Deciding On Lasik
Imagine being able to work, drive, and play sports
without having to depend on glasses or contact
lenses. LASIK (laser in-situ keratomileusis) may
make this a reality for you. This laser eye surgery
can treat many common vision problems.
Your Eye Care Team
You may work with the following
eye specialists:
- An ophthalmologist, a physician
who performs your surgery and
oversees your eye care.
- An optometrist, an eye doctor
who may be involved with your
pre- and postoperative care.
- An ophthalmic technician, who
may assist during LASIK surgery.
What Lasik Can Do
LASIK (pronounced “LAY-sik”) can
improve your vision. This procedure
reshapes the cornea (surface of the
eye), helping to more clearly focus
what you see. Advanced laser
technology makes LASIK fast and
often painless. Vision begins to
improve soon after surgery, and
may become stable within weeks.
Today’s Lasik Technology
Tools that your eye doctor may
use during LASIK include:
- An excimer laser, which
produces a concentrated beam
of cool ultraviolet (UV) light.
Each pulse of this laser can
remove a tiny portion of corneal
tissue. An excimer laser is so
accurate that it can cut a notch
in a human hair. It generates
no heat and is gentle to tissue.
- A microkeratome, a microsurgical
instrument that can make
extremely thin, precise cuts.
- A femtosecond laser, which
produces rapid pulses of light.
Like a microkeratome, it can
make thin, precise cuts.
What you should consider, lasik is not for everyone. Be sure to discuss your medical
history with your eye doctor. You may not be a good
candidate if you:
- Do not have stable vision.
- Have a vision problem
that is too severe.
- Have a disease or
condition that slows
healing or increases
your risk of infection.
- Have an eye disease,
such as advanced
- Are taking certain
medications.
- Are pregnant or nursing,
or are planning to become
pregnant in the near future.
- Are uncomfortable with
the idea that you may still
need glasses or contacts
after LASIK surgery.
Note:
An excimer laser is a precise
surgical tool.
How The Eye Works
Sharp vision depends on many factors. The
parts of the eye work together to refract (bend
and focus) light rays. If the cornea or the eyeball
as a whole is not the right shape, light doesn’t
focus correctly, and vision is blurry.
Turning Light Into Sight
Light enters the eye through the cornea,
the eye’s clear, dome-shaped covering.
The cornea bends light rays to help
focus them. Light rays then pass through
the pupil to the lens, which changes
shape (accommodates) to aid in focusing
these rays. Light then reaches the retina
(inside lining of the eye). The retina
sends signals to the brain, which tells
you what you’re seeing.
- Hyperopia (farsightedness)
occurs when light focuses
behind the retina. Nearby
objects appear blurry.
- Lens
Retina
Astigmatism occurs when
light focuses in more than
one place. Both nearby and
distant objects are distorted.
- Emmetropia (normal
vision) is maintained
when light focuses
on the retina.
- Myopia (nearsightedness)
occurs when light focuses
in front of the retina. Distant
objects appear blurry.
Pupil
Light is
focused
on retina
Cornea
Cornea
Evaluating Your Vision
To find out whether you’re a good candidate for LASIK, you’ll
need to have a thorough eye exam. This exam may include:
- Tests of refraction (your
corrective lens prescription).
- Measurement of your pupil.
- A thorough exam of
your cornea.
- Mapping or scanning of
the corneal surface to
reveal its exact shape.
- Ultrasound (images made
using sound waves) to
measure corneal thickness.
- Dilation (enlargement) of
your pupil to allow your
eye doctor to examine the
inside of your eye.
- Questions about your
general health, eye health,
and medical history.
How Lasik Treats Vision Problems
LASIK permanently reshapes the cornea so
that light focuses correctly. First, the surgeon
uses a microkeratome or a femtosecond laser
to create a flap in the surface of the cornea. He
or she then uses an excimer laser to reshape
the cornea. Finally, the flap is replaced so the
cornea can heal.
If You’re Over 40
With age, the eye’s lens becomes stiff and
can’t accommodate easily. This causes
presbyopia (difficulty focusing on nearby
objects). LASIK can’t treat presbyopia, so if
you’re over 40 you may need reading glasses
even after surgery. Another option for coping
with presbyopia is monovision. To create
monovision, LASIK is used to adjust one eye
for near vision and the other for distance
vision. This option is not for everyone, so
discuss it with your eye doctor.
A trial period
of monovision using contact lenses may help
you decide if it’s right for you.
Your Lasik Experience
The LASIK procedure is quick and causes little or no
discomfort. The procedure takes about 15 minutes
for each eye. After surgery, your eye doctor monitors
your progress and postoperative care.
Getting Ready
Your eye doctor will discuss
with you how to prepare for
surgery. You’ll also decide
whether both eyes will be
treated in the same session.
Arrange in advance for a ride
home after surgery.
What To Expect During The Procedure
- You may be given medication to
help you relax. You then lie on
your back in a reclining chair.
- The area around your eyes
is cleaned. Eyedrops numb
your eye. Your eyelashes are
taped out of the way. A small
device keeps your eye open.
- A suction ring is then placed
on the eye. This will cause
your vision to dim and may
cause slight discomfort.
- Your surgeon creates a flap
in the surface of your cornea.
This takes less than a minute.
You may feel light pressure,
- During the rest of the
procedure, your vision
is blurry.
- The laser is positioned
above your eye. You are
asked to stare at a light.
When your eye is in the
right position, the laser
is activated.
- You will hear the laser
clicking. After 10 to 90
seconds, laser treatment
is finished.
- The flap is then put back
in place. The corneal
tissue sticks to itself.
Your Recovery
While you recover, you may wear a shield to
protect your eye. At first, your eye may itch,
burn, or feel irritated. It may also water or
hurt a little. To promote healing:
- Protect your eye from bumps and pokes.
Don’t scratch, rub, or touch your eye.
- Use eyedrops as directed by your eye doctor.
You may be prescribed several kinds of drops.
- Follow your eye doctor’s instructions about
sports, swimming, driving, and other activities.
Wear sunglasses and restrict your use of
makeup and sunscreen as directed.
As Your Vision Improves
- You may have mild blurry vision
at first. If you have vision problems,
you may notice them more at night.
- Vision often clears within a few
days. It should become stable in
4 to 12 weeks.
- If you’re over 40, you may need
reading glasses, even if you didn’t
use them before.
- In follow-up visits, your eye
doctor will monitor healing and
vision changes.
Risks And Complications
You may experience temporary or permanent:
- Burning
- Dryness
- Blurriness
- Halos
- Glare
- Starbursts
Medical complications may include:
- Inflammation
- Infection
- Flap problems
- Vision loss
Call your doctor if:
- You have increased pain
more than 24 hours
after surgery.
- You have discharge,
redness, or increased
irritation.
- Your vision worsens.