Laser-Assisted Intrastromal Keratomeleusis or LASIK is an advanced refractive surgical technique. In this technique the outer layer of the cornea is lifted up to form a flap and the inner corneal tissue is reshaped with the laser. Air is then used to seal the flap. The whole procedure takes ten minutes and has a rapid visual recovery time. Many of the people who have specific general health or eye problems who are not candidates for PRK can have LASIK surgery. LASIK is also proving to be the ideal surgical technique for surgically corrected severe cases of myopia. LASIK is an ideal procedure for most patients looking into refractive surgery because it is available to correct for myopia, hyperopia and astigmatism.
Frequently asked questions regarding LASIK surgery
- What is Refractive Surgery/LASIK Surgery?
- What is laser vision correction and what problems can it correct?
- Can I have both eyes done at once?
- Can you guarantee 20/20 vision?
- How long will it last?
- How can mono vision delay my need for reading glasses?
- What will my recovery be like?
- Will my activities be restricted?
- How do I prepare for my procedure?
- How does the excimer laser work?
- What are common complications?
What is Refractive Surgery/LASIK Surgery?
Our job as refractive surgeons is to reshape the cornea, which is the clear dome over your iris. The cornea provides most of the focusing power of the eye by directing light through the lens, which is located in the center of your pupil behind the iris. The lens fine tunes the focus by shining the light on the retina of the eye. The retina transmits the image to the brain to produce vision.
What is laser vision correction and what problems can it correct?
Today, laser vision correction is recognized as the most important development since the introduction of the contact lens three decades ago. Correction of nearsightedness, farsightedness and astigmatism with the excimer laser is the most technologically advanced method available to reduce your dependence on glasses and contact lenses. This exciting refractive technology uses a cool laser beam of light to gently reshape your eye.
Over one million laser vision correction procedures have been performed, in 52 countries around the world, for more than a decade. Laser vision correction has been used since the late 1980s to successfully correct nearsightedness (myopia) and astigmatism.
Recent advances also give us the ability to treat farsightedness (hyperopia). Typically, hyperopic patients are those who need corrective lenses to read before the age of 40 to correct their up-close vision. The FDA approved the excimer laser in 1998 for use in the treatment of hyperopia.
We perform LASIK (Laser In Situ Keratomileusis) at Cleveland Eye Clinic, to insure a lifetime of visual stability.
Can I have both eyes done at once?
Yes, for LASIK, one eye at a time can be done if the patient requests this.
Can you guarantee 20/20 vision?
While laser vision correction has proven overwhelmingly successful in reducing dependence on glasses and contact lenses, the degree of improvement may vary from individual to individual. How well and how quickly your vision improves depends on how well you heal and the severity of your prescription. Although we can’t promise patients “perfect” or 20/20 vision, 98% of nearsighted patients will be within 2-3 lines of 20/20 after one or more treatments. This means they no longer need glasses or contacts to drive, play sports, watch movies and TV, or participate in careers requiring excellent vision such as police and fire departments.
How long will it last?
We believe it will last forever, problems are usually detected within the first year.
How can mono vision delay my need for reading glasses?
When you have laser vision correction, one eye can be intentionally left slightly nearsighted. This is called mono vision, and it allows you to maintain your ability to read after presbyopia (the lose of reading often after age 40) begins. Your other eye will be fully corrected for distance vision. Gaining this near vision means giving up some distance sharpness in that eye. (Many people have already elected mono vision correction with their contacts or glasses.)
Mono vision is helpful for near-tasks such as reading your watch, opening the mail, scanning a menu or article, but not for reading fine print or reading for a prolonged time. Almost everyone will require reading glasses at some point.
For active individuals, such as those who play golf or tennis, or who drive a great deal at night, mono vision may not be suitable.
What will my recovery be like?
Most patients notice dramatic visual results within the first few days following their procedure. However, the speed of visual recovery depends on personal healing patterns. LASIK patients usually see quite well the next day, but patients with higher prescriptions may recover more slowly from either procedure,
LASIK patients may receive an eye patch to protect the flap while sleeping during the first few days. LASIK patients may experience some irritation or discomfort, but this usually lasts only for a few hours. Sleep is strongly recommended after the procedure, and work in one to three days. Most patients are quite comfortable after taking a short nap. Along with resting LASIK patients often find that placing a cold compress over the eyes is soothing.
Will my activities be restricted?
Many patients return to work the next day, others a few days later. You will need to restrict the activities mentioned below. Otherwise, as long as you follow your doctor’s instructions, you should be free to resume all your normal activities.
- Wait one full day before taking a shower.
- Resume driving after one day to one week, as your doctor advises.
- Sunglasses should be worn for the first few days.
- Read and watch TV in moderation the first few days.
- Do not wear eye makeup for four days.
- Do not rub your eyes for four days.
