LASIK (laser-assisted in situ keratomileusis) is refractive eye surgery that reshapes your cornea and helps improve your vision.
Chances are you’ve heard of LASIK, or know one of the millions of Americans who have had this popular surgery. And now you may be wondering:
“Will LASIK laser eye surgery work for me and my vision problem?”
“Is LASIK surgery a permanent solution for my vision problems?”
“How much does LASIK laser eye surgery cost?”
“What are the risks of LASIK eye surgery?”
This comprehensive guide is here to help you to understand everything you need to know about LASIK laser eye surgery so that you can make an informed and confident decision.
If you wear prescription eyeglasses or contact lenses in order to see clearly, LASIK laser eye surgery might be right for you.
If you do have one of these conditions, a short, simple and painless LASIK procedure may be able to significantly improve your vision. It could even mean that you would no longer need to wear your glasses or contacts.
For a more detailed list of requirements for LASIK surgery, jump to our Checklist: Am I a Good Candidate for LASIK? section section.
At the front of the eye, is a clear, dome-shaped section called the cornea. In order to see properly, light must hit the cornea and then refract from there onto a collection of cells at the back of the eye called the retina. The retina then uses the information it receives from these light rays and sends messages to the brain that we recognize as images.
For a variety of reasons, light rays not properly focus on the retina and this will affect a person’s vision, making images appear blurry. This is called a refractive error.
Why do refractive errors occur?
Usually, a refractive error occurs because one part of the eye is not correctly shaped (typically the cornea or the lens) as a result of genetic or environmental factors. In the case of presbyopia, it is because the lens is not changing shape enough to refract the light correctly.
How can they be corrected?
There are three main ways to correct refractive error and ensure light is focused on the retina correctly.
LASIK eye surgery is just one type of refractive eye surgery. Your glasses or contact lenses might be doing the trick to temporarily treat refractive errors when worn correctly. But surgeries like LASIK can help you see this way all day every day. To learn about other treatment options, jump to this section of the guide.
During the bladeless LASIK procedure, the femtosecond laser is used to create a smooth, precise, and thin flap of the cornea. The flap is gently lifted and the cornea is reshaped using the excimer laser beam. This will remove some of the corneal tissue to reshape and change the curvature of the cornea in order to allow light in and focus on the retina to create clearer vision. After this is completed, the flap is carefully repositioned on the surface of the eye to allow the inner cornea to heal. (Source: National Eye Institute)
LASIK surgery permanently changes the shape of the cornea. This change will then allow light entering the eye to be properly focused onto the retina at the back of the eye. This should correct the refractive error, and significantly improve a person’s vision.
Firstly, and most importantly, the procedure is very safe and has a very high success rate. Over 96% of patients who choose to have LASIK surgery will have their desired level of vision after they undergo the procedure (source: WebMD ).
Many patients find that they no longer have to use glasses or contacts at all. If for any reason you cannot or do not feel comfortable wearing glasses or contacts, LASIK surgery is a good alternative option to treat refractive error. (source: National Eye Institute)
For most patients, the entire surgical procedure only takes approximately 5 -10 minutes per eye. No stitches or bandages are required, and the corneal flap will heal on its own over the course of a few days. Patients are usually able to see dramatically better within 12 to 24 hours after the LASIK eye surgery procedure and are able to return to normal activities within a day or two without the need for glasses or contacts.
LASIK laser eye surgery is an extremely safe procedure and complications are very rare. Still, it is important to be aware of the potential risks and side effects that could occur. It’s important that you consider all of these potential complications and discuss any concerns you may have with your eye doctor before you decide to have LASIK surgery. Your doctor will be able to advise you if LASIK is right for you.
Undercorrection, overcorrection, or new or additional astigmatism.
There is a chance that vision will not be as good after the surgery as before, even with the use of glasses or contacts. This is typically because the laser has removed too little or too much tissue from your eye, meaning that you won’t get the clearer vision you wanted. Similarly, uneven tissue removal can result in astigmatism. In some instances, you may need to have a second surgical procedure or ‘retreatment’ to achieve the desired vision correction. This is more likely for people who required a greater correction to their vision than normal. Approximately 10.5 percent of LASIK patients in the United States require a retreatment. (source: American Academy of Ophthalmology)
Corneal flap problems.
