LASIK Eye Surgery
Medically Reviewed by Joseph Christenbury, M.D.
Are you ready to move beyond your eyeglasses or contact lenses? If yes, than LASIK Eye Surgery may be the right procedure for you. LASIK, or “laser-assisted in situ keratomileusis,” is one of the most popular types of laser eye surgery. As a refractive procedure, it can correct common vision problems such as nearsightedness, farsightedness and astigmatism by altering the way light is bent (refracted) by your eye.
A complete eye exam can determine whether this procedure may be able to improve your vision. You may be a good candidate for LASIK if you are:
- Currently wearing glasses or contact lenses
- Your prescription has not changed over the last one or two years
- Are nearsighted, farsighted or have an astigmatism
You may NOT be able to have LASIK if you:
- Have unstable vision
- Are under age 18
- Are pregnant or breast-feeding
- Have a corneal disease or abnormality
- Have an autoimmune or connective tissue disease
Certain eye conditions, health problems, or medications may interfere with your ability to undergo LASIK. For example, if a patient has thin corneas, or corneal surface irregularities he/she may not be a good candidate. If you have large pupils, you should speak with a qualified LASIK surgeon about whether he/she may be able to adjust the treatment to compensate. Generally speaking, LASIK patients with large pupils are at greater risk for night vision complications.
Patients with mild dry eye may still be candidates for LASIK, but certain conditions that predispose the patient to severe dry eye can be disqualifying. Taking certain prescription medications may also make the patient a poor candidate for LASIK. Disclose to your surgeon all medications you are taking during your LASIK consultation.
If you are not a good candidate for LASIK, you can discuss alternative options with your doctor. One option is a refractive surgery commonly known as PRK.
PRK (photorefractive keratectomy) was the predecessor for LASIK. In fact it was the first laser eye surgery for vision correction. Although newer procedures like LASIK and SMILE have become increasingly popular, PRK remains a viable alternative for vision correction.
One of the reasons that PRK is less popular these days is the fact that it boasts a longer recovery time than LASIK. Although both PRK and LASIK are capable of yielding similar results, the short-term recovery differential is an important caveat. During PRK, the entire outer layer of the cornea is removed and discarded (rather than folded back in a flap like LASIK), meaning that these epithelial cells must regenerate over the course of several days.
Removal of the outer layer of the cornea also puts patients at greater risk of infection with PRK than LASIK. Short-term vision may be hazier after PRK than LASIK, and the procedure itself tends to cause slightly more discomfort than the essentially painless LASIK procedure.
But PRK does have its pros over LASIK, chief among which is candidacy. Since no corneal flap is created during PRK, thin corneas are not disqualifying in the same manner as they can be for LASIK.
Speak with your ophthalmologist to learn more about PRK and whether it might be a better corrective option for you.
Before the surgery, your surgeon will measure your cornea to find out where it needs reshaping and program these measurements into the laser. There are two types of customized LASIK treatments that are available: wavefront-guided and wavefront-optimized.
Wavefront-guided LASIK provides extra precision to your procedure by correcting additional small aberrations in the visual pathway of your eye. Wavefront-optimized LASIK fine-tunes the correction of the patient’s vision based on their preoperative prescription measurement. Both treatment types have a high likelihood of delivering excellent visual outcomes. Your surgeon may recommend one or the other depending on the preoperative evaluation.
LASIK is an outpatient procedure usually done under local anesthesia in the surgeon’s office or an outpatient surgical center. Using a laser or a precise microscopic blade, the surgeon creates a small flap in your cornea. Next, the flap is gently lifted up, and then a different, pre-programmed laser repeatedly removes tiny amounts of tissue, without damaging nearby tissue, until it has reshaped your cornea correctly. The surgeon then replaces and realigns the flap to complete the procedure.
If PRK is performed , the surgeon gently removes the surface layer of the cornea without making a flap and then the vision correction laser treatment is done. Next, in most situations, anti-inflammatory medicine is placed briefly on the surface of the cornea and then rinsed off. At the end of the procedure a bandage contact lens is placed.
For each of these procedures, the surgical time is normally 15 minutes or less per eye, and the entire procedure from preparation to the time you leave the recovery room is typically only a few hours.
LASIK and PRK are very safe procedures. However, every eye surgery comes with some risks. Common temporary side effects of LASIK include:
- Eye irritation and watering
- Dry-eye symptoms, which can last for six months or so and can usually be relieved with eyedrops
- Blurry vision, which may last for a few weeks
The risk of more serious complications is low, but may include:
- Double vision
- Clouded vision, which is usually temporary and caused by inflammation, but may require more surgery to correct
- Trouble with night vision, like halos around lights
- Sensitivity to bright lights
- Inflammation under the LASIK flap
- Over- or under-correction
- Haziness in the cornea which can decrease vision
- Astigmatism, caused by uneven removal of tissue
- Corneal infection, which can threaten your vision
- Increased pressure in the eye, which can lead to glaucoma and also threaten your vision
Don’t let the potential risks and side effects steer you away from LASIK. It’s one of the safest medical procedures performed today and has a track record of success.
Here are a few reasons that you shouldn’t fear LASIK surgery:
Volume: LASIK has been successfully performed on more than 15 million satisfied customers.
Immediate Results: With LASIK, you don’t need to wait weeks or months before you know if your vision has improved. Although results vary, most LASIK patients achieve 20/20 vision immediately after the procedure.
Quick and Painless: The entire procedure takes roughly 10 minutes per eye, and discomfort is minimal thanks to numbing eye drops applied before the procedure.
Navy Seal Approved: LASIK is an approved treatment for Armed Forces members including some of the most elite operators like Navy Seals. The military is confident in its effectiveness, as is NASA which also approved LASIK for its astronauts.
Recovery is usually very fast and most people see clearly by the day after surgery, although it can take about a week. You will need someone to drive you home, even if you can see well. If your vision is blurry, do not drive until it has cleared. The recovery for PRK is generally a week longer than LASIK. It is common for patients to experience some discomfort and light sensitivity anywhere from one-to-five days after the procedure. This discomfort typically subsides by the first week.
You will probably need to wear an eye patch for part of the day on the first few days. Your doctor will probably give you a prescription for eyedrops to reduce discomfort and inflammation and to prevent infection. Use them for as long as directed, possibly several months.
You will return to the surgeon the day after the procedure and will need regular follow-up visits for at least six months.
For two weeks after surgery, avoid:
- Eye rubbing
- Vigorous activity
- Eye makeup
- Getting water in the eye
The majority of people who get LASIK end up with better eyesight, but how much better depends on how bad their vision was to begin with. Most patients achieve at least 20/40 vision. Up to 72% of people with mild to moderate myopia end up with at least 20/20 vision, and about 64% of those with high myopia also achieved this clarity.
The cost of LASIK eye surgery does vary, but is usually between $1,000 and $5,000. Unfortunately, it is typically considered an elective procedure and is not usually covered by health insurance. However, do not let the cost steer you away from getting your vision corrected. There are many doctors who offer financing options for those who can’t afford the upfront fee. While you are encouraged to shop around to make sure you’re getting a good deal, do not base your decision on price alone.