walk into the surgery center, have the procedure and walk out again. In fact, the actual surgery usually takes less than five minutes, and you're awake the whole time. Occasionally, the doctor will give a mild oral sedative beforehand. Even though the procedure is relatively quick, this does not minimize the importance of having it performed by a highly skilled surgeon with proper equipment because LASIK is a very delicate procedure. You also should have someone accompany you to drive you back home afterward.
Before your LASIK procedure begins, anesthetic drops are placed in each eye to numb them. These drops help to ease any discomfort during the procedure. Most people don't feel pain during LASIK surgery.
The doctor will have you lie down, and then make sure your eye is positioned directly under the laser. (One eye is operated on at a time.) A kind of retainer is placed over your eye to keep your eyelids open — normally, this is not uncomfortable. It has a suction ring that keeps your eye pressurized, which is important in LASIK for allowing the surgeon to cut the corneal flap.
The surgeon will use an ink marker to mark the cornea before the flap is created. The flap is then created with either a microkeratome or with a laser,
The doctor uses a computer to adjust the laser for your particular prescription. You will be asked to look at a target light for a short time while he or she watches your eye through a microscope while the laser sends pulses of light to your cornea.
The laser light pulses will then painlessly reshape the cornea. You'll hear a steady clicking sound as the laser is operating. You're also likely to smell a mildly acrid odor due to the tissue removal. The higher your prescription, the more time the surgery will take. The surgeon has full control of the laser and can turn it off at any time.
After the procedure is finished, you will rest for a little while. If you're having both eyes done the same day, the surgeon will probably do the other eye after a short period of time. Some people choose to have their second eye done a week later.
The doctor may prescribe medication for any postoperative pain, but many people feel no more than mild discomfort after LASIK. That's one advantage over PRK, which can be quite painful afterward.
During your LASIK recovery, your vision may seem blurry and your eyes may be watery until the cornea heals completely. Many people see clearly shortly after their laser procedure; however, everyone responds differently. You may be sensitive to bright lights, see "halos," or have difficulty seeing in low light. All of these conditions should dissipate within weeks, if not days, of the procedure.
The doctor will ask you to schedule a visit shortly after your procedure. On this and later LASIK recovery visits, your doctor will test your vision to assess the results of the surgery. He or she will also check to see if your eyes are healing properly, and look for any post-procedure side effects explained when you both discussed LASIK's risks.
Following your LASIK recovery, you should be able to return to normal activities very quickly. However, your doctor may tell you to:
Wait one to three days before participating in any non-contact sports.
Avoid more strenuous contact or water sports for at least one to two months.
Continue washing gently around your eyes with a mild cleanser.
Of course, all this depends on how you feel and your doctor's instructions.
In most cases, patients have excellent results and are not only free of any serious, long-term complications after their LASIK recovery; they're likely to see as well - or in some cases, even better - than they did with their eyeglasses or contact lenses.
The only major difference is they're free of eyeglasses or contacts.
For a first-hand view of laser vision correction, take a look through the eyes of typical patients who describe their LASIK experiences.
Immediately after LASIK, the doctor will have you rest for a bit, then you can go home. At home, you should relax for at least a few hours.
You may be able to go to work the next day, but many doctors advise a couple of days of rest instead. They also recommend no strenuous exercise for up to a week, since this can traumatize the eye and affect healing.
Avoid rubbing your eye, as there is a chance (though slim) of dislodging the corneal flap.
With LASIK surgery, most patients are extremely pleased with their LASIK results.
LASIK eye surgery benefits: include improved visual activity (Most people achieve 20/20 or better vision with LASIK. Some may achieve only 20/40 or not quite as good. In fact, 20/40 is fairly good vision. In most states, the law considers it good enough for driving) freedom from corrective eyewear, and possibly new career opportunities. Patients who achieve a successful LASIK outcome can eliminate their need for glasses or contact lenses, and enjoy the freedom of clear vision at all times. Patients can play sports, swim, spend a day at the beach, and participate in various activities without the restrictions that glasses and contacts bring. LASIK eye surgery is a safe and effective treatment that has continued to gain popularity among patients.
Some patients may still need glasses or contact lenses following laser vision correction, though their prescription level typically will be much lower than before.
Postoperative complications can include infection or night glare (starbursts or halos that are most noticeable when you're viewing lights at night, such as while you're driving). Rarely, people will experience improvement, and then notice a gradual worsening of vision (called "regression"). If this happens, discuss it with your surgeon to determine if more surgery (called an enhancement or "touch-up") will be necessary.
Even if you see perfectly after laser eye surgery, you may still need reading glasses or bifocal contact lenses once you hit your 40s. This is because of a condition called presbyopia, which begins to develop in most people when they're between the ages of 38 and 42. Your distance vision will probably remain crisp, but seeing up close will be more difficult. However, researchers are studying ways to correct presbyopia surgically. So it's possible that you could have one of those procedures later, once they are FDA-approved.
Why do 1.5 million Americans each year have the LASIK procedure? Imagine being able to see your child's recital from the back row. Or drive at night comfortably. Or take part in meetings without worrying about unattractive eyeglasses or uncomfortable contact lenses.
In short, people choose the LASIK procedure – the most common laser vision correction procedure – because they want to enjoy life without eyeglasses or contacts. Reading other people's experiences is an excellent way to learn what having the LASIK procedure is like.
With the LASIK procedure, you can have the convenience and ease of taking part in your normal daily activities without being hampered by vision devices. Play sports. Carpool. Use a computer. Read. No eyeglasses to get dirty or lose; no contacts to fall out or itch.
Since 1995, 3.7 million Americans have had a successful LASIK procedure. And with Alcon's Customized LASIK, which uses the latest in wavefront technology, results are often better than 20/20 vision. A wavefront LASIK system uses an eye-safe beam of light to map the eye's wavefront. Your doctor uses this map to create a detailed vision correction plan for the LASIK laser to follow.
If in the rare event your vision correction isn't what you expected following your LASIK recovery, you have options. You may have to return to using eyeglasses or contact lenses. Your doctor may also suggest enhancements to reshape the cornea to give you even better vision.
Now that you understand the long-term benefits of the LASIK procedure, learn more about which laser vision correction procedure is right for you.
