LASIK (laser-assisted in situ keratomileusis)

A surgical procedure that uses a laser to reshape the cornea of the eye. This reshaping changes focusing power and corrects vision. Surgery may be performed on both eyes, either at the same time or on separate occasions.

Parts of the Body Involved

Cornea of the eye

Reasons for Procedure

LASIK is done to correct refractive (focusing) problems, in hopes of eliminating the need for glasses or contact lenses.

Risk Factors for Complications during the Procedure

  • Pre-existing eye disease (such as glaucoma) or abnormalities
  • Persistent eye infections (such as blepharitis)
  • Autoimmune disease (such as rheumatoid arthritis or lupus), immunodeficiency, and other conditions or use of medications that alter wound healing
  • Changing eyesight due to medication use or medical conditions (such as pregnancy or breastfeeding)
  • Diabetes

What to Expect

Prior to Procedure

Your doctor will likely do the following:
  • Complete eye exam
  • Review of medications
In the days leading up to your procedure:
  • Stop wearing your contact lenses at least two to four weeks before your pre-operative eye evaluation and surgery; the length of time depends on the type of contact lenses
  • Arrange for a ride to and from the procedure
  • Do not wear lotion, cream, make up, or perfume the day before or day of surgery to decrease the risk of infection
  • You may be asked to scrub your eyelashes before the surgery
During Procedure - Anesthesia, possibly a sedative

Anesthesia - Drops are given to numb the surface of the eye; you may be given an oral sedative

Description of the Procedure - You are positioned on your back in a reclining chair. The area surrounding your eye is cleaned, numbing drops are given, and the eyelid is held open with a special device. A ring is placed on the eye and pressure is applied to create suction. A blade is then attached to the suction ring. The doctor uses the blade to cut a flap in the cornea, and the ring and blade are removed. The doctor folds back the flap. You look into a light (not the laser). The doctor directs the laser to remove a specific amount of tissue, and the laser makes a ticking sound as it reshapes the cornea. At this point, some patients report a smell similar to burning hair. Once the laser is finished, the flap is put back, antibiotic drops are put into the eye, and a shield is placed over the eye. Your doctor will remove this shield at your first visit, within 48 hours of the surgery.

After Procedure - You'll wear a shield to protect your eye from injury or pressure, even while sleeping

How Long Will It Take? Less than 30 minutes

Will It Hurt? You'll likely feel some discomfort when the suction ring is applied. And just after the procedure, expect a burning or itching sensation, or the feeling that there is a foreign object in your eye. Your eye may tear, and may be red and bloodshot.

Possible Complications:
  • Infection
  • Under or over vision correction
  • Scarring
  • Fuzzy or blurry vision
  • Poor night vision
  • Seeing halos or sunbursts around light
  • Long-term dryness, scratchiness, or pain
  • Correction may not last
  • Loss of vision
Average Hospital Stay - None

Postoperative Care:
  • Do not rub your eyes
  • Vision may be hazy or cloudy; you may see starbursts or halos around lights
  • Take pain medication as recommended by your doctor
  • Use antibiotic and anti-inflammatory eye drops ordered by your doctor to prevent infection and decrease swelling
  • Do not put a contact lens in the operative eye
  • Wash your eyelid as instructed by your doctor, but try not to get water in your eye for about a week
  • Do not use cream, lotion, or make-up near the eye for at least two weeks

Outcome

Vision changes and redness should gradually improve over several days. However, it may take up to six months for your vision to stabilize. Schedule a doctor visit the first or second day following surgery. Additional visits are necessary throughout the next six months.

You can return to work after the glare, redness, and vision difficulties subside. Patients can usually return to non-contact sport activities within three days but must avoid strenuous contact sports for at least four weeks. Do not swim or sit in a hot tub or whirlpool for one to two months.

Additional surgery may be necessary to further correct or enhance vision. If more surgery is needed, wait until your eyesight has stabilized. It has stabilized when you have consistent measurements on two consecutive exams at least three months apart.

You may still need reading glasses at middle age to correct for presbyopia (decreased ability to focus due to age).

Call Your Doctor If Any of the Following Occurs

  • Severe pain
  • Vision worsens
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site