LASIK is the most commonly performed refractive surgery procedure. The name is actually short for "laser-assisted in situ keratomileusis."
(General Information)
Technical name: Laser-Assisted In Situ Keratomileusis
Body Parts: Eyes
Age Recommended: Around 20, when you should be refractive stable
Anesthesia: A numbing drop
Surgery time: On average, less than 30 minutes
Pre-operative: Exams and stop wearing contact lenses
Post-operative: An eye shield will be worn for a day
Recuperation period: from 3 days to 3 months, depending on the activity desired
Results duration: Variable
LASIK is a refractive surgery procedure that reduces or eliminates the use of glasses or contact lenses used to compensate refraction problems. Refraction problems are caused by a defect on the shape of the cornea. LASIK surgery works permanently changing this shape.
There are several refractive surgery procedures intended to improve the focusing power of the eye. In case of LASIK, this improvement is made by removing corneal tissue with the help of a special laser. [ Top ]
When the shape of the cornea is defective, the image formed on the retina in blurred or distorted. There are three types of refractive errors
To undergo a LASIK Eye Surgery, you should be at least 18 and be refractive stable. A person is considered refractive instable when its prescription glasses or contact lenses have been changed in the past year. On average, people under 20 are refractive instable. However, people who present hormonal changes (might be caused by diabetes), are pregnant, breast-feeding or taking medications that might alter vision are also likely to present refractive instability.
In addition, people who practice sports that expose the face and eyes like boxing and martial arts or whose job prohibit refractive procedures should not undergo this procedure.
People who have medical conditions like HIV, diabetes, lupus and rheumatoid arthritis or who take medications like retinoic acid and steroids are more likely to present problems on healing process and should not undergo a LASIK surgery.
In case of patients with diseases involving the eye like herpes (simplex or zoster), glaucoma, ocular hypertension, inflammations of the eye such as uveitis/iritis, eye injuries or previous eye surgeries and keratoconus (conical eyes), the safety and effectiveness of LASIK have not been proved/established yet.
You should also be aware of possible complications and about the significant cost of the surgery, which is usually not covered by medical insurance.
Also, patients with Blepharitis, an inflammation of the eyelids, are more likely to present an infection or inflammation during post-operative.
Once refractive procedures remove tissue of the cornea in order to reshape them, people who have thin corneas (the colored part of the eye is too thin) might present blinding complications.
Patients with large pupils might present symptoms like glare, halos and ghost images after surgery. These symptoms might debilitate the patient in a way that it no longer can drive at night or in a fog.
If the patient has a history of previous refractive surgery, another surgery is not recommended. You should discuss with the doctor about some exceptions. In addition, in case of previous condition of dry eyes, a LASIK is not recommended because might be aggravated. [ Top ]
First, you should schedule a consultation with a specialist, so you can be evaluated and see if you are a good candidate for LASIK. Before your evaluation, you should stop wearing contact lenses, because they change the shape of the cornea. Inaccurate cornea measurements would lead to a poor surgery result. These exams might need to be repeated at least a week after the first evaluation and also before surgery, in order to ensure a correct measurement.
Depending on lenses type, the time necessary to stop wearing them before evaluation is:
Also, you should talk to your doctor about your history of medical and eye conditions and about all medications you are taking and that you might be allergic to.
During your eye exam, should also be discussed if you are able to undergo the procedure, surgery benefits, possible risks and alternatives. He should also discuss surgery expectations, and patient’s responsibility.
At the day before surgery, you should stop using creams, lotions, makeup and perfumes, because they might increase surgery risks of infection. In some cases, the doctor might tell you to scrub your eyelashes before surgery in order to remove residues on the lashes. At the day of the surgery, some medication might be given in order to make you relax. [ Top ]
On average, LASIK Eye Surgery takes less than 30 minutes. The patient lies on a reclining chair during this time. The area near the eye will be cleaned and an anesthesia – a numbing drop, will be placed. A lid speculum, an instrument to make your eyelids remain open will also be placed.
A blade device called Mechanical Microkeratome or a laser device called Laser Keratome will be used to cut a flap on the cornea. Then, the patient will have to stare at a light for at least 60 seconds, in order to keep the eye fixed in the correct position.
After that, the excimer laser reshapes the cornea with the action of its high energy ultraviolet light. The correction desired is controlled by a computer program. After the correction, flap is replaced and there is no need to use stitches.
