LASER in-situ keratomileusis, or LASIK, is a popular surgical approach used to correct vision in people who are nearsighted, farsighted, or have astigmatism.
All laser vision correction surgeries work by reshaping the cornea, or clear front part of the eye, so that light travelling through it is properly focused onto the retina located in the back of the eye. LASIK laser eye surgery is one of a number of different surgical techniques used to reshape the cornea.
What Are the Advantages of LASIK Laser Eye Surgery?
LASIK laser eye surgery has many benefits, including:
- It works! It corrects vision. Around 80% of patients will have their desired vision after LASIK laser eye surgery. An enhancement can further increase this number.
- LASIK laser eye surgery is associated with very little pain.
- Vision is corrected nearly immediately or by the next day after LASIK laser eye surgery.
- Recovery is quick and usually no bandages or stitches are required after LASIK laser eye surgery.
- Adjustments can be made years after LASIK laser eye surgery to further correct vision.
- After having LASIK laser eye surgery, most patients no longer need corrective eyewear.
What Are the Disadvantages of LASIK Laser Eye Surgery?
Despite the pluses, there are some disadvantages:
- Changes made to the cornea cannot be reversed after LASIK laser eye surgery.
- Corrections can only be made by additional LASIK laser eye surgeries.
- LASIK laser eye surgery is expensive.
- LASIK laser eye surgery is technically complex. Problems may occur when the doctor cuts the flap, which can permanently affect vision.
- LASIK laser eye surgery can cause a loss of "best" vision with or without glasses at 1 year after surgery. Your best vision is the highest degree of vision that you achieved while wearing your contacts or eyeglasses.
What Are the Potential Side Effects of LASIK Laser Eye Surgery?
Some patients experience discomfort in the first 24-48 hours after surgery. Other side effects, although rare, may include:
Some patients lose vision. Some patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses, or surgery as a result of treatment.
Some patients develop debilitating visual symptoms. Some patients develop glare, halos, and/or double vision that can seriously affect night-time vision. Even with good vision on the vision chart, some patients do not see as well in situations of low contrast, such as at night or in fog, after treatment as compared to before treatment.
You may be under treated or over treated. Only a certain percent of patients achieve 20/20 vision without glasses or contacts. You may require additional treatment, but additional treatment may not be possible. You may still need glasses or contact lenses after surgery. This may be true even if you only required a very weak prescription before surgery. If you used reading glasses before surgery, you may still need reading glasses after surgery.
Some patients may develop severe dry eye syndrome. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual symptoms. This condition may be permanent. Intensive drop therapy and use of plugs or other procedures may be required.
Results are generally not as good in patients with very large refractive errors of any type. You should discuss your expectations with your doctor and realise that you may still require glasses or contacts after the surgery.
For some farsighted patients, results may diminish with age. If you are farsighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops).
Long-term data is not available. LASIK is a relatively new technology. The first laser was approved for LASIK eye surgery in 1998. Therefore, the long-term safety and effectiveness of LASIK surgery is not known.
How Should I Prepare for LASIK Laser Eye Surgery?
Before your LASIK laser eye surgery, you will meet with a coordinator who will discuss what you should expect during and after the surgery. During this session, your medical history will be evaluated and your eyes will be tested. Likely tests include measuring corneal thickness, refraction, and pupil dilation. Once you have gone through your evaluation, you will meet the surgeon, who will answer any further questions you may have. Afterwards, you can schedule an appointment for the procedure.
On the day of your surgery, eat a light meal before going to the doctor, and take all of your prescribed medications. Do not wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you are not feeling well that morning, call the doctor's office to determine whether the procedure needs to be postponed.
What Happens During LASIK Laser Eye Surgery?
During LASIK laser eye surgery, an instrument called a microkeratome is used to cut a thin flap in the cornea. The cornea is then peeled back and the underlying cornea tissue is reshaped using an excimer laser. After the cornea is reshaped so that it can properly focus light into the eye and onto the retina, the cornea flap is put back in place and the laser eye surgery is complete.
LASIK laser eye surgery is performed while the patient is under a local anesthesia and usually takes about 10 minutes to complete.
What Should I Expect After LASIK Laser Eye Surgery?
Healing after LASIK laser eye surgery usually occurs very rapidly. Most patients notice improved vision within a few days after LASIK laser eye surgery. However, your vision may be blurry and hazy for the first day. You should plan to have someone drive you home after LASIK laser eye surgery.
Your eyes will be dry even though they do not feel that way. Your doctor will give you prescription eye drops to prevent infection and keep your eyes moist. These eye drops may cause a momentary slight burn or blurring of your vision when you use them. Do not use any eye drops not approved by your ophthalmologist. Specific follow-up after the surgery varies from one surgeon to another. You will revisit the doctor for an evaluation 24-48 hours after LASIK laser eye surgery, as well as at regular intervals within the first six months after surgery.
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