How do I know if I'm a candidate for LASIK?
A complete eye exam will confirm whether you are nearsighted, farsighted and/or have astigmatism. There must be no ocular health problems present, such as cataracts or untreated glaucoma. Additional diagnostic procedures will be performed to measure the amount of near- or farsightedness,astigmatism, the thickness and detailed shape of the cornea, pupil size and the unique optics of your entire eye (wavefront measurement). A qualified ophthalmologist will ultimately determine whether you are a candidate for LASIK.
What is involved in LASIK? How long does it take?
The procedure takes 7 to 10 minutes per eye. It is done under topical anesthetic drops. During LASIK, an instrument called a microkeratome is used to lift a thin layer of the cornea. Laser energy is applied to remove a precise amount of corneal tissue. After the laser treatment, the flap is laid back into position and kept in place by natural suction, without sutures. Eye drops are used and goggles are worn over the eyes to protect them until the following day. Results are almost immediate, with minimum discomfort during the first 24-hour period.
How does the laser work?
The excimer laser uses a cold light beam to sculpt the cornea’s surface to the desired shape by removing a microscopic amount of tissue, correcting nearsightedness, farsightedness and/or astigmatism.
Does it hurt?
The cornea is easily numbed with eye drops during the procedure. Most patients may experience a pressure sensation for 15 to 20 seconds during the procedure but say they have little to no discomfort both during and after LASIK.
What about recovery?
Recovery is fast. The first couple of hours after surgery, the eye feels somewhat irritated, with a burning sensation and some tearing. Vision is typically blurry during this time. A 3 to 4 hour nap is recommended immediately after the procedure to rest the eyes and aid in the healing process. After several hours, the irritation goes away and vision begins to clear. The day after surgery, most irritating sensations are completely gone and vision is remarkably clear.
What if I am really nervous?
A mild sedative is available prior to surgery to encourage relaxation during the procedure and sleep afterwards. The surgeons and operating room technicians talk throughout the procedure to put patients at ease.
Are both eyes done at the same time?
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.
What if I move my eye or blink during the procedure?
You will be lying back in a comfortable chair, gazing up into a flashing fixation light. During the procedure, an eyelid opener is used so you don’t have to worry about blinking. The surgeon has complete control of the laser at all times and, if the need should arise, can stop the procedure until the patient can focus on the fixation light. In addition, the laser uses a highspeed eye tracking system, which matches the laser pulses with the position of the eye during the treatment.
Will I need glasses after the surgery?
With any vision correction procedure, there is never a guarantee of perfect vision. Almost everyone experiences improved vision after LASIK 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, requiring reading glasses or bifocal correction. The laser cannot directly correct presbyopia as this condition results from changes in the crystalline lens inside the eye. However, there are some indirect treatments available. Ask your doctor about monovision or blended vision correction to reduce dependence on reading glasses.
How long will I need to take off work?
Most patients return to work within one to three days.
Will LASIK interfere with my lifestyle?
Active sports should be postponed for two weeks or until the eye is fully healed, unless protective eyewear is approved by the surgeon. Swimming, hot tubs and saunas should be avoided for three weeks. After full recovery, normal activity can resume, and the ability to play sports without glasses makes them more enjoyable for many patients.
How long will the correction last?
LASIK is a permanent procedure. In some cases, an enhancement procedure may be required. Some patients’ eyes may change throughout their lifetime, which can happen with glasses or contact lenses as well.
Is it true that it takes six months to improve vision after LASIK?
Fluctuation can occur, but visual improvement is almost immediate following the procedure. Most patients feel that major fluctuations have stopped after two weeks. It may take additional time for minor visual aberrations to subside (e.g. glare, halos around night-time lights).
How safe is the procedure? Are there complications?
The procedure is very safe, and that is why it has been so readily accepted. With any surgical procedure, however, there may be complications. Vision-threatening complications do exist, but they are extremely rare. These include infections (an 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 Los Angeles LASIK patients should confirm the credentials 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.
What is the success rate?
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.
I am farsighted. Can LASIK correct my vision?
In the low and moderate ranges, LASIK can treat farsightedness. For high levels of farsightedness, LASIK does not work as well. Other refractive procedures may provide a better level of correction.
What about astigmatism?
Astigmatism occurs when the eye is oval rather than round. The laser can treat most levels of astigmatism. The laser does this by removing more tissue in one direction of the eye than another to make it more round.
I have dry eyes. Can LASIK help?
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 plugs that are placed in the lower eyelid tear ducts can be inserted with a significant improvement in dryness. The”permanent” plugs are easily removed in the office once the dryness resolves. Dissolvable plugs are also available that disappear over a period of several months. Your doctor will determine which are most appropriate for you.
I need reading glasses. Can LASIK correct my vision?
LASIK is typically used to correct distance vision. If LASIK is performed to correct distance vision in patients who are 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 or blended vision, where one eye is corrected fully for the distance and the other is left slightly nearsighted. Your doctor will discuss all of the available options with you to decide which refractive procedure best fits your individual needs.