These are just some of the FAQs that we receive about LASIK. If you don’t find the answer to a question below or need more information, please do not hesitate to contact us so that we can provide you with as much insight as needed to make a sound decision. If you’ve had all of your questions answered and feel as though you are ready to take the next steps in LASIK, please contact us and we will help you set up an appointment to have a LASIK pre-operative evaluation.
First we offer a free LASIK screening. This screening will determine if a patient has thick enough corneas and a prescription that is within the limits of what LASIK can correct. A complete eye exam will confirm the prescription of the patient, and whether the inside of the eye is healthy. There must be no ocular health problems present, such as cataracts or untreated glaucoma. Additional measurements are needed, such as quality of the tear film and a corneal surface mapping, which will be done in a pre-operative evaluation. A qualified optometrist or ophthalmologist can ultimately determine whether the patient is a candidate for LASIK
The success of any LASIK procedure depends more on the skills and experience of the surgeon than other surgical procedures. A qualified surgeon should meet the following basic criteria: board certification by the American Board of Ophthalmology, with advanced training in cornea and refractive surgery; skills and experience with a prominent ophthalmology practice, having performed thousands of LASIK and refractive surgical procedures; and the ability to help patients understand potential outcomes and complications. It is important to keep in mind that you are making a lifetime investment when choosing to have LASIK so you should take your time and select the right surgeon.
The LASIK procedure takes 5-7 minutes per eye. It is done under topical anesthetic drops. During LASIK, a laser creates a thin corneal flap. The surgeon will use an instrument to lift the thin flap, and will laser the next layer of tissue to change the shape of the eye. After the laser treatment, the flap is laid back into position and kept in place by natural suction, no sutures. Eye drops are used and plastic shields are placed over the eyes to protect them until the following day. Results are almost immediate (meaning patients see well enough to drive by the next day), with minimal discomfort during the first 24-hour period.
Recovery is fast. The first couple of hours after surgery, the eye may feel somewhat irritated, with a burning sensation and some tearing. Vision is typically blurry during this time. Most patients nap for a couple of hours to rest the eyes. After several hours, the irritation goes away and the vision begins to clear. The day after surgery, most irritating sensations are completely gone and vision is remarkably clear.
A mild sedative is available prior to surgery to encourage relaxation during the procedure and to encourage sleep afterward. The surgeons and operating room technicians often talk throughout the procedure to put patients at ease.
Some patients may prefer to have each eye done on different days. In most cases, however, both eyes are done on the same day. This avoids the period of imbalance that occurs if one eye still needs correction while the other one doesn’t. This is a discussion that you should have with the surgeon so that you can decide what is best for you. It is always ultimately your choice to do both eyes simultaneously, or one at a time. Clear Choice does not charge more if you choose to pursue one eye at a time.
As with any medical procedure, there is not a guarantee of perfect vision. Almost everyone experiences improved vision, however, and most see well enough to pass a drivers’ test without corrective lenses. It is important to know that LASIK does not eliminate the need for reading glasses. Beginning at around the age of 40, a condition called presbyopia usually appears in all adults, requiring reading glasses or bifocal correction. The laser cannot correct presbyopia at this time; however, there are some treatments like the KAMRA inlay that can be done after LASIK to give a patient better reading vision.
Active sports should be postponed for about a week or until the eye is fully healed, unless protective eyewear is approved by the surgeon. Swimming, hot tubs and saunas should be avoided, as well for two weeks. After full recovery, normal activity can resume, and the ability to play sports without glasses makes them more enjoyable for many patients.
LASIK is a permanent procedure. In some cases, however, an enhancement procedure may be required. Some patients’ eyes may change throughout their lifetime, which can happen with glasses or contact lenses as well.
Fluctuation can occur, but visual improvement is almost immediate following the procedure. Most patients feel that major fluctuations have stopped after two weeks. At the same time, it may take additional time for all of the swelling in the eye to resolve and fluctuations to cease. Many patients do have healing that, in a minor sense, may continue to improve over six to nine months.
The procedure is very safe, and that is why it has been so readily accepted. With any surgical procedures, however, there may be complications. Vision-threatening complications do exist, but they are extremely rare. These include infections (a statistical incidence of 1 in 5,000) and irregular healing processes that can lead to something called “irregular astigmatism” that glasses cannot correct and contact lenses or further surgery may be required to improve. There are also complications, which may lead to temporary blurriness, temporary dependence on glasses or contact lenses or a need for additional surgery. In most cases, the patient can still do well and recover with good vision. It is for this reason that LASIK patients should confirm the experience of their surgeon to determine if he or she has specialized training in cornea surgery. Because LASIK is performed on the cornea, knowledge of the healing properties of the cornea and management of any complications are critical to the patient’s well being. Knowing how to handle a complication, should one occur, can make a significant difference in the patient’s outcome.
Success depends on several factors, the most important being the degree of nearsightedness, farsightedness or astigmatism. Depending on the prescription, the surgeon can help determine the likelihood of reaching 20/40 or greater vision. Approximately 95 percent of eyes treated with LASIK reach 20/40 or better vision with one procedure, which is the requirement for driving legally without correction. If a patient does not achieve his or her goal with one procedure, additional correction often improves their vision to a satisfactory level.
Many patients who desire LASIK surgery have dry eyes. They have become intolerant of their contact lenses because the dryness makes them uncomfortable. LASIK occasionally worsens dry eyes, but typically, this is temporary and usually treated with frequent artificial tear lubrication. In special cases of severely dry eyes, special punctal plugs that are placed in the lower eyelid tear ducts can be inserted with a significant improvement in dryness. These are easily removed in the office once the dryness resolves, or they can be left in place permanently. Sometimes PRK or implantable lenses are a better option for a patient with severe dryness.
LASIK only corrects the distance vision. If LASIK is performed such that distance glasses are not needed, and the patient is over 40, it is likely that they will need to put on a pair of glasses to read. The exception to this is when patients opt to have monovision, when one eye is corrected fully for distance and the other is left nearsighted. Only about 10 to 20 percent of patients opt to have monovision correction, and it is only recommended in patients who have tried it with contact lenses and liked the results.
Presbiopic inlays, like the KAMRA, can be better procedures for patients who wear reading glasses. When a patient gets a KAMRA inlay, the surgeon uses a laser to create a pocket inside the cornea. Then the surgeon places the inlay inside of the pocket. The inlay allows the patient to keep good distance while gaining better reading.