Laser in situ keratomileusis, or LASIK, is an outpatient surgical procedure used to treat nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. With LASIK, a surgeon uses a laser to reshape the cornea, changing the way light rays are focused onto the retina.
LASIK may decrease your dependence on glasses and contact lenses or, in certain cases, allow you to do without corrective lenses entirely. If you have LASIK to correct your distance vision, it is still possible that reading glasses will be needed. Therefore, it is important for you to consider the possibility that LASIK may not give you perfect vision, and to discuss all possible scenarios with our optometrists.
LASIK is not for everyone. Our doctors will advise you about certain conditions that may prevent you from being a good candidate for this procedure. Should you not be a good candidate for LASIK, there may be alternative options, which may be discussed.
Prior to surgery, our doctors will perform a thorough eye exam to determine your visual status and check for any abnormalities that might affect the procedure. We will check your eyes for unusual dryness, which could cause worsening symptoms postoperatively, or unusually large pupils, which could affect night or low-light vision.
LASIK is performed with the patient reclining under the laser in an outpatient surgical suite. First, the eye is numbed using topical anesthetic drops. A speculum is then placed between the eyelids to keep them open and prevent you from blinking. Suction is then applied to the eye to lift and flatten the cornea, helping to keep your eye from moving during the procedure. You may feel pressure as this occurs. Once suction is applied to the eye, vision may appear dim or perhaps black. An automated surgical instrument called a microkeratome is then attached to the suction ring. As the microkeratome blade moves across the cornea, you will hear a buzzing sound. The microkeratome stops at a preset point, far enough from the edge of the cornea to create a hinged flap of corneal tissue.
The microkeratome and suction ring are then removed from your eye and the flap is lifted and folded back. As the flap moves, your vision gets blurrier. The laser, preprogrammed with measurements customized to your eye, is then centered above the eye. In most cases, a pupil tracker will be used to keep the laser centered on your pupil during surgery. As you fixate a target, the laser sculpts the exposed corneal tissue, making an audible clicking sound during the procedure. After the laser has completed the reshaping of the cornea, the surgeon places the flap back into position and smoothes the edges. The flap adheres on its own in several minutes.
In order to protect your cornea, you will be instructed to wear and sleep in a protective shield. It is normal for your eye to have a burning sensation or feel “scratchy.” This sensation usually subsides within several hours. Plan on going home and taking a nap or relaxing. You will be given eye drops to help the eye heal and alleviate dryness.
Similar to any surgery, LASIK has risks and complications that should be carefully considered. LASIK can sometimes result in under correction or overcorrection. Fortunately, these can often be improved with glasses, contact lenses or additional laser surgery. Most complications can be treated without any loss of vision. Permanent vision loss is very rare and although small, there is a chance that your vision will not be as good after the surgery as before, even with corrective lenses. Temporary side effects after LASIK may include:
discomfort or pain
hazy or blurry vision
small broken blood vessels
halos or starbursts around lights
Almost everyone experiences some dryness in the eyes and fluctuating vision during the day. These symptoms usually fade within a month, although they may continue for a longer period of time. With any surgical procedure, there is always a small risk of infection. Rarely, complications during surgery may cause irregularities in the corneal flap, requiring further treatment.
It is important that anyone considering LASIK have realistic expectations. 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. If vision is undercorrected after the procedure, a second procedure may be performed to further refine your vision.
LASIK cannot correct or delay presbyopia, the age-related loss of focus. Some people, however, choose monovision, which leaves one eye slightly nearsighted, to allow for near vision in that eye. To determine your individual needs and whether or not you could adapt to this correction, you may wish to try monovision with contact lenses prior to surgery.
As with any surgery, the surgical skill, experience and complication rate of the person performing the operation is extremely important, as is the cost. The doctors at Williamsburg Eye Care work closely with area surgeons depending on the diagnosis and procedure desired. With regards to LASIK, we follow refractive surgical patients post-operatively beginning the morning after their procedure. Because we see what the eye looks like within 24 hrs, we have developed a comfort level with several area LASIK surgeons. By working with these surgeons in co-managing your pre- and post-operative care, feel confident that we have answered any questions you might have regarding who should perform your LASIK.