LASIK Eye Surgery (cont.)
What should I expect before, during and after surgery?
What you should expect
before, during, and after surgery may vary slightly from patient to patient and
from surgeon to surgeon; however, the information listed below is a general
guideline for the LASIK process. Each patient may also have slightly different
expectations, and it is important to talk to your eye doctor about these
expectations before surgery.
Before surgery
Prior to any procedure, you will need a full eye examination by
your eye doctor. This process will help determine if you are a good candidate
for surgery and whether you have certain risk factors listed above. If you wear
contact lenses, you should take them out for many days before your initial
examination and use your glasses full-time. This is important because contact
lenses will change the shape of your cornea, and if your cornea has not had
enough time without the contact lenses, then the measurements taken before
surgery may be inaccurate. You should discuss the amount of time you are
required to be out of your contact lenses with the surgical center performing
your evaluation.
During your initial examination, you should talk to your eye
doctor about your past and present medical and eye conditions, including any
previous eye surgery or trauma. It is also important to discuss all medicines
you are taking, including over the counter medicines, as these can sometimes
affect your vision or surgery. Also be sure to mention any medication allergies
you have.
During this eye exam, your doctor should discuss certain topics with
you, including whether you are a good candidate for refractive surgery. He or
she should discuss the risks, benefits, and alternatives of the surgery, and
what you should expect before, during, and after the procedure. Your doctor
should also explain what will be expected from you before, during, and following
the surgery.
It is quite important that you ask questions during this
examination, and ideally you should already have the questions you want answered
in mind before your examination. You will need to think about all of the risks
and benefits and take time to review handouts that are provided to you by your
doctor. After you have had plenty of time to think about these issues and had
all of your questions answered, you will need to sign an informed consent form.
It is not recommended to have your initial evaluation and surgery performed on
the same day, as this does not give you enough time to fully contemplate your
decision. It is also not ideal to first meet your surgeon on the day of surgery,
because this again does not give you ample time and opportunity to ask the
questions only your surgeon can answer before your procedure.
On the day of the
surgery, you will need to avoid using all lotions, creams, makeup, and
perfumes. Some of these items build up on the eyelashes and may increase your
risk of infection, while others (lotions and perfumes) can affect the function
of the laser. In an effort to clean your eyelid margin, your doctor may ask that
you scrub your eyelids and lashes with a gentle soap that is safe for the eyes
prior to surgery.
You will also need to arrange for transportation to and from
the surgery center both on the day of surgery and for your first follow-up visit
the following day. You will not be allowed to drive yourself home after surgery
under any circumstances.
During surgery
LASIK eye surgery normally takes less
than 30 minutes to perform surgery on both eyes. You will be taken to the
surgical suite and placed into a reclining chair or bed where you will lie on
your back. The laser system consists of a microscope that is attached to a large
machine and a computer screen.
After you are lying down and have been positioned
underneath the laser, numbing eye drops will be placed in your eyes, and the
area around your eyes will be cleaned thoroughly. After your surgical team,
including your surgeons and assistants, have reviewed and confirmed all of your
treatment information, a lid speculum will be placed to keep your eyelids open
during the surgery. When it is time to create the LASIK flap, a suction device
will be placed on your eye that will fixate it. During this period, you may feel
pressure that may be somewhat uncomfortable, and your vision will go dark for a
brief period of time. Your doctor will then use the microkeratome to create the
corneal flap. After the flap has been created, the microkeratome will be
removed, the suction will be off, and your vision will return, although it will
likely remain blurry for the remainder of the procedure.
Your doctor will then
carefully move the flap in order to expose the underlying corneal tissue. Any
excess moisture on the tissue will be dried, and your underlying corneal
thickness will be measured. The laser apparatus will then be positioned over
your eye. Your doctor will ask you to stare directly at the light. It should be
noted that the light you are staring at is not the laser that is being used for
the surgery and may have different colors based on the specific laser being used
for your treatment. This light is simply used so that your eye will remain in a
fixed position.
