Before deciding to undergo LASIK eye surgery, it’s important to know whether you are a good candidate and whether it’s the right option for you. Do your research to understand all of the risks and benefits, and develop realistic expectations about your vision before and after LASIK eye surgery.
LASIK (laser-assisted in situ keratomileusis) is a popular type of refractive surgery used to treat and correct vision problems. Lasers are used to correct refractive errors, which is when your eyes fail to bend light well, resulting in blurred vision.1
The purpose of having LASIK eye surgery is to treat your refractive errors for improved vision. LASIK surgery can be used to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.1
A possible result after LASIK eye surgery is a reduced need to wear corrective lenses, in the form of glasses or contact lenses. Some patients no longer need them at all after having the procedure.1
This article will help you feel prepared and well-informed as a patient considering laser eye surgery, and know what to expect before and after LASIK eye surgery. Though LASIK has a very high success rate, it is still important to understand what the risks are.
- LASIK is the most well-known refractive surgery used to treat nearsightedness, farsightedness, and astigmatism.
- LASIK eye surgery is successful for most patients, though you may still need glasses or contact lenses after surgery.
- Certain conditions make you a good candidate for LASIK eye surgery so start with an evaluation with an eye doctor (optometrist or ophthalmologist).
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What is LASIK Eye Surgery?
When you have LASIK surgery, your eye surgeon (ophthalmologist) creates a corneal flap using a laser to treat your vision problems. A specialized surgical laser is used to precisely change the shape of your cornea (the dome-shaped clear tissue at the front of your eye) so that light rays are more properly focused on the retina, improving your vision.
In eyes without vision problems, the cornea refracts (bends) light onto the retina properly. The cornea is located at the front of your eye while the retina is at the back. Your retina transforms light into messages sent to your brain, which your brain then interprets as objects and images.1
LASIK eye surgery is a procedure used to treat refractive errors that cause vision problems including:
- Nearsightedness (myopia) is when you can see close-up objects well, but struggle with distance vision, due to corneas that are too curved.
- Farsightedness (hyperopia) is having blurry vision close-up, and sometimes distance as well, due to flat corneas.
- Astigmatism means your eyes have trouble focusing on both near and far objects, due to a cornea that is unevenly curved.
After LASIK you may be able to see clearly without the need for glasses or contact lenses.
Are You a Good Candidate for LASIK Eye Surgery?
For the best outcome, consider the following criteria to determine whether you are a good candidate for LASIK surgery. If you wear corrective lenses and believe you could be a good LASIK candidate, start with an appointment with an eye surgeon.
The general requirements to be considered a good candidate for LASIK surgery are:1
- Being over the age of 18, though over 21 is preferable as your vision should have stabilized
- Your prescription for corrective lenses has not changed dramatically over the previous year
- You have a refractive error that can be treated by LASIK eye surgery: nearsightedness, farsightedness, or astigmatism
- Your corneas are thick enough for laser surgery, and your eye health is optimal
- You are realistic about the risks and benefits before and after LASIK eye surgery
The following conditions may result in a poor outcome, with greater risk factors, after LASIK eye surgery. People with these medical or eye issues may not make good LASIK candidates:
- Refractive errors that are unstable
- High degree of nearsightedness, farsightedness, or astigmatism
- Dry eye disease
- Thin corneas or cone-shaped corneas (keratoconus)
- Corneal disease or corneal scars
- Cataracts that affect your vision
- Glaucoma diagnosis
- Certain eye infections, eye injuries, or eye diseases in your medical history
- Poorly controlled diabetes
- Having rheumatoid arthritis or other autoimmune disorders
- Weakened immune system
- Regularly participation in contact sports that leave your eyes and face at risk of injury
- Women who are pregnant or breastfeeding, as pregnancy can cause vision changes
Speak with your eye doctor about your medical history and any concerns you have about your risk factors before and after LASIK eye surgery. Your eye doctor can determine whether you are a good candidate for LASIK or if a different refractive surgery, such as laser PRK surgery, would be a better option to match your needs.
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Evaluation Before LASIK Eye Surgery
Your first step before LASIK eye surgery will be a thorough eye examination and LASIK evaluation by an ophthalmologist (eye surgeon) to determine whether or not you are a good candidate.
