Charlotte, North Carolina
Frequently Asked Questions About LASIK
What is LASIK?
LASIK stands for LaserAssisted In Situ Keratomileusis. It is a type of refractive surgery used to treat myopia (nearsightedness), astigmatism, and farsightedness. The LASIK procedure changes the way light is focused by the eye by altering the shape of the cornea. During the initial portion of the LASIK procedure the automated microkeratome is used to create a protective cap of corneal tissue. Under the protective flap, the excimer laser is then used to remove a small pre-calculated amount of corneal tissue. The cap is then repositioned without sutures. The procedure involves minimal discomfort and requires only topical anesthesia (eye drops). Generally, it takes only a few minutes per eye.
How will I feel after LASIK?
Of the refractive laser procedures, LASIK has the shortest time to vision recovery. The protective corneal cap allows for overnight sealing of the corneal surface, which brings an end to scratchiness and irritation. Postoperative eye drops are used for the first week unless otherwise directed by your doctor. Generally, there is little to no postoperative pain.
What are some advantages of LASIK?
The protective corneal cap allows for rapid healing, which reduces the need for prolonged medication usage often required by surface PRK. Since the epithelium is not removed, more rapid restoration of clear vision occurs and patients feel little to no postoperative pain. Because of the rapid return of vision, having the procedure on both eyes at the same time is often more feasible. LASIK also allows for treatment of wide ranges of prescriptions even those who are "very nearsighted" or "very astigmatic".
What are the risks?
In our experience and in recent published studies, most patients achieve excellent results without significant complications. Serious complications appear to be rare.
Yet nothing is without risk, including walking across the street or even wearing contact lenses. In fact, we have treated a number of patients who have experienced extremely serious complications from wearing contact lenses.
Regarding LASIK, the most common potential "problem" involves the need for a second treatment in order to get the vision that the patient really desires. If a second treatment is needed, it is usually performed several weeks to months after the first procedure. This might be considered more of an inconvenience than a major problem.
Infections after LASIK have been reported, but are rare. Occasionally, your surgeon may cancel your procedure if the flap made is not adequate. Your LASIK can be rescheduled for about three months later. Another realistic concern is trauma to the eye early after the procedure, while the eye is still healing. If a patient is hit in the eye after the procedure, the flap can be moved, making it necessary to surgically reposition the flap. Care should be taken to avoid having anything strike the eye, and to avoid rubbing the eyes, for several months after the laser procedure.
Occasionally, some epithelial (skin-like) cells on the surface of the eye can grow underneath the flap and cause problems. This can usually be resolved by lifting the flap, brushing away cells, and replacing the flap.
Most patients experience halos around lights and some starbursts or glare at night for several weeks to months after LASIK surgery. In general, these are noticeable but not debilitating, and usually are resolved 6-12 months after the procedure.
Is laser vision correction FDA-approved?
Yes; we use only FDA-approved excimer lasers.
What about laser treatment of farsightedness?
Laser vision correction of farsightedness has been approved by the FDA since 1998. Treating farsightedness has now become a routine procedure similar to treating nearsightedness. Farsighted (or hyperopic) patients under 40 can generally achieve both excellent distant and near vision after laser surgery. For those farsighted patients over 40, we can usually give them excellent distance vision and markedly improved reading vision, but they will still need reading glasses for some activities as they age. In other words, the excimer laser cannot make a patient younger. “Monovision” is one option for both farsighted and nearsighted patients over 40 who want to reduce their dependence on reading glasses.
Why is farsightedness so confusing?
There are really two types of "farsightedness." Eye doctors use the term hyperopia for people who need reading glasses ( and occasionally distance glasses) before the age of about 40 years old. This type of "farsightedness" can be treated with laser surgery to give most patients excellent distance and reading vision without glasses.
Most people use the term "farsightedness" to describe the natural aging change that occurs when people start needing reading glasses over the age of 40.
For this natural aging change (which eye doctors call presbyopia), excimer laser treatment cannot eliminate the need for reading glasses unless one eye is made nearsighted to improve its reading ability. This would blur the distance vision in that eye. We call this option "monovision".
How will LASIK affect the development of cataracts or glaucoma?
There is no evidence that LASIK causes cataracts or glaucoma. If someone who has had LASIK eventually develops cataracts, cataract surgery can be successfully performed. Glaucoma is a disease involving pressure inside the eye that damages the optic nerve. If a patient develops glaucoma after LASIK, they may still be successfully treated for glaucoma at that time.
Any patient who has had LASIK should inform their eye doctor, so that the information is known when performing routine glaucoma testing over a lifetime. Also, patients who are quite nearsighted always have a higher risk of developing a retinal detachment in their lifetime. LASIK may dramatically improve their vision, but these patients will still continue to have a higher risk than normal of retinal detachment. All patients will need to continue to be treated by an eye doctor and to have regular eye examinations.
Are most people nervous about the procedure?
Our eyes and vision are very precious. It's perfectly natural to be nervous about having the procedure. Much of this comes from fear of the unknown. To help alleviate concerns, our staff spends a great deal of time describing exactly what's involved in the procedure and what sounds and sights will be experienced. We will talk with you constantly to "walk you through the process,” ensuring that you are as comfortable as possible with the process. We also prescribe a mild sedative prior to the procedure. Talking with patients who have had the procedure and asking questions about what to expect will help make you more comfortable about the decision to have LASIK surgery. Many of our patients have volunteered to talk about their laser correction experiences with anyone considering having the procedure. Just let us know if you would like to receive a list of their names and phone numbers, and/or if you would like to be part of this group after your procedure.
Should I have both eyes done at the same time?
For the majority of our patients, we perform LASIK on both eyes on the same day. There are pros and cons to this approach, but most people choose it to minimize any postoperative discomfort and time off from work. If after the procedure one eye is quite nearsighted and the other eye is corrected, this can be somewhat disorienting. In general, many of the potential problems that can occur in LASIK will be noticed at the time of the procedure. If LASIK of the first eye goes perfectly, we feel confident performing the second eye on the same day. If the first eye proceeds less than perfectly, however, we generally wait until that eye heals and then treat the second eye on another day. Please don't hesitate to approach us with any concerns or question you have about treatments of one or both eyes.
Does it hurt?
Most people have 12 hours of mild irritation after their LASIK, similar to the feeling of dirty contact lenses. One dose of Tylenol is all most people need. PRK surgery is usually more uncomfortable for a longer time, usually about three days.
Can I still wear contact lenses after LASIK?
Most people do not need glasses or contact lenses to see distance clearly after laser vision correction. If they do, or if they want to wear contact lenses to improve their close-up vision after LASIK, they generally can wear contact lenses. This is different than patients who have had RK surgery, who generally cannot wear contact lenses after the procedure.
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