Laser surgery for keratomileusis in situ (LASIK) involves the use of a precisely directed laser to reshape the cornea , the front part of the eye. This can correct refractive errors such as nearsightedness and farsightedness, problems associated with the bending of light rays in the eye, and often improves vision. Although generally considered safe and effective, you need to weigh the risks and recovery factors. Also, not everyone who may need LASIK is a suitable candidate.
What is LASIK eye surgery?
LASIK is elective surgery performed by an ophthalmologist (eye surgeon) for an adult in a doctor's office or outpatient eye surgery center.
LASIK eye surgery has three main parts:
- Creation of a corneal flap: A flap of corneal tissue is cut with a laser or mechanical blade and gently lifted. This "hinge" fabric keeps the flap attached to the eye so it can be gently reapplied later.
- Corneal reshaping – An excimer laser, a type of laser that emits ultraviolet light of a specific wavelength, is used to reshape the cornea so that light rays are perfectly focused on the retina without the need for corrective lenses.
- Changing the position of the cornea: Finally, the corneal flap is carefully repositioned on the cornea and smoothed.
Various surgical techniques
There are two main surgical techniques surgeons use to perform LASIK :
- Traditional LASIK: This method uses your refractive error measurement (used to determine your eyeglass or contact lens prescription) to program the laser as it reshapes your cornea during surgery.
- Individual LASIK: This technique uses a 3D mapping system of the human eye to direct the laser during surgery. The system, called wavefront technology, provides information about the exact shape of the patient's cornea, as well as unique distortions and irregularities in the eyes.
Although custom LASIK is usually a bit more expensive, it can potentially improve the patient's chances of achieving 20/20 vision or better after surgery. It can also reduce the likelihood of unwanted LASIK side effects, such as glare or ghosting, or impaired night vision .
Purpose of LASIK eye surgery
LASIK reshapes the cornea so that light can be bent (refracted) correctly and focused on the retina, where it is converted into nerve signals that are sent to your brain and interpreted as visual images.
LASIK eye surgery is done to treat the following refractive errors:
The goal of LASIK is to continually improve your vision. In most cases, LASIK eliminates the need for glasses or contact lenses. However, postoperative vision may not be permanently clear.
Who is eligible?
To undergo this operation, the patient must meet the following criteria :
- Be at least 18 years old.
- You have farsightedness, myopia, or astigmatism that are not too severe or stable (that is, they have not changed in the last year)
Optical abnormalities and conditions, such as cornea cone ( keratoconus ), dry eye, and advanced or uncontrolled glaucoma ), and certain health conditions, such as uncontrolled diabetes, exclude you as a candidate for this procedure.
Other conditions may be possible contraindications. Examples include certain autoimmune diseases (such as Sjogren's syndrome ) or a history of abnormal wound healing.
Several unique and challenging eye exams will be performed to ensure you are eligible for LASIK surgery .
How to prepare
Once your ophthalmologist determines that you are a good candidate for LASIK, be sure to discuss possible side effects and complications with him in detail and what to expect after surgery.
Then, if you're ready to move on, you can make an appointment and start preparing.
Preparing for LASIK eye surgery involves logistics, like knowing when to arrive and what to take with you, and arranging for someone to drive you home (and help you) after surgery.
It also includes steps to make your surgery as safe as possible, including preparing your eyes, avoiding contact lenses and makeup, and knowing which medications to stop (and when) before the procedure.
Follow the instructions of your healthcare professional exactly. If you are not sure about something, ask.
What to Expect the Day of Surgery
On the day of the operation, you will come and wait until you are called to the operating room. You will most likely fill out several forms, including a consent form for the operation.
When you enter the operating room and sit in a reclining chair, you may be given a sedative such as Valium (Diazepam) to help you relax and calm your nerves.
Next, your surgeon or his assistant will:
- A sterile wipe is applied to the eye area to ensure that bacteria are free from the workplace.
- Eye drops will be applied to relieve pain.
- After your eye is numb, it will be transported to an excimer laser, which will perform the operation.
- When convenient, use a special device to keep your eye open to prevent blinking. Sometimes a suction ring is applied to the front of the eye to prevent eye movement.
- The cornea will then be marked with special surgical ink to begin the process of creating the corneal flap.
During the procedure, some safety measures will be taken. Your surgeon is in full control and can turn off the laser at any time. If you move too much, the laser will turn off automatically.
The entire procedure generally takes less than 10 minutes per eye; Your surgeon will only operate on one eye at a time. However, you will be in the office or surgery center for about 90 minutes.
For the first 24 hours after LASIK eye surgery, your surgeon will ask you to rest and relax your eyes.
During this time, you may experience symptoms such as eye discomfort, dry eyes, blurred vision, and sensitivity to light. Some of them can go away in a day, while others can take up to a week, several weeks, or months.
Within one to three days after surgery, most patients can return to their daily routine, including returning to work.
However, for the next two to four weeks, you will be advised to wear sunglasses throughout the day, wear a bandage or eye shield at night, and do not touch or apply anything around the eyes.
Your surgeon will also recommend that you avoid certain activities for specific periods of time (one to several weeks), such as exercise and driving.
Long term care
Most people are very happy with the outcome of LASIK surgery, and the results can be impressive.
Research shows that 99% of patients achieve at least 20/40 vision after LASIK and more than 90% achieve 20/20 vision or better .
However, while LASIK eye surgery provides permanent improvement in your vision, your eyes naturally change with age (this is called presbyopia).
As such, your ophthalmologist will want to continue evaluating your eye health with regularly scheduled visits long after the six-month recovery period.
In addition to the symptoms that can occur during the recovery period, the potential but rare risks and complications associated with LASIK eye surgery include :
- Eye dryness that can occur after surgery and sometimes persists for weeks or months.
- Eye infection ( infectious keratitis )
- An inflammatory eye condition called diffuse laminar keratitis.
- Problems with the corneal flap (such as irregular or poor healing)
- Refractive complications such as irregular astigmatism, blurred vision, or, less commonly, vision loss (blindness ).
Get immediate medical attention.
Although you may experience mild eye discomfort after LASIK surgery, it is important to contact your healthcare professional immediately if you experience severe eye pain. Also contact your doctor if you experience any unusual or worsening visual symptoms, or if you receive a blow to the eye.
Get the word of drug information
Although LASIK surgery itself takes a few minutes, the preparation and recovery process takes time and patience. You will need to diligently follow the surgeon's instructions and attend all follow-up visits.