LASIK, formally known as (Laser Assisted In Situ Keratomileusis) is a refractive surgery procedure designed to reshape the cornea or outer surface of the eye. By reshaping the cornea LASIK eye doctors can correct the refractive error of a patient. The common refractive errors that LASIK can treat effectively include myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. LASIK eye surgery first involves creating a thin corneal flap with a unique device known as a microkeratome. Once the flap has been created it is carefully laid back and the inner part of the cornea is prepared for Excimer laser treatment. The Excimer laser is then utilized and applied to the cornea removing the calculated amount of corneal tissue. The amount of corneal tissue removed is directly related to your specific visual needs.

After the laser has been applied the thin flap is then repositioned in its normal position and several drops are administered. As patients begin to sit up from the surgical chair they typically notice immediate visual improvement. At first vision appears cloudy due to the drops administered but over the next day you will notice drastic improvements in your overall visual outcome. The LASIK eye surgery procedure lasts no more than 10 minutes. Because LASIK treats the inner part of the cornea, the healing process occurs more rapidly. Patients typically resume normal activities within a few days. No stitches are required; however, protective sunglasses can be used at night to prevent the rubbing or bumping of your eyes. The first 72 hours after the procedure are critical to this healing process. Patients are asked to return home, get plenty of rest on the first night and use the eye drops to aid in the healing process.

If you want to learn more or talk with a surgeon directly regarding your specific visual situation please fill out this self-evaluation form and we will call you to discuss your candidacy.

The EXCIMER laser, which is a specific type of “cool” laser, generates its power from light in the ultraviolet range. It cannot be visualized by the human eye. Because the laser does not generate any heat, there is no tissue damage as the result of the laser beam. The energy of the laser simply causes miniscule amounts of corneal tissue to disassociate on a microscopic level. As the treatment with the laser proceeds, microscopic layers of tissue, approximately 1/10th the width of a human hair, are removed. The laser is programmed to remove precisely the amount of tissue needed to achieve the desired result.

Determining Candidacy (Take the Self Candidacy Test)

The first step in undergoing LASIK is the pre-operative evaluation. This process involves a series of diagnostic tests that determine the overall health of your eyes. Your cornea thickness is a critical component to your LASIK candidacy. If you do not have the proper amount of cornea thickness the procedure is not recommended.  Your surgeon will be able to help you determine how successful the surgery could be. Expectations for LASIK surgery will be vital to your happiness so make sure to listen to your doctor’s synopsis.

LASIK Candidacy Requirements

• The patient must be over the age of 18
• The patient must have necessary amount of corneal thickness
• The patient must have had a stable glasses or contact lens prescription
• The patient’s prescription must be within the treatable parameters
• The patient must discuss expectations with the staff or surgeon
• The patient must not have an extreme case of dry eye syndrome

If you have been wearing contact lenses, you should consult your LASIK coordinator. It is best to start wearing glasses all the time if you are serious about getting LASIK eye surgery. By wearing glasses and not contacts, the practice can properly assess your visual requirements. Contact lenses do change the shape of the cornea making it difficult to properly evaluate the cornea. By not removing the contact lenses at least 2 weeks prior to the exam inaccurate measurements could be taken. These measurements are vital to the success of the surgery because they determine the amount of corneal tissue that will need to be removed.

If you wear:

• soft contact lenses, you should stop wearing them for 2 weeks before your initial evaluation.
• toric soft lenses or rigid gas permeable (RGP) lenses, you should stop wearing them for at least 3 weeks before your initial evaluation.
• hard lenses, you should stop wearing them for at least 4 weeks before your initial evaluation.

