LASIK (laser in situ keratomileusis) is a relatively safe and effective outpatient laser surgery used to treat short sight, long sight and astigmatism. With LASIK, the ophthalmologist uses a laser to permanently reshape the cornea, the transparent front layer of the eye. This improves the way the eye focuses light rays onto the retina, the light sensitive layer at the back of the eye. LASIK is a quick and often painless procedure, and for the majority of patients, the surgery improves vision and reduces the need for corrective eyewear.
How does LASIK work?
LASIK works by altering the curvature of the cornea. In long sight, the goal of LASIK is to flatten the too-steep cornea; in short sight, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more regular shape.
Who Is a Good Candidate:
People who can see well with corrective spectacles and whose eyes are otherwise healthy may benefit from LASIK. LASIK allows people to perform most of their everyday tasks without corrective lenses. However, people looking for perfect vision without glasses or contacts run the risk of being disappointed.
Over 90% of people who have LASIK achieve somewhere between 20/20 and 20/40 vision without glasses or contact lenses. A second surgery maybe required for perfect vision. Some people may need to wear glasses for certain activities, such as reading or driving at night.
Individuals that are not deemed good candidates given today’s technology may be able to have the surgery in the future, as technology advances and new techniques are refined.
The ideal candidate includes:
• Over 18 years of age
• Stable glasses or contact lens prescription for at least two years.
• Sufficient corneal thickness.
• Do not suffer from any disease, vision-related or otherwise, that may reduce the effectiveness of the surgery or the patient’s ability to heal properly and quickly.
• Fully informed individuals who have realistic expectation from the procedure.
Candidates should thoroughly discuss the pros and cons of the procedure with their physicians and understand that for most people, the goal of refractive surgery would be the reduction of dependency on glasses and contact lens, not their complete elimination.
How do you prepare for surgery?
It is important for each individual to weigh the benefits, complications, options and alternatives before deciding upon LASIK eye surgery. A good online research and knowledgeable expectations is central to ultimate satisfaction with LASIK procedure.
Patients wearing soft contact lenses are usually instructed to stop wearing them 5 to 21 days before surgery. Patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts have been worn.
The Procedure
LASIK is performed as an out-patient procedure. The patient will be lying down and the eyes are numbed with a few drops of topical anesthetic. A speculum is placed between the eyelids to keep the eyes open and prevent blinking.
A suction ring is placed on the eye and this prevents the eye from moving. The patient may feel pressure from the eyelid holder and suction ring, similar to a finger pressed firmly on the eyelid. From the time the suction ring is put on the eye until it is removed, the vision will appear dim.
A microkeratome is then used to create a hinged flap of paper-thin corneal tissue. This flap is lifted and folded back. The LASIK laser is preprogrammed with measurements customized to the patient’s eye. The patient will look at a special pinpoint light called a fixation light or target light while the laser sculpts the exposed corneal tissue. After the laser has reshaped the cornea, the surgeon places the flap back into position and smoothes the edges. Within two to three minutes, the flap sticks in position. The actual LASIK surgery usually takes less than five minutes.
After the procedure
• The patient can go home soon after the procedure.
• To help protect your cornea as it heals a transparent shield maybe placed over your eye.
• Eye drops are given to help the eye to heal and to alleviate dryness.
• It may take 3-6 months for the vision to stabilize.
What are the side effects.
LASIK, like any surgery, has risks and complications that. Most complications can be treated without any loss of vision. There is a chance, though extremely small, that the vision will not be as good after the surgery as before, even with glasses or contacts.
Some people experience temporary side effects after LASIK that usually disappear over time. These side effects may include discomfort or pain, hazy or blurry vision, scratchiness, dryness, glare, halos or starbursts around lights, light sensitivity, or small pink or red patches on the white of the eye. In rare situations, these effects may be permanent.
Infection is a small possibility with any surgical procedure, including LASIK. Antibiotics can usually clear up such infections. Rarely, complications during surgery may cause irregularities in the corneal flap, requiring further treatment.
The FDA website on LASIK states: "Before undergoing a refractive procedure, you should carefully weigh the risks and benefits based on your own personal value system, and try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so."