The laser will be started by your doctor once your eye is in a
satisfactory position. Do not be alarmed if you notice ticking sounds and new
smells during this part of the procedure. The ticking sound is the sound of the
laser pulses and the smell, which has been described by some as that of burning
hair, is the evaporation of fluid from your cornea during laser ablation. The
amount of laser treatment time varies among patients but is usually less than 60
seconds. After the appropriate amount of corneal tissue has been ablated by the
laser, the corneal flap is gently placed back down into its original position.
To protect your eye, a shield will be placed around your eye. This is to prevent
you from accidentally rubbing your eye or putting any pressure onto your eye.
Your cornea is especially vulnerable in this early postoperative period, which
is why it is very important to keep your eye protected. If you are having both
eyes treated during the same surgery, the surgeon will reposition the laser over
your other eye and the same process will be repeated for the second eye.
After
surgery
As soon as the procedure is finished, you may notice that your eyes feel
irritated, burn, itch, or feel like there is something in them. Your eyes will
frequently water or tear excessively, and your vision will be somewhat blurry.
The most important thing to avoid during this time is rubbing your eyes. Do
not rub your eyes under any circumstances, as rubbing can dislocate or shift the
corneal flap, which could require you to have an additional procedure to
reposition it. Using copious artificial tears and resting with your eyes closed
will most effectively ease these sensations. In some instances, there may be
increased discomfort or even a mild degree of pain, for which your doctor may
advise you to take a pain reliever. In most cases, nonsteroidal
anti-inflammatory drugs, such as ibuprofen, are enough to relieve the pain. In
addition to artificial tears, you will have antibiotic drops and
anti-inflammatory drops (steroids) to use beginning on the day of surgery that
you will continue to use for days to weeks after surgery.
Other symptoms you may
notice immediately after surgery include light sensitivity, hazy vision, glare,
seeing starbursts or halos around lights, and reddened or bloodshot eyes. All of
these symptoms should improve over the first few days following surgery. It is
very important that you contact your doctor immediately on the first night after
surgery if you are having severe pain or if your vision is getting worse and not
better. You do not need to wait until your first follow-up visit if you are
experiencing either of these things.
Your first postoperative visit should be
scheduled within the first 24 hours following surgery. At that visit, your
doctor will check your vision and examine your eyes. You will continue to use
your antibiotics and steroid drops as well as artificial tears. Your vision
should be clearer but may still be blurry the first few days after surgery, and
you may need to adjust your work or travel schedule or even take some time off
after surgery to fully recuperate.
You should ask your doctor how long you need
to wait to start participating in sports again, such as walking or jogging. In
general, you should wait anywhere from one to three days following surgery to
restart low impact sports, and avoid any possible eye trauma, such as more
competitive sports, for a minimum of two or more weeks. In addition, it is
unwise to expose yourself to eye infection risks such as pools, lakes, or hot
tubs during the early healing process. Your surgeon will tell you when you can
resume these activities.
As mentioned earlier, lotions, creams, makeup, and
perfumes can often cause buildup on the eyelids and may increase the risk for
infection. Ask your doctor when it is advisable to resume use of these products.
Typically, your vision will stabilize within the first week or two, but it may
continue to change over the first couple of months following surgery. It may
take anywhere from three to six months for your vision to stabilize completely.
Other visual symptoms, such as glare, seeing halos, and difficulty driving at
night, may continue during this stabilization period. Additional treatments, or
enhancements, may be needed after surgery, but the stability of your cornea will
need to be established before any repeat treatments are performed. Before
enhancements are considered, you should have had consistent eye measurements at
two consecutive visits. When considering additional treatments, you should know
that while it is likely that your vision can be improved by enhancements, just
as with the initial surgery, there are no guarantees, and there are still risks
associated with having surgery.
You should not hesitate to call your eye doctor
immediately if you develop worsening or unusual symptoms at any time after
surgery. These symptoms could be a sign of a serious problem that could result
in loss of vision if not treated properly in a timely fashion.
Next: What are the advantages of LASIK surgery? »
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