What is LASIK?
LASIK is a surgical procedure that is capable of correcting a wide range of nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.
What does the word LASIK mean?
LASIK is the acronym for laser in situ keratomileusis, sometimes referred to as laser assisted in situ keratomileusis. The name refers the use of a laser to reshape the cornea without invading the adjacent cell layers. In situ is Greek for "in the natural or normal place." Medically, in situ means confined to the site of origin without invasion of neighboring tissues. Kerato is the Greek word for cornea and mileusis means "to shape."
How long has LASIK been around?
LASIK has been performed internationally for approximately 10 years. It was first performed in clinical trials in the U.S. in 1995. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.
Why is LASIK considered an advancement in refractive surgery?
LASIK combines the precision of the excimer laser that is used in PRK surgeries with the corneal flap technique. It has greater precision than PRK, less complications, it has a quicker recovery time, requires less post-operative eye drops, and is more comfortable.
How can I benefit from LASIK?
LASIK can benefit a great number of people with myopia, hyperopia and astigmatism. Candidates should have a strong desire to be less dependent on corrective lenses and willing to accept the risks of surgery.
How come some people are not candidates for LASIK?
There are a number of factors that doctors must evaluate before they can determine who is an eligible candidate for LASIK. Some doctors deem certain pre-existing conditions contraindications to the procedure and will not perform surgery if you possess them. Other conditions may complicate the surgery and increase your risk of developing a complication. Patients with these conditions need to have a good conversation with their doctors regarding eligibility and expectation levels.
I am happy with my contact glasses. Should I pursue having LASIK?
Most surgeons agree that if you are comfortable wearing contact lenses and are not bothered by being dependent on them, you should carefully evaluate the risks and benefits of LASIK. It will depend on your needs and your lifestyle.
How much does LASIK cost?
The price practices charge will vary, depending upon the conditions specific to the patient and the country.
What kind of results can I expect from LASIK?
LASIK improves the uncorrected vision-one's visual capacity while not wearing corrective lenses-in most patients who have the procedure. Over 90% of patients with low to moderate myopia to achieve 20/40 vision, which most states and provinces consider good enough to drive without having to wear contacts or glasses, and many can expect to achieve 20/20 vision or better. However, there are no guarantees that you will have perfect vision, and patients with high myopia (more than -8D) and high hyperopia (more than +4D) should have lower expectations. People who are most satisfied with the results of laser correction clearly understand the potential risks and complications and possess realistic expectations of what their vision will be like after surgery.
Will my new vision after LASIK be permanent?
The effects of LASIK are permanent. The effects of LASIK do not wear off. But it is important to realize that a person's eye can still change internally. That is why many surgeons recommend having the procedure done after the major eye changes have occurred in one's life. For instance, LASIK is not recommended on children because their eyes change a great deal. They would need the vision fine-tuned in a few years. If the procedure is performed after the age of 18, the chance of long-term stable correction is more likely. Even the eyes of patients over the age of 18 can still be changing. Therefore, we recommend a good conversation with your surgeon so they can review the changes you have had and help you make a decision whether or not you should wait until the changes have slowed down. Patients should also note that while results are usually stable, they can be modified by enhancement procedures - procedures performed after the initial one - if necessary.
Can you have LASIK performed more than once?
Retreatment may be a viable solution to vision changes later in life, and other treatment options exist. You would need to see your ophthalmologist to determine the cause of the change and to determine which option is best for you.
How long does the LASIK procedure take?
The whole procedure takes about 10 minutes for two eyes, including creating the flap and performing the laser under the flap. The actual lasering is usually less than one minute.
What can I do immediately after LASIK is performed?
Patients may experience some discomfort and/or blurred vision for a few hours after surgery. And most patients receive a sedative prior to surgery. Therefore, you cannot drive home after undergoing the procedure, and you should plan not to drive for at least twenty-four hours.
Is an anesthetic used for LASIK? What type of anesthetic is used for LASIK?
The procedure is done with topical anesthetic (eye drops) to numb the eye. Patients may be given a small amount of oral sedative to help them relax.
Does LASIK hurt?
Patients are given a topical anesthetic (eye drops) to numb the eye, so they experience no pain during the procedure. When the surgeon applies the vacuum ring, the patient experiences a sensation of slight pressure just before his or her vision fades for a few seconds. The microkeratome - the instrument the surgeon uses to create the flap - and the laser do not cause any pain or discomfort. For several hours after the procedure, many patients describe a mild "foreign body" sensation, such as after opening the eyes while swimming in chlorinated water. Some people feel like there is a dirty contact lens in the eye. After the first few hours, this uncomfortable feeling usually subsides.
Will both eyes be done with LASIK at the same time?
You can have bilateral simultaneous LASIK (both eyes done at the same time). In the vast majority of cases, bilateral LASIK is fine and has been shown to be safe and effective. Most people, greater than 95% choose to have both eyes dome at the same time. If the surgery of your first eye is not perfect, your doctor will likely hold off on proceeding with the second eye. For more on bilateral surgery, consider the following links and resources: "Bilateral Safe & Effective", "Complications of Laser In Situ Keratomileusis for the Correction of Myopia" Ophthalmology, 1999; 106(1). (Published results of the Emory Study that considered 1062 eyes failed to notice any statistically significant differences with bilateral surgery.)