Because LASIK surgery requires a flap of the outer cornea to be lifted during the procedure and then put back in place, some people can experience complications in this part of the eye including These problems sometimes mean that further treatment is necessary.
Fluctuating or disturbed vision.
Some patients can experience changes in their vision after the surgery and notice that they have more difficulty seeing in certain situations. You might notice light sensitivity, glare, halos around bright lights or double vision, or difficulty seeing at night, particularly while driving. Some patients may have discomfort or pain in their eyes, or small pink or red patches on the white of the eye. These symptoms will usually only be temporary and will pass with time as the eye heals. In a small minority of patients, some of these effects can be permanent.
Because LASIK surgery causes a temporary decrease in tear production you may find that even once your eyes heal, they may feel unusually dry. You may experience an increase in dry eye.
There are some important requirements you should meet in order to be eligible for LASIK surgery, as well as some additional considerations that you and your eye doctor should discuss in order to determine whether you are a good candidate for the procedure.
The FDA along with the AAO have developed a short list of guidelines you should meet to be a candidate for LASIK (Source: Medline):
Even if you are a suitable candidate for LASIK, it is a good idea to ask yourself the following questions, and discuss any concerns you have with your eye doctor:
“Am I comfortable and happy wearing glasses or contacts?”
If you are, then it may not be necessary to undergo surgery in order to correct your vision.
“Do I have realistic expectations of the surgery?”
It is important that you have realistic expectations for the procedure. It is best to expect that the surgery will mean you are less dependent on glasses and contacts, but you may still need them from time-to-time if you need perfect vision. If you are looking to obtain perfect vision, you may be disappointed. LASIK will normally deliver vision that is between 20/20 and 20/40 without the use of glasses or contact lenses.
For people with certain conditions, including presbyopia, LASIK cannot ensure that both eyes will have clear vision in all situations. If you have presbyopia, LASIK is performed to achieve something called “monovision” which means that one eye is able to see clearly at a near distance, and the other will see clearly for far distance objects. This can still be a good option that may allow you to not need glasses all the time, but it is important that you discuss the pros and cons with your doctor beforehand and understand if monovision will work for you.
If LASIK if not an option, there are more treatment options available that are just as safe and worth discussing with your healthcare provider.
PRK or “Photorefractive Keratectomy” is also a laser treatment option for patients who are nearsighted or who have astigmatism. It is a proven procedure that uses the same laser technology as LASIK and is excellent for athletes or patients who have a thin cornea. PRK and LASIK procedures are very similar in nature; however, there are a few key differences. The main difference lies in how the laser penetrates the patient’s cornea for their vision correction to be permanent. Instead of creating a flap, the outermost layer of the cornea, or epithelium, is removed to expose the underlying cornea. The same excimer laser is applied to the underlying cornea to help reshape the cornea. A bandage contact lens is then placed on the eye to promote healing of the removed cornea which re-grows naturally within a week.
Implantable collamer lenses, or ICLs, act in the same way that traditional contact lenses do and are a good option for those with astigmatism, moderate to high myopia (nearsightedness) and high prescriptions who are not candidates for vision correction procedures like LASIK or PRK. ICL surgery can achieve results as good as LASIK or PRK, but requires surgery inside the eye as opposed to on the surface. The small lens is a removable implant that is placed inside the eye to provide patients with high-quality vision that is both sharp and clear without removing any corneal tissue. This means that the procedure is completely reversible and will not hinder any future eye surgeries (should they be needed).
Refractive Lens Exchange (RLE) is a surgical procedure for those who are over forty that may be experiencing new visual changes and want to lessen there dependence on glasses or contacts. Refractive Lens Exchange can be used to correct presbyopia, nearsightedness or farsightedness and is an alternative to LASIK. The surgery is very similar to cataract surgery in that your natural lens is removed and replaced with an intraocular lens (IOL) implant of your choice based on your vision needs and lifestyle goals. The procedure takes the same amount of time as LASIK and requires the same amount of downtime. Unlike LASIK, a significant advantage of refractive lens exchange for patients is that they will no longer need cataract surgery in the future.
