Before LASIK Surgery
Your eye doctor will perform a thorough eye exam to ensure your eyes are healthy enough for the procedure. He or she will evaluate: the shape and thickness of your cornea; pupil size; refractive errors (myopia, hyperopia and astigmatism); as well as any other eye conditions.
The moistness of your eyes will also be evaluated, and a precautionary treatment may be recommended to reduce your risk of developing dry eyes after LASIK.
Usually, an automated instrument called a corneal topographer is used to measure the curvature of the front surface of your eye and create a "map" of your cornea.
Your eye doctor will also note your general health history and any medications you are taking to determine if you are a suitable candidate for LASIK.
You should stop wearing contact lenses for a period of time advised by your doctor (typically around two weeks) before your eye exam and before the LASIK procedure, as contacts can alter the natural shape of your cornea.
How LASIK Works
Before your surgery begins, numbing eye drops are applied to your eye to prevent any discomfort during the procedure. Your doctor may also give you some medication to help you relax.
An ultra-thin flap is created on the eye's surface during LASIK. After laser energy is applied to reshape the eye, the flap is replaced, to serve as a type of natural bandage.
Your eye will be positioned under the laser, and an instrument called a lid speculum is used to keep your eyelids open.
The surgeon uses an ink marker to mark the cornea before creating the flap. A suction ring is applied to the front of your eye to prevent eye movements or loss of contact that could affect flap quality.
After the corneal flap is created, the surgeon then uses a computer to adjust the excimer laser for your particular prescription.
You will be asked to look at a target light for a short time while he or she watches your eye through a microscope as the laser sends pulses of light to your cornea.
The laser light pulses painlessly reshape the cornea, although you may feel some pressure on your eye. You'll also hear a steady clicking sound while the laser is operating.
LASIK is performed on each eye separately, with each procedure taking only about five minutes.
You should expect some blurry vision and haziness immediately after surgery; however, clarity should improve by the very next morning.
Your eyesight should stabilize and continue to improve within a few days, although in rare cases it may take several weeks or longer. For most people, vision improves immediately.
You may be able to go to work the next day, but many doctors advise a couple of days of rest instead.
Also, it is usually recommended that you refrain from any strenuous exercise for at least a week, since this can traumatize the eye and affect healing.
Generally, you will return to see your eye doctor or your LASIK surgeon the day after surgery.
At this initial check-up, he or she will test your vision to make sure you are legal to drive without glasses or contact lenses. In most states, this requires uncorrected visual acuity of 20/40 or better.
As with any other surgery, always follow your doctor's instructions and take any medication prescribed. Also, avoid rubbing your eyes, as there’s a small chance this could dislodge the flap until it heals and adheres more securely to the underlying cornea.
Laser eye surgery offers numerous benefits and can dramatically improve your quality of life. Most people achieve 20/20 vision or better after the surgery, but LASIK results do vary. Some people may achieve only 20/40 vision or less.
You may still need to wear glasses or contact lenses following laser vision correction, though your prescription level typically will be much lower than before.
While the procedure has an excellent safety profile, LASIK complications can occur and may include infection or night glare (starbursts or halos that are most noticeable when you're viewing lights at night, such as while you're driving).
A small percentage of people will need a LASIK enhancement, or "touch up" procedure, a few months after the primary LASIK surgery to achieve acceptable visual acuity.
While LASIK surgery has a high success rate, it is important that you discuss all facets of the procedure with your surgeon prior to consenting to the surgery.
PRK was the first type of laser eye surgery for vision correction and is the predecessor to the popular LASIK procedure. Though PRK recovery takes a bit longer than recovery from LASIK eye surgery, PRK is commonly performed and offers some advantages over LASIK.
The main difference between PRK and LASIK is that in LASIK surgery a thin, hinged flap is created on the cornea to access the treatment area, whereas in PRK the cornea's entire epithelial (outer) layer is removed to expose the area and no flap is created. For both PRK and LASIK, the excimer laser then sculpts the stromal layer of the cornea to correct your refractive error.
The final results of PRK surgery are comparable to LASIK outcomes, but initial PRK recovery is slower because it takes a few days for new epithelial cells to regenerate and cover the surface of the eye.
PRK does, however, offer some distinct benefits. Because PRK surgery does not create a corneal flap (which contains both epithelial and the deeper stromal tissues), the entire thickness of the underlying stroma is available for treatment. Therefore there is no possibility of complications in creation of the flap, and the risk of removing too much of the cornea with the excimer laser is reduced.
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