LASIK, which stands for laser-assisted in situ keratomileusis, is an operation on the eyes to correct vision and reduce the need for glasses or contact lenses. It is used to correct the shape of the cornea so that it refracts (bends) light properly. The cornea is the transparent part on the front of the eye. The cornea bending light incorrectly causes several common vision disorders, including:
- far-sightedness (inability to see near)
- near-sightedness (inability to see far)
- astigmatism (improper curvature of the cornea).
LASIK surgery is performed in an eye doctor’s office with a local anesthetic (drops are given to numb the surface of the eye) and sedation. It takes about 10 to 15 minutes for each eye. LASIK was originally performed using a special surgical knife, but now it is usually performed using a specialized laser.
According to the American Academy of Ophthalmology and the FDA, the ideal candidate for LASIK is (NIH, 2012):
- at least 18 years old (21 or older is preferred)
- not pregnant or breastfeeding
- not taking drugs like Accutane or oral prednisone
- someone with healthy eyes
- someone whose vision prescription has stabilized (usually occurs in the mid to late 20s)
- someone in good health
- someone experiencing vision problems due to a refractory error (usually near-sightedness, far-sightedness, or astigmatism)
Some people, especially those over 45, experience both far-sightedness and near-sightedness. Unfortunately, LASIK technology cannot yet create a bifocal effect, so these patients have two options:
- You could have the doctor correct for your near-sightedness and then use reading glasses to see items that are close to you.
- You could also ask the doctor about monovision, a surgical intervention in which one eye is corrected for far-sightedness and the other is corrected for near-sightedness. Some people find monovision disconcerting, while others adapt to it.
LASIK is performed as an outpatient procedure under local anesthetic. If your doctor plans to give you a sedative, he or she may ask you not to eat or drink after midnight the night before the surgery.
When you’ve checked in at your eye doctor’s office, a nurse or technician may place an IV in your hand, wrist, or arm so that your doctor can sedate you for the procedure. An IV also allows your doctor to give you medicine and fluids quickly if there is a problem.
You will then lie down on your back on a gurney or sit in a chair that reclines like a dentist’s chair. The doctor will numb the surface of your eye with eye drops. He or she will then use a small blade or laser to cut a flap in the cornea and roll it back to expose the stroma (the middle section of the cornea).
Using a laser, the doctor will carefully burn away part of the stroma, thus changing the shape of the cornea to better refract light. When the doctor is finished, he or she will replace the flap. No stitches are necessary—the flap will join with the surrounding tissue on its own. You will wear an eye patch or other protective covering on the eye for the first 24 to 48 hours after the procedure.
You will go home when the procedure is over. If you received sedation, you may feel groggy for the rest of the day. Arrange beforehand to have someone drive you home from the doctor’s office.
You may experience burning, itching, and irritation in your eyes. The doctor may prescribe pain medication to control these symptoms. Typically, they only last for about six hours after surgery. It’s important not rub your eyes. This will only irritate them further and increase your risk of infection.
The next day, you can resume most of your usual activities, with a few exceptions. Do not drive without the doctor’s permission. Avoid swimming, contact sports, and wearing eye makeup for two to four weeks after LASIK.
You will have a follow-up appointment with your doctor in 24 to 48 hours. At that time, he or she will remove your eye patch, make sure that your eye is healing properly, and test your vision. Some people notice improved vision immediately. It takes a few days for others’ eyes to heal before they can see a significant difference.
As with any surgical procedure, there is always a slight risk of complications. Very rarely, LASIK may actually harm your vision.
More common but less serious complications include:
- eye infections
- corneal scarring that makes it impossible to wear contact lenses
- sensitivity to light
- seeing a glare or perceiving a halo around objects
- vision problems when driving at night
Some of these complications, such as having trouble with night driving, may fade three to six weeks after surgery.