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LASIK Eye Surgery

By Jenilee Matz, MPH, Staff Writer

What is LASIK eye surgery?
Laser-assisted in situ keratomileusis or LASIK is a surgery that's done on the eyes. It is done to reshape the cornea and improve vision. This can reduce the need for glasses or contact lenses in some people. LASIK can correct a wide range of visual problems:

  • Nearsightedness (myopia). Only close objects are clear.
  • Farsightedness (hyperopia). Only far away objects are clear.
  • Astigmatism. Images are blurred.

Some people get LASIK on only one eye. LASIK won't work for presbyopia, which refers to age-related vision changes.

Is LASIK eye surgery for me?
LASIK isn't safe for everyone, including those who:

  • Are younger than 18 years old (age 21 for some lasers). The vision of people younger than 18 is often still changing.
  • Have refractive instability. This means your prescription for glasses or contact lenses has changed in the past year. People who are more likely to have refractive instability include:
    • Pregnant or nursing women
    • Young adults in their early 20s or younger
    • People who take medicines such as Accutane or oral prednisone, which can cause fluctuations in vision
  • Have certain medical problems or are not in good general health. The procedure may not be suggested for people with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye or cataracts. Having certain health conditions can affect how your eyes heal from surgery.
  • Have other eye problems. LASIK may not be advised for people who have blepharitis (swelling of the eyelids), large pupils, thin corneas or dry eye, or who have had previous refractive eye surgery.

If you're considering LASIK, discuss its risks and benefits with your eye doctor. Choose a doctor who has plenty of experience with LASIK. Ask your doctor:

  • How do you define success?
  • What are my chances of achieving 20/20 vision?
  • What laser will you be using for my surgery? Make sure your surgeon is using a laser approved by the Food and Drug Administration.
  • What kind of recovery should I expect?
  • What alternatives are there to LASIK?

Are the results from LASIK permanent?
The effects of LASIK are permanent, but a person's eye can still change internally. That's why many surgeons advise having the procedure done only when vision has remained stable for at least a year.

If you are farsighted, the results of LASIK may fade as you age.

How do I prepare for LASIK surgery?
Before surgery, you'll have an eye exam by your surgeon. Take your eye prescription records with you to the exams. You'll be asked to sign an informed consent form after a thorough discussion of the risks, benefits, alternative options and possible complications.

Your doctor may tell you to stop wearing your contact lenses for a while before the surgery because they can temporarily change the shape of the cornea. You may also need to stop wearing makeup, creams, lotions or perfumes for a few days before surgery. These products can interfere with the laser and increase the risk of infection after surgery.

How is the procedure done?
LASIK is an outpatient procedure, meaning you can go home the same day as surgery. You'll need to arrange for someone to drive you home after the operation.

First, you'll get eye drops to numb the surface of the eye. Your doctor may also give you medicine to help you relax. A device is placed to keep your eyelids open and prevent blinking. A suction ring keeps the eyeball still. The pressure from the suction ring can dim or darken vision. The surgery will take less than 30 minutes for each eye. Both eyes may be done at the same time. Doctors often wait, though, to see the result of the first eye before doing the second one.

You will look at a target light during the procedure. A special device is used to cut a flap of thin tissue from the outer layer of the cornea. Then the flap is lifted out of the way. The laser is directed to reshape the cornea. Reshaping the cornea helps the eye focus light rays onto the retina for better vision. Finally, the surgeon replaces the flap, which quickly reattaches to the eyeball. You will not need stitches. A shield is then placed over the eye to protect the flap.

What should I expect after the surgery?
Healing takes place relatively quickly. There may be some side effects, but they usually improve in the few days or weeks after the procedure. These include:

  • Discomfort
  • Burning or scratchiness
  • Watery eyes
  • Sensitivity to light
  • Dry eye
  • Glare or difficulty driving at night
  • Halos or starbursts in vision
  • Fluctuations in vision for up to 6 months
  • Rarely, vision is worse or vision loss (very rare)

Report any side effects to your doctor right away. Ask how long you can expect to have any side effects.

After surgery, note that you:

  • Won't be able to drive until you have been cleared by your doctor
  • May need to limit participation in sports or exercise for days or weeks after the procedure
  • Won't be able to swim or use a hot tub for until your doctor says it is OK

What are the risks of LASIK surgery?
All surgeries have the potential for complications. Some risks of LASIK include:

  • Over- or under-correction. Few people have perfect 20/20 vision after LASIK. But these problems can often be improved with glasses, contact lenses and enhancements.
  • Debilitating visual symptoms including corneal scarring, irregular astigmatism (permanent warping of the cornea), inability to wear contact lenses, flap problems, glare, halos, double-vision or problems seeing at night.
  • Corneal infection.
  • Problems with the flap, including displacement.
  • Loss of vision that cannot be corrected with glasses, contacts or surgery.
  • A decrease in contrast sensitivity, crispness or sharpness. That means even though you may have 20/20 vision, objects may appear fuzzy or grayish.
  • Severe dry eye. Your eye may not be able to make enough tears after surgery.

Related Articles

Vision Aids and Devices That Can Help People Cope With Vision Loss

How to Protect Your Eyes at the Computer

6 Things to Know Before Getting LASIK Surgery

External Sources

American Academy of Opthalmology. Is LASIK for me? A patient's guide to refractive surgery.. Accessed May 12, 2010

U.S. Food and Drug Administration. What should I expect before, during and after surgery?. Accessed May 06, 2010

American Academy of Opthalmology. LASIK.. Accessed May 12, 2010

U.S. Food and Drug Administration. LASIK Eye Surgery.. Accessed May 05, 2010

Federal Trade Commission. Basik Lasik: tips on Lasik eye surgery.. Accessed May 05, 2010

U.S. Food and Drug Administration. When is LASIK not for me?. Accessed May 06, 2010

This article was reviewed and updated 08-01-2009.

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