What is LASIK?
LASIK stands for Laser Assisted In Situ Keratomileusis. It is a type of refractive surgery used to treat nearsightedness, astigmatism, and farsightedness. The LASIK procedure changes the way light focuses in the eye, by altering the shape of the cornea. During the initial portion of the LASIK procedure, a microkeratome is used to create a protective flap of corneal tissue. Under the protective flap, the excimer laser is then used to remove a small pre-calculated amount of corneal tissue to reshape the cornea. The flap is then repositioned without sutures. The procedure involves minimal discomfort and requires only topical anesthesia (eye drops). Generally, it takes only few minutes per eye.
How will I feel after LASIK?
Of the refractive laser procedures, LASIK has the shortest time for vision recovery. The protective corneal flap allows for overnight sealing of the corneal surface which brings an end to scratchiness and irritation. As the laser treatment is performed under the corneal flap rather than on the surface, there is generally no haze. Postoperative eye drops are used for the first 7 days and are usually not required after that. Generally, there is little to no postoperative pain.
What are some advantages of LASIK?
The protective corneal flap 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, bilateral procedures are often more feasible. Enhancements are generally not needed but can be readily done under the flap. LASIK also allows for treatment of wide ranges of refractive error-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 can occur but are rare.
The LASIK consent form can be very confusing and intimidating. While it is true that anything is possible, patients generally want to know what are the most likely problems that may occur. We tell patients that in our experience, 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. Another realistic concern is trauma to the eye early after the procedure, while the eye is still healing. Patients may inadvertently be hit in the eye after the procedure, which can move their flap and make it necessary to surgically reposition the flap. Care should be taken not to have anything strike the eye or to rub 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.
Is Laser Vision Correction FDA approved?
YES - we use only FDA approved excimer lasers and microkeratomes to perform LASIK.
What about laser treatment of farsightedness?
Laser Vision Correction of farsightedness has been FDA approved since 1998. Treating farsightedness has now become a routine procedure similar to treating nearsightedness. Farsighted patients under 40 can generally achieve both excellent distant and near vision after laser. 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 get older. In other words, the excimer laser cannot make you younger. One option for both farsighted and nearsighted patients over 40 who want to reduce their dependence on reading glasses is "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 that the doctor can take this into account when performing routine glaucoma testing over that person's 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 followed by an eye doctor and 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. Our staff will spend a great deal of time describing exactly what's involved in the procedure and what sounds and sights you will experience. We will talk with you constantly to "walk you through the process" to make you as comfortable as possible. We also prescribe a mild sedative prior to the procedure.
Should I have both eyes done at the same time?
We perform LASIK on both eyes on the some day in the overwhelming majority of our patients. There are pros and cons to this approach but most people would like to minimize any postoperative discomfort and time off from work. Also, 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 can be noticed at the time of the procedure. Therefore, we believe that if LASIK of the first eye goes perfectly, we feel confident performing the second eye on the same day. If, however, the first eye proceeds less than perfectly, we generally wait until that eye heals and treat the second eye on another day. Please don't hesitate to approach us with any concerns or question you have about one eye or two eye treatments. |
