LASIK Surgery - What to Expect
What to expect before, during, and after surgery will vary from doctor to doctor and patient to patient. The following information serves as a guide, but cannot replace the dialogue you should have with your doctor. Read this information carefully and with the checklist, discuss your expectations with your doctor.
Before Surgery
If you decide to go ahead with LASIK eye surgery, you will need an initial or baseline evaluation by your optometrist to determine if you are a good candidate. This is what you need to know to prepare for the exam and what you should expect:
If you wear contact lenses, it is a good idea to stop wearing them before your baseline evaluation and switch to wearing your glasses full-time. Contact lenses change the shape of your cornea for up to several weeks after you have stopped using them depending on the type of contact lenses you wear. Not leaving your contact lenses out long enough for your cornea to assume its natural shape before surgery can have negative consequences. These consequences include inaccurate measurements and a poor surgical plan, resulting in poor vision after surgery. These measurements, which determine how much corneal tissue to remove, may need to be repeated at least a week after your initial evaluation and before surgery to make sure they have not changed, especially if you wear RGP or hard lenses. If you wear:
- soft contact lenses, you should stop wearing them for 2 weeks before your initial evaluation.
- toric soft lenses or rigid gas permeable (RGP) lenses, you should stop wearing them for at least 4 weeks before your initial evaluation.
- hard lenses, you should stop wearing them for at least 4 weeks before your initial evaluation.
You should tell your optometrist:
- about your past and present medical and eye conditions
- about all the medications you are taking including over the counter medications and about any medications you may be allergic to
Your optometrist should perform a thorough eye exam and discuss:
- whether you are a good candidate
- what the risks, benefits, and alternatives to the surgery are
- what you should expect before, during, and after surgery
- what your responsibilities will be before, during, and after surgery
You should have the opportunity to ask your doctor questions during this discussion. Give yourself plenty of time to think about the risk/benefit discussion, to review any informational literature provided by your doctor, and to have any additional questions answered by your doctor before deciding to go through with surgery and before signing the informed consent form.
You should not feel pressured by your doctor, family, friends, or anyone else to make a decision about having surgery. Carefully consider the pros and cons.
The day before surgery, you should stop using:
- creams
- lotions
- makeup
- perfumes
These products as well as debris along the eyelashes may increase the risk of infection during and after surgery. Your doctor may ask you to scrub your eyelashes for a period of time before surgery to get rid of residues and debris along the lashes.
Before your surgery, you must arrange for transportation to and from your surgery as well as for your first follow-up visit on the day after surgery. On the day of surgery your doctor may give you some medicine to make you relax; this will impair your ability to drive and may blur your vision.
The Surgery
The surgery usually takes less than 30 minutes.
A mild oral sedative such as Ativan will be offered to you prior to surgery to help you relax and you will be given eye drops to numb the eye and eliminate the reflex to blink. Most patients report little or mild discomfort. During the procedure you will be positioned on the reclining laser chair. An eyelid holder is used to prevent blinking.
While the suction ring is in place, you will lose the perception of light for less than one minute and you may feel pressure in the eye and experience some discomfort. Following removal of the microkeratome and the suction ring, you will experience fluctuating degrees of blurred vision during the rest of the procedure.
At this point in the surgery, you may become aware of new sounds and smells. The pulse of the laser makes a ticking sound. As the laser removes corneal tissue, some people have reported a smell similar to burning hair.
At the conclusion of the procedure, antibiotic drops are placed in the eye and the patient will return to the exam room for a final assessment with their surgeon.
A shield will be placed over your eye at the end of the procedure as protection, since no stitches are used to hold the flap in place. It is important for you to wear this shield to prevent you from rubbing your eye and putting pressure on your eye while you sleep, and to protect your eye from accidentally being hit or poked until the flap has healed.
After Surgery
Prior to leaving the center, a patient consultant will review your post-operative care.
You should not drive for at least twenty-four hours following surgery and in no event should you drive until your vision is clear.
After the procedure you may experience some discomfort. This could range from scratchiness to moderate discomfort. Your vision may be blurry and may fluctuate in the first few weeks following surgery. Your vision may be clear just after surgery and become reduced later depending on your healing response. This may require further treatment once the vision has stabilized. Some patients may have trouble tolerating the fluctuating vision even on a temporary basis.
Immediately after the procedure, your eye may burn, itch, or feel like there is something in it. You may experience some discomfort, or in some cases, mild pain and your doctor may suggest you take a mild pain reliever. Both your eyes may tear or water. Your vision will probably be hazy or blurry. You will instinctively want to rub your eye, but don't! Rubbing your eye could dislodge the flap, requiring further treatment. In addition, you may experience sensitivity to light, glare, starbursts or haloes around lights, or the whites of your eye may look red or bloodshot. These symptoms should improve considerably within the first few days after surgery. You should plan on taking a few days off from work until these symptoms subside. You should contact your doctor immediately and not wait for your scheduled visit, if you experience severe pain, or if your vision or other symptoms get worse instead of better.
You should see your doctor within the first 24 to 48 hours after surgery and at regular intervals after that for at least the first six months. At the first postoperative visit, your doctor will remove the eye shield, test your vision, and examine your eye. Your doctor may give you one or more types of eye drops to take at home to help prevent infection and/or inflammation. You may also be advised to use artificial tears to help lubricate the eye. Do not resume wearing a contact lens in the operated eye, even if your vision is blurry.
You should wait one to three days following surgery before beginning any non-contact sports, depending on the amount of activity required, how you feel, and your doctor's instructions.
To help prevent infection, you may need to wait for up to two weeks after surgery or until your doctor advises you otherwise before using lotions, creams, or make-up around the eye. Your doctor may advise you to continue scrubbing your eyelashes for a period of time after surgery. You should also avoid swimming and using hot tubs or whirlpools for 1-2 months.
Strenuous contact sports such as boxing, football, karate, etc. should not be attempted for at least four weeks after surgery. It is important to protect your eyes from anything that might get in them and from being hit or bumped.
During the first few months after surgery, your vision may fluctuate.
- It may take up to three to six months for your vision to stabilize after surgery.
- Glare, haloes, difficulty driving at night, and other visual symptoms may also persist during this stabilization period. If further correction or enhancement is necessary, you should wait until your eye measurements are consistent for two consecutive visits at least 3 months apart before re-operation.
- It is important to realize that although distance vision may improve after re-operation, it is unlikely that other visual symptoms such as glare or haloes will improve.
- It is also important to note that no laser company has presented enough evidence for the FDA to make conclusions about the safety or effectiveness of enhancement surgery.
Contact your eye doctor immediately, if you develop any new, unusual or worsening symptoms at any point after surgery. Such symptoms could signal a problem that, if not treated early enough, may lead to a loss of vision.
Much of the information above has been supplied courtesy of the U.S.A. Food and Drug Administration.
