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LASIK is the
acronym for laser in situ keratomileusis. "In situ" is a
means confined to the site of origin without invasion of neighboring
tissues. Kerato is the Greek word for cornea and mileusis means "to
shape." Therefore, the procedure reshapes the cornea, using a laser
applied to a site in the inner cornea.  |
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How long has LASIK been performed? |
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The first LASIK
procedure in the United States was performed in 1991. Other types of
refractive surgery involving reshaping of the cornea proceeded LASIK by
over 35 years. The "wavefront" or "custom" type of LASIK has been FDA
approved since 2002. |
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Why is "custom" or "wavefront" LASIK considered an advancement in refractive surgery? |
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LASIK combines
the precision of the excimer laser with the creation of a corneal flap,
which allows rapid healing and recovery of vision. "Custom"
or "Wavefront" LASIK adds an automatic measurement of more subtle
distortions (called higher order aberrations) than just nearsightedness,
farsightedness, and astigmatism corrected by conventional LASIK.
However, these “higher order aberrations” account for only a small
amount (usually no more than 10%) of the total refractive error of the
average person’s eye. Conventional LASIK increases higher order
aberrations. Although wavefront treatments attempt to eliminate higher
order aberrations, results from the clinical studies have shown that the
average aberrations still increase, but less than they do after
conventional LASIK. In a few studies comparing wavefront LASIK to
conventional LASIK, a slightly larger percentage of subjects treated
with wavefront LASIK achieved 20/20 vision without glasses or contact
lenses compared to subjects treated with conventional LASIK. |
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Who can LASIK benefit? |
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LASIK can benefit
a great number of people with myopia, hyperopia and astigmatism.
Candidates should have a desire to be less dependent on
corrective lenses, have reasonable expectations, and willing to accept the risks of surgery.
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Who can't have LASIK? |
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There are a number
of factors that doctors must evaluate before they can determine who is
an eligible candidate for LASIK. Persons who are not good candidates
include those with very high refractive errors, corneal or retinal
diseases, cataract, pregnancy, changing
prescriptions, or lazy eye |
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I am happy with my contact lenses. Should I pursue having LASIK? |
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If you are comfortable wearing contact lenses and are not
bothered by being dependent on them, you do not need to have LASIK. Many
patients experience dryness or discomfort with contact lenses, or are
unable to wear contact lenses, and therefore consider having LASIK
surgery. |
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LASIK improves the uncorrected vision—one's visual capacity while not wearing corrective lenses—in almost all cases. Over 95% of patients with low to moderate myopia achieve 20/20 vision. Approximately 5% of patients may require a touch-up correction (an enhancement procedure) to achieve satisfactory vision at some point following the original procedure. This is generally an easy procedure involving a re-lifting of the pre-existing LASIK flap with additional laser treatment. Patients with
high myopia (more than -7D) and high hyperopia (more than +4D) have a
higher probability of requiring a touch up procedure or my require
different types of refractive surgery to optimally correct their vision. |
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Are the results achieved from LASIK permanent? |
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The effects of
LASIK are permanent, although it is
important to realize that a person's eye can still change internally.
That is why it is recommended to wait to have LASIK until refractive
changes have been relatively stable over at least one year. The age at
which this occurs differs and must be considered on an individual basis.
The FDA approval allows LASIK in individuals over the age of 18, but
many will need to wait beyond age 18 until the refraction has
stabilized. |
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How long will the LASIK procedure take? |
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The whole
procedure takes about 15 to 20 minutes for two eyes, including creating
the flap and performing the laser under the flap. Patients need to
arrive at the laser center one hour in advance for preoperative
measurements and eye drops. A mild sedative, such as Valium, may be
administered for your relaxation prior to the procedure. |
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Can I drive immediately after having LASIK? |
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Patients may
experience some mild discomfort or blurred vision for a few hours after
surgery. Most patients also receive a sedative prior to surgery.
Therefore, you must have a friend or relative drive you home after the procedure.
