Lasik eye surgery
If youre tired of wearing glasses or contact lenses, you may be considering Lasik eye surgery. Lasik is one of the newest procedures to correct vision problems. Before you sign up for lasik surgery, be sure to get a clear picture of what you can expect.
What is Lasik?
Lasik is eye surgery to a very delicate part of the eye.
Hundreds of thousands of people have had Lasik, most very successfully. As with any surgery, there are risks and possible complications. Lasik may not give you perfect vision.
The American Academy of Ophthalmology (AAO) reports that seven out of 10 patients achieve 20/20 vision, but 20/20 does not always mean perfect vision. If you have Lasik to correct your distance vision, you may still need reading glasses.
Lasik surgery is too new to know if there are any long-term ill effects beyond five years after surgery.
One of the cautions about Lasik surgery is that it cannot be reversed. Most insurance companies do not cover the surgery. While Lasik is very advanced, you may need additional surgery to get the best possible vision after Lasik eye surgery.
About the eyes
To see clearly, the cornea and the lens must bend, or refract, light beams so they focus on the retina. The retina is a layer of light-sensing cells that line the back of the eye. The retina converts the light rays into impulses that are sent to the brain, where they are recognized as images.
If the light rays dont focus on the retina, the image you see is blurry. This is called a refractive error. Glasses, contacts and refractive eye surgery attempt to reduce these errors by making light rays focus on the retina.
Refractive errors are caused by an imperfectly shaped eyeball, cornea or lens, and are of four basic types:
Myopia - nearsightedness - only nearby objects are clear.
Hyperopia - farsightedness - only objects far away are clear.
Astigmatism - images are blurred at a distance and near.
Presbyopia - also known as aging eye. This condition usually occurs between ages 40 and 50, and can be corrected with bifocals or reading glasses.
Lasik is not for everyone
You should be at least 18 years old (21 for some lasers), since the vision of people younger than 18 usually continues to change due to physical immaturity.
You should not be pregnant or nursing as these conditions might change the measured refraction of the eye.
You should not be taking certain prescription drugs, such as Accutane or oral prednisone. Your eyes must be healthy. If youre myopic, you should postpone Lasik until your refraction has stabilized, as myopia may continue to increase in some patients until their mid- to late 20s. You should be in good general health.
Lasik may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. You should discuss this with your eye
surgeon.
Weigh the risks and rewards. If youre happy wearing contacts or glasses, you may want to forego the surgery.
Understand your expectations from the surgery. Ask your doctor if youre a candidate for monovision, the correction of one eye for distance vision and the other eye for near vision. Lasik cannot correct
presbyopia so that one eye can see at both distance and near. Lasik can be used to correct one eye for distance and the other for near. If you can adjust to this correction, it may eliminate or reduce your need for reading glasses.
In some instances, surgery on only one eye is required. If your doctor thinks youre a candidate, ask about the pros and cons.
Risks and possible complications
Before the surgery, your eye surgeon should explain to you the risks and possible complications, and potential side effects, including the pros and cons of having one or both eyes done on the same day. This is known as the informed consent process. Some risks and possible complications include:
Over- or under-correction. These problems can often be improved with glasses, contact lenses and enhancements.
Corneal scarring, irregular astigmatism (permanent warping of the cornea), and an inability to wear contact lenses.
Corneal infection.
Loss of best corrected visual acuity - that is, you would not be able to see as well after surgery, even with glasses or contacts, as you did with glasses or contacts before surgery. A decrease in contrast sensitivity, crispness, or sharpness. That means that even though you may have 20/20 vision, objects may appear fuzzy or grayish.Problems with night driving that may require glasses.
Flap problems, including: irregular flaps, incomplete flaps, flaps cut off entirely, and ingrowth of cells under the flap.
The following side effects are possible after Lasik eye surgery, but usually disappear over time. In rare situations, they may become permanent:
Discomfort or pain
Hazy or blurry vision
Scratchiness
Dryness
Glare
Haloes or starbursts around lights
Light sensitivity
Small pink or red patches on the white of the eye
Lasik eye surgery: what to expect before, during and after
Before your lasik surgery
You will need a complete eye examination by your eye surgeon. A preliminary eye exam may be performed by a referring doctor (Eye MD or optometrist). Take your eye prescription records with you to the exams.
If your doctor doesnt think Lasik is right for you, you might consider getting a second opinion. However, if the opinion is the same, believe it.
If you qualify for Lasik eye surgery, your doctor may tell you to stop wearing your contact lenses for a period of time before the surgery is scheduled because contacts can temporarily change the shape of the cornea. Your cornea should be in its natural shape the day of surgery. Your doctor also may tell you to stop wearing makeup, lotions or perfume for a few days before surgery. These products can interfere with the laser eye treatment or increase the risk of infection after surgery.
During surgery
Lasik is an outpatient surgical procedure. The only anesthetic usually needed is an eye drop that numbs the surface of the eye. The surgery takes 10 to 15 minutes for each eye. Sometimes, both eyes are done during the same procedure. Sometimes surgeons wait to see the result of the first eye before doing the second eye.
The surgical procedure
A special device cuts a hinged flap of thin corneal tissue off the outer layer of the eyeball (cornea) and the flap is lifted out of the way.
The laser reshapes the underlying corneal tissue, and the surgeon replaces the flap, which quickly adheres to the eyeball. There are no stitches. A shield, either plastic or perforated metal, is placed over the eye to protect the flap.
After surgery
Healing is relatively fast, but you may want to take a few days off after the surgery.
Be aware:
You may experience a mild burning or sensation for a few hours after surgery.
Do not rub your eye(s).
Your doctor can prescribe a painkiller, if necessary, to ease the discomfort.
Your vision probably will be blurry the day of surgery, but it will improve considerably by the next day when you return for a follow-up exam.
If you experience aggravating or unusual side effects, report them to your doctor immediately. Do not drive until your vision has improved enough to safely do so. Avoid swimming, hot tubs and whirlpools for two weeks after surgery.
Alternatives to lasik
You may want to discuss some of the following surgical alternatives to Lasik eye surgery with your eye doctor:
Photorefractive keratectomy (PRK) is a laser eye surgery procedure used to reduce myopia, hyperopia and astigmatism without creating a corneal flap.
Astigmatic keratotomy (AK) is an incisional procedure to reduce astigmatism.
Intrastromal corneal rings are clear, thin, polymer inlays placed on the eye to correct low myopia only.
Compiled by: Dr. Rafiqul Islam
