LASIK Surgery

It is a surgical procedure that uses a cool (non-thermal) beam of light to gently reshape the cornea — the surface of the eye — to improve vision. The laser removes microscopic bits of tissue to flatten the cornea (to correct nearsightedness), steepen the cornea (to correct farsightedness) and/or smooth out corneal irregularities (to correct astigmatism).

The goal of laser eye surgery is to change the shape the cornea so it does a better job of focusing images onto the retina for sharper vision. LASIK and PRK are two types of laser vision correction.

The FDA recognizes LASIK and PRK as proven, safe and effective. Laser vision correction uses a cool (non-thermal) beam of light that is computer controlled. The surgeon turns the laser on and is able to turn it off at any moment. Many safeguards are in place to reduce the risk of error. However, risks are associated with any surgical procedure.

Although no one knows the exact number of complications, studies suggest that the incidence of minor difficulties such as dry eyes and nighttime glare is around 3 percent to 5 percent, while the risk of serious incidents such as lost vision is thought to be less than 1 percent. There are no known cases of blindness from LASIK or PRK. Again, outcomes generally are very good.

Most surgeons perform a LASIK procedure on both eyes at the same time. Because it takes longer for clear, comfortable vision after PRK, many surgeons will wait a week or two between eyes for PRK.

How is eye laser surgery different from previous types of refractive eye surgery?

Current FDA-approved laser vision correction methods, such as LASIK (laser-assisted in situ keratomileusis), have a higher predictability of the final result with a lower incidence of complications. Additionally, older techniques typically involved manually performed incisions rather than automated lasers for correction.

You won't feel pain during LASIK or PRK, because your surgeon will place anesthetic eye drops in your eye first. Afterward, he or she may prescribe pain medication if necessary. Many LASIK patients report no more than mild discomfort for a day or so after surgery. There is more discomfort after PRK because the procedure exposes the deeper layers of the cornea. For clear and comfortable vision after PRK, protective surface cells have to grow back over the treated area. This process can take a week or two, sometimes longer.

The laser treatment itself usually takes less than a minute, while the entire procedure takes approximately 15 minutes per eye.

How do I know if I'm eligible for laser vision correction?

Your eye care practitioner can help you decide, but here are some general guidelines:

• You must have healthy eyes — no glaucoma, infection, cataracts, severe dry eye or any other condition that would affect postoperative healing.
• You must be an adult: age 21 or older (with some exceptions).
• Your vision must be stable for at least a year before surgery.
• If you're pregnant or nursing, your hormonal levels can affect the shape of your eye. You'll need to wait until your hormones are back to normal levels.
• You cannot have a degenerative or autoimmune disease, since this would
• affect healing.

Your eye care practitioner will give you a thorough eye exam to make sure your eyes are healthy and you're a suitable candidate for laser vision correction. He or she will test for glaucoma, cataracts and other disqualifying conditions. He or she also will use a machine called a corneal topographer to photograph and electronically map your eye. The surgeon will use this map to plan your surgery for the most precise results possible.

Learn more about what to expect before, during, and after LASIK.

LASIK and PRK are outpatient procedures, which means you'll spend around an hour at the surgeon's office and walk out afterward. Someone else must drive you home, because your vision will be a little blurry right after surgery.

You'll lie down in a reclining chair. The surgeon will place anesthetic drops in your eye, position your head under the laser, and place an eyelid speculum (retainer) under your lids to comfortably hold your eye open.

In LASIK, the surgeon creates a thin flap in the top of the cornea, folds it back out of the way, uses the laser to remove some corneal tissue and then puts the flap back in place. If you're having PRK, no flap is created. The laser simply removes the outer layer of the cornea (epithelium), which grows back after surgery.

Learn more about what to expect before, during, and after LASIK.

The surgeon will place eye drops or ointment in your eye. You may relax for a little while then go home and rest. You'll probably notice clearer vision immediately, and typically it will improve even more as the weeks go by.

Learn more about what to expect before, during, and after LASIK.

You may begin driving as soon as you see well enough, excluding the day you had LASIK or PRK performed.

Most people who have LASIK return to work the next day. With PRK, many surgeons recommend two or three days of rest instead.

You may resume wearing makeup about one week after your surgery. However, throw out your old makeup and buy new to decrease your risk of infection.

Some people experience dry eye after LASIK, which usually is relieved with eye drops and disappears over time. Others may experience starbursts or halos around lights, especially at night. Usually this effect lessens or disappears over time, too. In a small number of people (probably fewer than 1 percent), their vision worsens rather than improves.

Depending on your surgeon, you will probably return the next day, then one week or one month later and then three months later. Your doctor will let you know if more visits are necessary.

A small number of patients see well after surgery then experience regression, a gradual worsening of vision. If this happens, consult with your eye care practitioner to determine the cause and to see if retreatment (enhancement) is appropriate.

There is no one answer regarding what LASIK costs, since fees vary from one surgeon to the next. Prices range from less than $1,000 per eye to more than $3,000 per eye. The average cost for all laser-based vision correction procedures is about $2,150 per eye. You also can ask your eye surgeon's staff about the possibility of financing a procedure.

The absolute best source of information about LASIK is a LASIK surgeon, and most provide free consultations. All you have to do is make an appointment.