Now that you’ve considered the benefits and risks, and fulfilled all of the requirements, it’s time for surgery.
Checkup with doctor
Before the LASIK procedure is undertaken, an eye surgeon will need to carefully test and examine your vision as well as your medical history. Your doctor will be checking your eyes to make sure they’re healthy, and looking for any signs of eye disease and other eye conditions including dry eye.
If you have a medical history of any of these conditions or notice any unusual symptoms in your eyes before surgery you should make sure your surgeon is informed, as it may affect the desired outcome of your surgery.
The surgeon will also need to take measurements of your eye to ensure that the surgical procedure is precise. In order to make sure the surgery goes smoothly, your surgeon may ask you to take a few precautions before the procedure such as:
Possibly: Stop wearing contact lenses
If you normally wear contact lenses, you may need to stop wearing them for a week or two prior to the exam. Contact lenses can change the shape of your cornea, so to make sure that they do not interfere with the measurements taken of your eye prior to surgery it may be best to avoid wearing them. Your doctor will advise you if you will need to do so.
Possibly: Stop wearing cosmetics
Your doctor may also tell you to stop wearing certain cosmetic products for a few days prior to surgery. These products can sometimes interfere with the laser treatment or increase the risk of infection after surgery.
You should arrange to have someone take you home after the surgery as your vision may not be as good as it normally is immediately after the surgery.
The procedure itself is quick, but you will need time to rest and recover afterwards. Most patients will be able to resume normal activities within a day or two, but your doctor may advise waiting several days before you resume a normal work schedule, exercise, or strenuous activity.
Although the LASIK procedure itself is relatively painless, and anesthetic eye drops will be used to ensure that you do not feel any discomfort, some patients will experience mild pain in the first day or two after the procedure as their eye heals. This pain is usually easily managed with painkillers and aftercare.
Prescription Eye Drops.
You will receive eye drops to help care for your eye these will prevent infection, inflammation, and dryness in the eye as it heals. It’s important that you follow the instructions that your doctor gives you and take these eye drops as often as prescribed.
After your surgery, you will need to look after your eyes carefully. Avoid rubbing your eyes, which could cause the corneal flap to move out of place. The surgeon may have placed a protective shield over your eye to help protect the cornea, but you may find that you only need this shield at night to prevent you from rubbing the eye accidentally during sleep.
Following your post-op instructions are just as important as the procedure to ensure long term results. Patients are typically seen the day after surgery, one week, one month, three months, six months, and one year after the procedure is completed to ensure there are no changes and your vision has remained stable.
Prescription eye drops that include a steroid and antibiotic will be used daily for one week to decrease any inflammation and risks of infection. We also recommend to avoid swimming in public pools for four weeks and to wear no makeup around the eye area for one week after the procedure.
With LASIK, there is little to no downtime; however, you should keep in mind that it can take up to six months for your vision to stabilize completely. During this period, you should monitor your eye health carefully, and see your eye doctor if you experience any unusual symptoms.
If you have private health insurance, it may cover (or partially cover) the cost of LASIK eye surgery. However, it is important to be aware that in the majority of cases, private insurance does not cover LASIK surgery costs. This is because the procedure is often considered to be elective or cosmetic surgery. However, there are some situations where you may be able to have part of the cost covered. In some cases, patients who are unable to wear glasses or contact lenses for medical reasons may be able to present a case to their insurer. So it is best that you discuss your options with your insurer.
If you find that your insurance will not cover the costs, you will need to pay for the surgery in full. The cost of LASIK will vary on several factors, depending on market conditions and the surgeon’s fee.
If you would like to know more about the cost of LASIK surgery, you can get in touch with Milan Eye Center today and book an appointment. Your initial consultation is free and will be used to determine whether or not you are a good candidate for this procedure.
LASIK laser eye surgery is one of the most common, safe and effective elective surgical procedures performed in the United States today. If you have a refractive error condition and are looking to have surgery to correct your vision and reduce your dependency on glasses or contacts, we would love to hear from you.