LASIK Eye Surgery: Overview

LASIK is a type of laser eye surgery that improves your vision by reshaping the front portion, or cornea, of your eye. In most cases, LASIK eliminates the need to wear eyeglasses or contact lenses.

What Is LASIK Eye Surgery?

LASIK is an elective surgery performed by an opthalmologist (an eye surgeon) on adults, either in the doctor's office or in an outpatient eye surgical center. 

There are three main parts to LASIK eye surgery:

  • Corneal flap creating
  • Corneal reshaping
  • Corneal repositioning

Corneal Flap Creation

Depending on the type of laser procedure you are having, your surgeon will cut a flap of tissue from your cornea using a special type of surgical blade or laser.

After the corneal flap is created, it will be gently lifted. One area of the flap will be left untouched. This "hinge" tissue keeps the flap attached to the eye so that it may be gently reapplied later.

Corneal Reshaping

An excimer laser—a type of laser that emits ultraviolet light at a specific wavelength—will then be used to reshape your cornea, so that light rays focus perfectly on your retina without the need for corrective lenses.  The laser will be applied for as little as 10 to 60 seconds.

During the reshaping process of your cornea:

  • You will be asked to hold very still and fixate your eye on a target.
  • Your surgeon will use a computer to track your eye so that the laser will move carefully with your eye if you make small micro-eye movements. 
  • You may hear a series of clicking sounds while the laser fires.
  • You may also smell an odor while the laser removes some of the cornea tissue.

Corneal Repositioning

After the cornea is reshaped, the corneal flap will be placed carefully back onto your cornea and smoothed out. A special solution called balanced salt solution will be used to help re-float the flap for proper placement.

In addition to ensuring that the corneal flap is positioned perfectly, your surgeon will also check for any air pockets or loose debris that could hinder the healing process.

Contraindications

Not everyone is a candidate for LASIK eye surgery. In order to undergo this surgery, a patient must meet the following criteria:

  • Be at least 18 years old
  • Have farsightedness, nearsightedness, or astigmatism that is not severe and is stable (meaning not changing within the last year)

Absolute medical contraindications to undergoing LASIK surgery include:

Possible contraindications include:

  • Certain autoimmune diseases (e.g., Sjogren's syndrome)
  • History of abnormal wound healing
  • History of herpetic keratitis
  • Diabetes (even if controlled)
  • Glaucoma (even if controlled)

Several unique and sophisticated eye tests (for example, a refraction test and images of your retina and the surface of your eye) will be performed to ensure you are a good candidate for LASIK surgery. 

Purpose of LASIK Eye Surgery

The goal of LASIK is to permanently improve your vision.

LASIK reshapes the cornea so that light can bend properly and be focused on the retina. Your retina then converts the light into nerve signals—which are sent to your brain and interpreted as visual images. 

LASIK eye surgery is performed to treat the following refractive error eye conditions:

How to Prepare

Once your opthalmologist has determined that you are a good candidate for LASIK (which will entail a review of your medical history and a very detailed examination of your eye), you can schedule your appointment and begin to prepare.

Preparing for your LASIK eye surgery means addressing the following issues with your surgeon prior to your surgery date:

  • Arrival time for your surgery and what you need to bring with you (e.g., form of payment)
  • Eye preparatory strategies (e.g., avoiding makeup and cleaning your eye thoroughly on the day of the surgery)
  • Medications you should skip on the day of your surgery
  • Arranging to have someone drive you home after the surgery
  • Expectations and recovery after surgery
  • Potential side effects and complications (e.g., eye dryness and infection)

What to Expect on the Day of Surgery

On the day of your surgery, you will arrive at either your doctor's office or an outpatient surgical center.

Upon entering the surgical room, and sitting in a reclining chair, you may be given an anti-anxiety medication, such as Valium (diazepam), to help you relax and calm your nerves.

Next, the following steps will be performed by your surgeon or their assistant:

  • A sterile drape will be applied over the eye area to ensure a bacteria-free work area.
  • Several numbing eye drops will be placed into your eye.
  • After your eye is numb, you will be asked to lie down close to the excimer laser.
  • When you are comfortable, a special tool will be used to hold your eye open and prevent it from blinking. Sometimes, a suction ring is also applied over the front of your eye to prevent eye movement.
  • The front part of your eye, called your cornea, will then be marked with special surgical ink to start the process of creating a corneal flap.

Keep in mind—several safety measures will be taken during the procedure. Your surgeon has complete control and can turn the laser off at any time. For example, if you move too much, the laser will automatically shut off.

Also, your surgeon will only be operating on one eye at a time. The whole procedure usually takes less than ten minutes per eye. You will, however, probably be in the office or surgical center for approximately 90 minutes.

Recovery

During your immediate recovery (the first 24 hours) from LASIK eye surgery, your surgeon will ask you to rest, relax your eyes, and watch out for symptoms like eye discomfort, dryness, or itching and burning sensations.

To ease these symptoms your surgeon may recommend lubricating eye drops or an over-the-counter pain reliever, such as Tylenol (acetaminophen).

You will be advised to wear sunglasses during the day, wear a patch or eye shield at night, and avoid touching or applying anything around your eyes.

Within one to three days after surgery, most patients can return to their daily routine, including returning to work.

Your surgeon will, however, advise you to avoid certain activities for specific periods of time (one to multiple weeks), such as:

  • Exercising
  • Driving at night
  • Engaging in contact sports
  • Swimming in a pool or hot tub

Long-Term Care

Most people are very satisfied with the outcome of their LASIK surgery, and the results can be dramatic.

In fact, research shows that 99 percent of patients achieve at least 20/40 vision after LASIK, and more than 90 percent achieve 20/20 vision or better.

That said, while LASIK eye surgery provides a permanent improvement in your vision, your eyes will naturally change as you age (called presbyopia).

Therefore, your opthalmologist will want to continue evaluating your eye health with regularly scheduled appointments, long after the six-month recovery period.

Potential Risks

Certain side effects of LASIK are somewhat common but usually temporary, such as eye dryness and visual symptoms like seeing glare, halos, and starbursts. Visual symptoms tend to be most bothersome at night when driving.

Other potential rare risks or complications associated with LASIK eye surgery include:

  • Eye Infection (called infectious keratitis)
  • An inflammatory eye condition called diffuse lamellar keratitis
  • Corneal flap problems
  • Refractive complications like irregular astigmatism, worsening vision, or loss of vision (blindness)

Seek Immediate Medical Attention

While you may experience some mild eye discomfort after LASIK surgery, it's important to contact your doctor right away if you experience any severe eye pain. Seek immediate medical attention too if you experience any unusual or worsening visual symptoms.

A Word From Verywell

While the actual LASIK surgery takes minutes to complete, the preparatory and recovery process requires time and patience. You will need to be diligent in following your surgeon's instructions and attending all of your follow-up appointments.

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Article Sources
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