FDA Statement: Before your initial exam, stop wearing contact lenses. 4 weeks before initial exam, hard (PMMA) lenses. 3 weeks before, rigid gas permeable (RGP) lenses. 2 weeks before, soft lenses

The LASIK Surgery Experience

Generally speaking what you will experience during LASIK eye surgery will vary from practice to practice. Each patient has unique corneas so every patient does have a slightly different experience. Once you have signed the informed consent documentation and you are ready for surgery you will be escorted into the laser suite where you will be given a mild sedative to calm your nerves. It is important that no eye creams or makeup be used the day of surgery. It is not uncommon that patients experience stress and fear at this point.The LASIK eye surgery procedure is relatively quick and painless. The surgery should take no more than 20 minutes. Once you are positioned under the laser microscope the surgeon will be ready to start the procedure. Numbing drops will be placed in your eye to sanitize and relax your eye. A device known as the "lid speculum" will then be applied. The lid speculum will hold back your eye lids making it impossible for you to blink during the LASIK surgery. A suction ring and microkeratome are then applied. Once everything is set up properly with the microkeratome the flap will then be created. The surgeon will lift back the flap and then use the excimer laser to remove the necessary corneal tissue. The flap is then repositioned over the treated area and drops are applied.

After LASIK Eye Surgery

Once you sit up from the surgical chair you will start to notice that you can see better. Your vision will be blurry for a while so the practices asks that you go home relax and get rest. Eye shields will be placed over your to prevent any bumping or rubbing of the eyes. It is important for you to wear this shield to prevent you from rubbing your eye and putting pressure on your eye while you sleep, and to protect your eye from accidentally being hit or poked until the flap has healed. Please consult your surgeon directly for a specific list of post-LASIK surgery instructions

Post-Operative Care

After your LASIK eye surgery you will need to have your vision examined on a regular basis. Make sure to ask your surgeon ahead of time what the costs involved with this process will entail. Traveling long distances to get your post-operative care might prove to be a serious burden, so make sure to weigh the benefits of selecting a surgeon within driving distance. You will need to schedule regular exams to examine your vision and check the healing process and bonding of the corneal flap made in surgery. Most LASIK complications occur as a result of a flap complication. If detected early enough your doctors will be able to react and correct the problem.

• Some LASIK centers may have hidden fees regarding post-operative care. Please make sure to ask about the cost of continued post-operative care. If you feel you have been improperly informed by a LASIK center with false advertising or hidden fees please let our trade associations know about the matter or contact the Eye Surgery Education Council or ASCRS (American Society of Cataract and Refractive Surgery)

Choosing A LASIK Surgeon

Selecting a surgeon for your lasik eye surgery is a very important decision that will ultimately affect your vision for the remainder of your life. It is important to discuss your personal situation with a surgeon and ask your questions directly to the doctor if possible. Choosing a surgeon that has high quality and safety standards can often times reduce unnecessary surgical risk. Experience with lasik eye surgery is also a very important factor when selecting your surgeon. Not all eye doctors share the same level of training or experience in refractive surgery. A surgeon with a vast amount of experience should also be able to show you some basic information regarding outcomes. When constantly analyzing surgical outcomes, the better surgeons find that the consistency and predictability of their results gets better. If a surgeon tracks outcomes this actually demonstrates his or her concern with achieving the best possible results.

LASIK technology is constantly improving every year. Some practices and surgeons aim to keep up with the latest technology in order to provide the best possible equipment for the best visual outcomes. In recent years we have seen the advent of wavefront optimized LASIK and special diagnostic equipment to measure aspects of corneal thickness. Each piece of equipment contributes significantly to the LASIK process and can make the procedure better and safer. If a practice does not discuss your cornea or corneal thickness this could be an indicator that you need to see another practice.

LASIK Risks

LASIK is a surgical procedure conducted on the cornea part of the eye, and it is crucial that patients are well educated on the potential benefits and risks of this procedure. As with any type of surgery risks are involved. After your pre-operative evaluation you will have a good idea about the risks and what they imply to your specific situation. It is important to discuss any concerns with your surgeon and weigh the risks and potential benefits. Each patient’s vision is different and different treatment options are available in order to give the best possible results. The only way to determine if LASIK is right for you is to come in and discuss your options with our LASIK coordinator.