At the end of the procedure, a shield is usually placed to protect the operated eye from pressure and rubbing. [ Top ]
After surgery, some discomfort is expected. You may feel your eyes burn, itch or scratch. In case of pain, a pain reliever might be prescribed. Your eyes may also tear or water and your vision might be blurry or hazy. Whatever happens, do not rub your eye, because it might dislodge the flap.
At the first visit following surgery, your eye shield will be removed, your eye examined and your vision will be tested.
At the first few days following surgery, symptoms such as sensitivity to light, glare, starbursts, haloes around lights and red eye are expected and should improve soon. If the symptoms do not get better a few days later, or get worse, and you feel severe pain, contact your doctor immediately.
Eye drops might be given in order to prevent infection or inflammation and artificial drops might be recommended in order to help on lubricating. Even if you are not seeing properly, do not wear contact lenses. It might take up to six months following surgery so your vision can be stable.
On average, from one to three days after surgery the patient can already practice non-contact sports, depending on the activity and on your recovery.
In order to ensure a safer recovery, less likely to infection, you should wait up to two weeks before using lotions, creams or make-up near the eyes. In some cases, the doctor will also tell you to continue scrubbing your eyelashes a few days after surgery.
Swimming and hot tubs should be avoided from 1 to 2 months following surgery.
Hard exercising like boxing, football and karate, should not be practiced before 4 weeks following surgery. You should protect your eyes from being hit and anything that could get in them.
In case of additional surgery needed, a minimum 3 months break should be taken, because eye measurements should remain the same for at leas two consecutive visits. However, it is important to say that refraction problems might improve after a second surgery, but other symptoms are usually not improved. The safety and effectiveness of another surgery haven’t been proved yet. [ Top ]
Just like any surgery procedure, there are some risks. It is important to ask your doctor everything you would like to know and share with him all your feelings and fears.
Also, you should carefully read the patient handbook provided by the doctor, which contains information from the manufacturer of the device. Expected results and possible complications should be discussed by this time.
People might feel interested in undergoing LASIK surgery on both eyes at the same time; however, some important aspects about it should be explained. It is riskier than operating one eye each time, because the doctor and not even the patient would be able to tell about the evolution of the post-operatory. There is no time to wait to see how the first eye will respond to surgery before operating the other. In addition, both of the eyes should be blurred during recovery, which will cause much more discomfort to the patient.
Some people present Presbyopia, gradual loss of the ability of the eye to focus on near objects caused by loss of elasticity of the crystalline. In this case, there is a technique called Monovision, which consists on making the patient use one eye for distance viewing and the other for near viewing. This technique has been used in contact lenses wearers and now is used for LASIK and other refractive surgeries. This way, one eye is operated to correct near vision and the other to correct distance vision.
The problem is that, having each eye operated in a different way, they wouldn’t work together anymore. This way, the patient would present a decreased quality vision, which would be aggravated in low lighting conditions and when a sharp vision is necessary. In addition, the patient might have to complete eye correction using glasses or contact lenses, especially to drive at night, operate equipment or to read something really small.
Some patients present difficulties to get adapted with one eye always blurred. This way, if the patient desires a Monovision with LASIK, a period of tests with contact lenses is recommended. It is also important to check if you will be able to drive and if your Presbyopia is still expected to increase. You should also ask your doctor about how long the surgery is expected to last.
In some cases, patients might permanently lose lines of vision on the vision chart after surgery. Also, some patients might be under treated or over treated after surgery. In case of people with very large refractive errors, the results may not be satisfactory, and the patient may still need to use glasses or contact lenses after LASIK. If the patient is farsighted, the result might decrease with age.
Following the procedure, some patients might develop severe dry eye syndrome, which causes discomfort and lost of visual quality. Use of drop therapy and plugs are usually recommended, but sometimes this syndrome is permanent.
LASIK is approved since 1998. This way, there aren’t long-term studies and patients to ensure safety and effectiveness of LASIK.
Complications are considerable reduced if the procedure is performed by an experienced doctor, and if his pos-operatory instructions are carefully followed. Patients are usually satisfied with the results.
LASIK is an elective surgery; you should do it for yourself, as a personal decision. You should not submit this procedure because of someone else or to fit an ideal image. As a patient, you should be aware of expected results and possible risks. [ Top ]