Patients with the highest success rate after LASIK eye surgery are carefully screened before LASIK eye surgery to ensure they are likely to have long-term positive results.
As part of your LASIK consultation, your eye doctor will conduct a comprehensive eye examination to assess your vision and determine whether you have any risk factors that would make eye surgery a bad option for you. He or she will ask about your medical history and any previous eye surgeries as well.
Your eye doctor will measure and evaluate the corneas of your eyes to determine the areas that need reshaping. The surgeon will analyze the shape, contour, and thickness of your corneas and note the amount of corneal tissue that would be removed during the LASIK procedure.
Scanner technology may be used to create a digital map of your eyes so that precise measurements can be made before and after LASIK eye surgery.
Some of the concerns and risk factors your eye doctor will look for before surgery are:
- Dry eye symptoms
- Large pupil size
- Thin corneas
- High eye pressure
- Eye infections
- Unusual eye discharge
- Other abnormalities
If you are a good candidate, your eye doctor will also go over the risks and what to expect before and after LASIK eye surgery.
Risks to Consider Before and After LASIK Eye Surgery
Serious complications after LASIK eye surgery are rare. However, there are side effects that are fairly common for most patients. In most cases, side effects are mild and temporary, however, there is a chance that side effects can be permanent.
Common risks and side effects after LASIK include:
- Dry eyes due to reduced tear production and increased tear evaporation. Artificial tears can be beneficial for reducing dry eye discomfort. However, if you develop severe dry eye disease, your eye doctor may recommend a punctal plugs procedure to stop your tears from leaving the surface of your eyes too quickly.
- Glare, halos around bright lights, light sensitivity, and double vision. Your vision at night or in dim light may be reduced in the days or weeks immediately after LASIK eye surgery.
- Under-corrections and over-corrections are caused by the laser removing too little or too much corneal tissue from your eye. A second LASIK surgery can fix under-corrections, however, over-corrections are difficult to repair.
- Astigmatism after LASIK eye surgery is due to the uneven removal of corneal tissue by the laser. To correct astigmatism, you may need another refractive surgery or will require glasses or contact lenses.
- Poor healing of the corneal flap created during LASIK can result in eye infections and watery eyes.
- Vision loss, regression, and unpredictable vision changes are also possible in rare cases.
Preparation Before LASIK Eye Surgery
Once approved for surgery, it is important to follow your doctor’s recommendations to prepare before LASIK eye surgery.
The steps to prepare for your surgical procedure may include:
- Understanding the cost of LASIK eye surgery. The procedure is considered elective surgery, and therefore, not usually covered by medical or vision insurance. Ask your LASIK surgeon about the charges to expect so that you are prepared to cover the costs.
- Making arrangements for a ride before and after LASIK eye surgery. You may feel side effects due to the medications used and you may experience blurry vision after the procedure, and it will not be safe to drive.
- Stop wearing contact lenses. Your ophthalmologist will likely instruct you to wear glasses instead of contact lenses for weeks before surgery.
- Keeping your eyes clean. Avoid the use of creams, lotions, and eye makeup the day before and after LASIK eye surgery. You may be told to use eyelid wipes to clean your eyelids and eyelashes in the days before surgery. Good eyelid hygiene can minimize your risk of infection after eye surgery.
The better you follow your eye doctor’s instructions, the more likely you will have a good experience before and after LASIK eye surgery.
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How LASIK Surgery is Performed
LASIK surgery takes approximately 10-15 minutes per eye in your ophthalmologist’s office or an outpatient surgical center. You will sit in a reclining chair or bed that allows your eye surgeon to easily reach your eyes.
The procedure generally follows these steps:1
- First, your eye surgeon will place eye drops that numb your eyes before starting the procedure.
- Your ophthalmologist will then place a device to hold your eyes open and a suction ring to keep your eye from moving. There will be a mild feeling of pressure and you may notice your vision dims.
- Using a microkeratome (surgical cutting blade) or a laser, your ophthalmologist cuts a thin corneal flap to gain access to the corneal tissue beneath.
- During surgery, you will focus on a targeted light source to keep your eyes still while the eye surgeon uses a programmed laser to reshape your cornea. The laser makes a clicking sound as it works and you may notice a smell like burning hair while the laser cuts.