Most patients feel comfortable to drive the following day. |
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The procedure is
done with topical anesthetic (eye drops) to numb the eye. Patients may
be given a small amount of oral sedative to help them relax. |
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Does the LASIK procedure hurt? |
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Patients are given
a topical anesthetic (eye drops) to numb the eye, so they experience no
pain during the procedure. When the LASIK flap is made, a slight
pressure sensation (not pain) is felt for a few seconds. Some patients may
experience a mild burning or sandy sensation in the eyes temporarily
following the procedure. This is often avoided by taking a nap for the first 2
to 3 hours after LASIK and with use of artificial tears. |
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Most patients choose to have both eyes done at the same time, as this is the most convenient option. Studies have shown equivalent safety between doing both eyes at the same time vs. individually. |
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How long will I be out of work after having LASIK? |
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Most people are
able to return to work one or two days following the LASIK procedure. |
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You can resume
most normal activities immediately after surgery. Swimming is not
recommended during the first week after LASIK. Safety glasses are
recommended when playing contact sports for at least the first month
following LASIK. |
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How long will it take before I can see well, and how long will it take before I have my best vision? |
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Fast visual
recovery is typical, with the vast majority of patients able to see
better than 20/40 (required vision for driving) by the day following the
procedure. Typically, the vision continues to improve over the first few
weeks after the procedure. Visual recovery may be longer in patients
having LASIK for hyperopia. |
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Will I need to wear glasses once my eyes have healed? |
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Most
patients who have LASIK do not wear glasses for their daily activities.
However, patients may need to wear reading glasses if they are over the
age of 40. This is caused by the normal aging of the eye known as
presbyopia. This condition occurs whether a patient has LASIK or not. Some patients
may need a minimal prescription for some activities such as night
driving. |
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Will my eyes look different after LASIK? |
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No,
there is no change in appearance. |
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After LASIK, how will my vision be at night or in low light? |
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Some patients will
see glare, halos or starburst around objects in dim or low-light
conditions. For the vast majority, these symptoms are temporary.
However, others will continue to experience them for several months or
longer. Although these symptoms do not necessarily interfere with visual
acuity as it is measured by an eye chart, a very small percentage of patients
may
experience symptoms which can interfere with daily activities and driving at night. |
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Will my eyes be dry after LASIK? |
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All patients
should be aware that temporary increased dryness of the eye is common during the first three
to six months following LASIK. It may be necessary to use lubricating eyedrops
or to close the tear drain in the eyelid to conserve tears in the eye.
Generally, the eye lubrication returns to the preoperative state within
three to six months following LASIK, although in a very small percentage
of patients, increased dryness may be permanent following LASIK. |
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I wear bifocals now, and my doctor says that I'll still need to wear reading glasses even if I have LASIK done. Why is this? |
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Most people in
their 40s or older will need reading glasses if their eyes are corrected
for distance because the eye's lens loses flexibility as we age. This
condition, called presbyopia, cannot currently be treated by LASIK.
Some patients in
this age group select monovision, such as is done with contact lenses.
This option allows patients to use one of their eyes for distance and
the other to see at near. |
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If I'm corrected for distance, will I lose my ability to see well up close? |
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If you are
near-sighted and are over 40 years old, LASIK can correct your distance
vision, but you may require reading glasses to focus at near. People who
would rather continue to read without glasses over the age of 40 should
either consider monovision or opt not to have LASIK. |
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Does insurance cover this surgery? |
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Although
LASIK is not a cosmetic procedure, it is considered an elective surgery.
Therefore, most insurance companies do not cover LASIK. In many
cases, the cost of the procedure can be covered by medical flex plans or
medical cafeteria plans that allow pretax dollars to be set aside for
medical expenses. You should check with your employer to see if your
company offers this type of benefit. It is possible that the cost of
LASIK may be deducted from your U.S. federal income taxes. You should
check with your accountant to see if you can take LASIK as a deductible
health expense. |