Will I need to take time off from work after having LASIK?
It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery.
Will I be able to play sports after LASIK surgery?
You can resume most normal activities immediately after surgery. However, for at least two weeks you will need to avoid activities that would cause perspiration to run into the eyes. You should wear safety glasses while playing contact sports whether or not you have had surgery. But if you do not routinely wear safety glasses, your surgeon may recommend wearing them for at least one month after LASIK. You will also need to avoid such activities as contact sports and swimming for several weeks. It is important to talk specifically with your doctor about limitations on activities after LASIK.
How long will it take before I can see clearly, and how long will it take before I have my best vision?
Fast visual recovery characterizes this operation. Most patients achieve good vision the day of surgery and find that their eyes feel fairly normal within a day. However, vision can continue to improve, and best vision can still take two to three months to occur, particularly with higher prescriptions. If necessary, adjustments to the surgery called enhancements can be done. Patients who undergo hyperopic LASIK often need to wait longer to able to see clearly. Typically, they are unable to see with intense clarity for one or two weeks, with best vision coming in several months post-operatively.
Will I need to wear glasses after my eyes have healed?
Most patients who have LASIK do not wear glasses for their daily activities. However, patients may need to wear reading glasses if they are over the age of 40. This is caused by the normal aging of the eye known as presbyopia. This condition occurs with or without LASIK. Some patients may need a minimal prescription for some activities such as night driving.
Will my eyes look different after LASIK?
No. Your eyes will look exactly the same.
How safe is the LASIK procedure?
Most studies show that the LASIK procedure has minimal risk of complications. The overall complication rate is a fraction of one percent. Even if complications do occur, most of the complications are resolved within three months and do not result in long-term interference with vision. The complication rate cited in large studies is between 0.5% and 1.9%. LASIK is a surgical procedure done on a delicate part of the eye, and complications can occur.
After LASIK, how will my vision be at night or in low light?
With Total Cornea LasikTM the vast majority of night vision disturbances are eliminated, since the area of cornea treated is larger than the dilated pupil size. Some patients may see mild glare, halos or starbursts around lights in dim or low-light conditions temporarily right after surgery. These symptoms do not usually interfere with driving at night, or night time activities. For the vast majority, these symptoms are temporary, usually lasing a few days to a week. With this newer technology it is extremely rare for these symptoms to be permanent.
Will my eyes be dry after LASIK?
All patients should be aware that dry eye is a possible complication after LASIK, although it is very rare. The surgery makes everyone's eyes somewhat dryer afterwards, but only temporarily. Your doctors will carefully test you if you have suffered from dry eye before, or are severely bothered by contact lenses, for the potential of developing this complication after surgery. Everyone should use lots of tear drops after the surgery.
I wear bifocals now, and my doctor says that I'll still need to wear reading glasses even if I have LASIK done. Why is this?
Most people in their 40s or older will need reading glasses if their eyes are corrected for distance because the eye's lens loses flexibility as we age. This condition, called presbyopia, cannot currently be treated by surgical methods. Some patients in this age group select monovision, such as is done with contact lenses. This option allows patients to use one of their eyes for distance and the other to see up close. Although monovision proves to be satisfactory for some patients, many are not comfortable with this arrangement.Patients need to discuss the options with their doctors. Most doctors suggest patients to test monovision with contact lenses for a few weeks prior to opting for monovision with LASIK. Be sure to ask if this trial option is available to you. Click here to learn more about Monovision.
If I'm corrected for distance, will I lose my ability to see well up close?
If you have LASIK done to correct your distance vision, you can expect clear overall vision. However, images close to you may not appear as clear after having LASIK if you are over 40. After the age of 40 expect to need reading glasses for up close work.
Does insurance covert the LASIK procedure?
Although LASIK is not a cosmetic procedure, it is considered an elective surgery. Such surgeries are covered in many European and Asian countries. However, in the United States and Canada insurance policies often will not cover the procedure, nor will Medicare usually cover it. If you reside in the U.S. you should check with your insurance company to see if your policy offers partial or full coverage. In some cases, the cost of the procedure can be covered by medical flex plans that allow pretax dollars to be set aside for medical expenses. You should check with your employer to see if your company offers this type of benefit. It is possible that the cost of LASIK may be deducted from your U.S. federal income taxes. You should check with your accountant to see if you can take LASIK as a deductible health expense.
What is PRK?
PRK, or photorefractive keratectomy, is similar to LASIK in that both procedures employ a computer-controlled excimer laser to reshape the cornea of the affected eye. However, LASIK preserves the epithelium (the outermost protective layer of the eye) because the surgeon creates a flap. During PRK, the epithelium is removed by gently scraping the surface. Anesthetic drops in the eye ensure that the patient experiences as little discomfort as possible. PRK is characterized by a lengthier healing process and more discomfort than LASIK.