- Do not exercise for one week.
- Avoid swimming, hot tubs, and whirlpools for one week.
- Avoid gardening and dusty environments for one week.
- Avoid contact sports that could result in an eye injury for one month.
- Smoking is allowed, but you will probably find smoke very irritating.
How do I prepare for my procedure?
There are no restrictions on eating, drinking or medications immediately prior to your procedure. However, you should avoid alcohol and medications that cause drowsiness.
Contact lenses change the shape of your cornea. Since this is the area that’s treated, it’s important to allow time for your cornea to return to its normal curvature. Soft contact lenses should be removed at least 72 hours (3 days) before your procedure. Hard or gas permeable contact lenses should be removed at least 4 to 6 weeks before your procedure. Patients who have worn rigid contact lenses for over 20 years may need to remove them for up to 8 to 12 weeks. Your eye doctor can help you make this determination and even fit you with disposable contact lenses or glasses in the interim.
How does the excimer laser work?
The excimer laser was invented to etch microchips more than two decades ago at IBM’s Watson Laboratories. Subsequently, the remarkable discovery was made that the excimer can also be used to re-sculpt human tissue, particularly the cornea, with a great degree of precision.
Today, the excimer provides accuracy, predictability, and the capability to correct a wide range of refractive errors. This Argon-Fluoride gas laser emits computer controlled pulses of cool ultraviolet light with an unparalleled degree of precision. Each pulse of the excimer laser can remove 39 millionths of an inch of tissue in as little as 12 billionths of a second. In fact, the excimer laser can remove as little as 1/40 of a human cell. This precision leaves the integrity of the eye unchanged. The excimer works by breaking molecular bonds. It is the ability of the excimer laser to remove a single cell without damaging the remaining cells that allows doctors to perform laser vision correction with precision. We perform two procedures with the excimer laser: LASIK and PRK. Both procedures can achieve the same results, but employ different methods.
What are common complications?
- UNDER-CORRECTION AND OVER-CORRECTION There are two phases to your procedure: the surgical phase and the healing phase. Both are equally important to your outcome. The speed of visual recovery, the quality and sharpness of your vision, and your final outcome will be determined by your healing pattern, preoperative prescription, ocular findings and corneal shape. Typically, distance vision clears first, followed by reading vision.The more severe your initial prescription, the more correction you will need, the more healing you will require, and the greater the chance you will not be fully corrected in just one procedure. Enhancement procedures usually are performed a minimum of one to four months after the initial LASIK procedure, and a minimum of four to six months after the initial PRK procedure. We estimate that about 10% of patients require a second procedure to enhance their final results. On the other hand, some patients experience an over response or over-correction, leaving them somewhat farsighted.
- INFECTION Infection rarely occurs since patients receive antibiotic drops both before and after the procedure. Following your prescribed eye drop regimen is very important. Most minor infections are treated easily, but should be treated quickly. The risk of infection is greatest 48 to 72 hours following the procedure.
- NIGHT GLARE Even before having laser vision correction, many people experience poor night vision or night glare such as haloes and starbursts. Night glare is common immediately following the procedure and lasts for about three or four months. If you treat one eye at a time, or are extremely nearsighted with large pupils, you may notice night glare for a longer period. By the time both of your eyes are treated, or six months have passed, night glare tends to decrease to minimal levels. Some patients may benefit from glasses when driving at night. In FDA trials, this condition occurred in less than 4% of PRK patients the risk is significantly reduced with LASIK.
- LOSS OF BEST CORRECTED VISION A small number of patients experience a slight loss of visual sharpness following laser vision correction. You may lose the ability to read the bottom few lines of the eye chart, which you could read with your glasses before the procedure. In many cases, sharpness improves over a period of six. to 12 months. In some instances, patients’ natural vision following the procedure is actually better than their pre-procedure best corrected vision was.
- CORNEAL FLAP RISKS While LASIK offers a faster recovery, this procedure does have specific risks due to the creation of a corneal flap. A corneal flap which is irregular, too short, or too thin can prevent the procedure from being completed. In such a case, the corneal flap is closed, and the eye allowed to heal. Three to six months later, the procedure can be performed.As long as the corneal flap heals smoothly, patients can achieve an excellent result. However if irregularities in the flap persist, a loss of best-corrected vision may result.Other corneal flap risks include displacement of the flap and epithelial ingrowth. Epithelial ingrowth means that epithelial cells grow beneath the corneal flap prior to the sealing of the corneal flap margins. Although most cases do not require any treatment, severe epithelial ingrowth can disrupt corneal flap integrity. It is usually treated within one month by lifting the flap and cleaning the area.
- PAIN OR DISCOMFORT There is no pain during the LASIK procedures, but some irritation or discomfort may be experienced after surgery. LASIK patients, irritation, if any, usually lasts only for a few hours.