- After your eye surgeon is done reshaping your cornea, the corneal flap is folded back down. The flap will re-attach without the need for stitches, and begin healing.
The best thing to do after LASIK eye surgery is to rest and let your eyes heal.
Eye Care After LASIK Eye Surgery
It’s normal to experience discomfort in the hours, or even days, after LASIK eye surgery. Your eyes may be watery, itchy, and have a gritty feeling. There may be a burning sensation and mild eye pain. You will be able to see after surgery, but will likely have blurred vision which will gradually improve.
Your eye surgeon may prescribe pain medication, suggest over-the-counter eye drops, or recommend using artificial tears to reduce discomfort and support healing. You may be told to wear an eye shield while sleeping until your eyes have fully healed.
Your first post-surgical follow-up appointment will be 24-48 hours after LASIK eye surgery. This is important to assess any complications and to make sure your eyes are healing as expected. You will return again in a few weeks for another follow-up with your eye surgeon. It can take a few months for your eyes to heal after surgery and your vision correction to settle in.
Be careful to keep your eyes clean of make-up, creams, and lotions, and avoid swimming, hot tubs, and contact sports for as long as your eye doctor recommends.
Get plenty of rest before and after LASIK eye surgery for the best results, and follow your eye surgeon’s guidance for healing and recovery.
In most cases, you will be able to resume work within a few days after your surgical procedure. However, resting your eyes is still important in the first weeks to reduce eye strain and promote healing.
Results to Expect After LASIK
It’s possible you will notice improved vision immediately in the days following refractive surgery, though for some patients it may be months before your eyesight improves. Some patients achieve 20/20 vision, or better, after LASIK, though this is not guaranteed.
Depending on the state of your corneas before and after LASIK eye surgery, you may still need to use glasses for reading, or wear contact lenses, after the procedure.
For 8 out of 10 LASIK patients, refractive surgery eliminates the need for glasses or contact lenses entirely.2
Your own vision correction results depend on the refractive errors you had before LASIK eye surgery
In rare cases, some LASIK patients’ eyes gradually regress to the original refractive errors that were present before LASIK eye surgery. This may be caused by poor healing, hormonal imbalances, or the development of cataracts.
Side effects after LASIK can be temporary or permanent. The most common side effects are:1
- Eye pain and discomfort
- Foggy or blurry vision
- Gritty or scratchy feeling in the eyes
- Discomfort due to glare and sensitivity to light
- Seeing halos around lights
- Pink or red spots of blood of the whites of the eyes
Another possible outcome after LASIK eye surgery is vision under-correction or over-correction. You may opt to wear glasses or contact lenses or have additional refractive surgery to correct your vision.
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Complications After LASIK Eye Surgery
Serious complications after LASIK are rare. Choosing the right eye doctor, having a thorough evaluation, and following all instructions before and after LASIK eye surgery, can minimize your risk factors. Also, be sure to allow yourself a long rest period after your procedure.
Though rare, possible complications after LASIK eye surgery include:1
- Eye infections
- Vision that is worse than before surgery, even with the use of eyeglasses or contact lenses
- Partial or complete blindness
The FDA proposes clearer warnings for patients before and after LASIK eye surgery. They warn that the risks include double vision, dry eyes, long-term eye pain, and depression. The FDA also stresses that patients may still need to wear glasses or contact lenses after LASIK.3
Your Vision After LASIK Eye Surgery
The best post-operative results tend to be in people who have minimal nearsightedness before LASIK eye surgery. If you have a high level of nearsightedness or you have farsightedness, your results will vary. The same is true for patients with astigmatism.1
The majority of patients (90%) enjoy vision between 20/20 and 20/40 after LASIK eye surgery. With these results, they no longer require glasses or contact lenses for most activities.1
However, keep in mind that LASIK is not able to correct presbyopia. Presbyopia is the normal decline of close-up vision due to aging. After the age of 40, most people require reading glasses to focus on close-up activities, even if they have refractive surgery and good distance vision.1
Putting It All Together
The more you know before and after LASIK eye surgery, the better prepared you will be for this surgical procedure.
After years of wearing glasses or contact lenses, you may be comfortable with the routine and choose not to face the potential risks of having LASIK surgery. Discuss the benefits and risks with your ophthalmologist before making a decision about having refractive surgery.
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