What You Need to Know About LASIK
Posted by: Delray Eye Associates
After 30 years and 30 million procedures, LASIK has proven to be as much of a paradigm shift in vision correction as the invention of the internet has been to all of life. As technology continues to advance and LASIK becomes more common, the possibility of having to live a lifetime with blurry vision becomes increasingly optional. If you’re reading this article, you or a loved one are probably considering LASIK. There are some things you should know.
History of LASIK
There was a time when the thought of changing or correcting vision was as radical as saying you could change someone’s height or extend their life to 150 years. When researchers discovered they could correct the curvature of the cornea with an excimer laser, thereby correcting vision in the impaired eye, doctors were skeptical. A few short years later, when everyone had seen the results of the FDA clinical trials, the belief system of eye doctors around the world changed. The profession itself and the world of eye care had changed forever.
Types of LASIK Surgery
Laser vision correction consists of two primary types of laser procedures. Both procedures produce the same results of 20/20 vision for the majority of patients. The original procedure is called Photorefractive Keratectomy (PRK). PRK is performed directly on the surface of the cornea, and patients become comfortable and see clearly after three or four days. This is the technique which produced all of the original excitement around people having their vision corrected. It continues to be the procedure of choice for 20-25% of all patients, based upon their individual corneal anatomy.
The term LASIK refers to the second generation of laser vision correction. Prior to 2010, LASIK involved a blade creating a surface flap in the cornea. For the past decade, that blade has been eliminated. LASIK creates a surface flap on the cornea using a femtosecond laser. This laser creates a layer of bubbles to separate the surface layer of the cornea, which is then simply lifted by the surgeon without any blades being utilized. That’s right; there’s no “cutting” involved. This process results in the fastest vision restoration and comfort recovery, often with patients seeing 20/20 the next day.
If having LASIK sounds intimidating to you, why not just have your vision corrected with blinking light vision therapy? Simply watch a blinking light for 35 to 40 seconds and then, after a recovery nap, your vision is corrected for the rest of your life. Does this sound more appealing?
That’s actually a vivid description of what it’s like to have LASIK surgery. It is unfortunate that the word LASIK was the name chosen for laser-based, blinking light vision correction technology. It is a harsh sounding word and does not convey properly what a patient-friendly experience it is. The number one reason people choose to stay in their glasses rather than have their vision corrected is because they find the concept of LASIK intimidating. If people could appreciate the reality of how easy it is to have their vision corrected, far more would be excited to free themselves from glasses and contacts.
The Day of Your LASIK Procedure
Patients are always struck by how anti-climactic their LASIK experience turns out to be. Upon arrival, patients are escorted to a pre-op room where their eyelids are cleansed and they receive their first anesthetic eye drops. After receiving post-op instructions, they meet with the surgeon to ensure all their questions have been answered. From there they are escorted to the room where the treatment process occurs. Typically, the entire procedure is completed in under 10 minutes. The surgeon performs one last examination of the patient’s eyes under a microscope before clearing the patient to be driven home.
LASIK Side Effects
The earliest side effects of LASIK were speechless patients and doctors. No one could believe their eyes. During the original FDA clinical trials, some patients with larger pupils reported glare and/or halos at night, so to this day, glare and halos continue to be listed as potential side effects. What those surveys failed to ask the same patients was, “Did you experience similar glare or halos with your glasses or contact lenses?” It was later discovered that these same patients had indeed experienced similar optical effects while wearing their glasses and contacts. The visual side effects of LASIK are no different than what is normal for a given individual.
Some patients also experience dryness for the first few weeks after LASIK. Most report these symptoms to be similar to the feeling of dryness experienced while wearing their contact lenses. These moderate symptoms are easily managed by most patients with the use of artificial tear drops during the first few weeks after surgery.
Before and After LASIK Surgery
To determine if an individual is eligible for LASIK, a doctor at Delray Eye Associates needs to perform some highly specialized tests to analyze every aspect of a patient’s vision, as well as their corneal anatomy and topography. The goal is to do everything possible to disqualify candidates. If the doctor is unable to find a reason not to perform the procedure, then it’s an ideal indicator that the patient can feel confident about the outcome of LASIK for them. For candidates who are determined to be less than ideal, doctors can recommend an alternate procedure to meet their goals for treatment.
Before their LASIK procedure, patients are usually asked to stop wearing their contacts for three to seven days. This allows the cornea to equilibrate to its most natural state, assuring the best outcome from the surgery.
After their LASIK procedure, patients are instructed to go home and nap for about three hours. This helps patients remain comfortable, because their eyes are expected to sting for a few hours afterward. Usually, doctors provide a sleep aid to help patients fall asleep. After this daytime nap and a good night’s sleep, patients are often able to return to work the next day.
Post LASIK Care
Doctors typically want to see LASIK patients the morning after the procedure, one week later, one month later, and three months later to ensure proper healing is taking place. Often post-operative medicated eye drops are prescribed to be used daily for the first week. After that, most patients only need artificial tears to maintain the moisture of their eyes. Artificial tears also assure the best healing for the cornea.
Night Driving After LASIK
There is mild corneal swelling for 24 to 72 hours after LASIK. The swelling may cause patients to struggle seeing on the road at night. It might look to them like there is a fine mist on the windshield. Oncoming headlights and streetlights can have a faint glow around them for one to two weeks after surgery. After this time, the corneal swelling completely subsides and night vision returns to its original state, equivalent to when glasses or contact lenses were worn.
LASIK with Dry Eyes
It is normal for LASIK patients to have symptoms of dryness that require the use of artificial tears. Most patients can discontinue their artificial tears after a couple of months. Post-op dryness of the cornea results from the corneal nerves becoming desensitized for a short time after the procedure. Corneal nerves sense the moisture level on the surface of the eye and send the signal for tear production to the lacrimal gland. Prior to the cornea fully recovering, the nerves don’t fully transmit their normal signal for moisture production. While this dryness is always present to some degree, some patients feel it and others don’t. This is why all patients are encouraged to give their eyes the extra level of moisture.
LASIK Halo Effect
Because halos around lights were reported in the 1995 FDA clinical trials, they continue to be listed as a possible side effect of LASIK. With advances in treatment over the past 25 years, very few patients have experienced halos. They remain a possibility, though, especially when patients have unusually large pupils which dilate more under dark conditions. With the advanced treatment protocols of contemporary LASIK, halos have become a rare and manageable issue.
The Expanded Benefits of LASIK
Before LASIK, patients talked about the challenges of swimming with contacts or playing sports with glasses. There were added daily routines that included cleaning contacts, keeping up with glasses, renewing prescriptions, and waking up in the middle of the night without being able to read the clock.
People come to their LASIK consultation at Delray Eye Associates excited about how nice it would be to be free from their glasses and contacts. While they are excited to be investigating LASIK, it is impossible for them to imagine living with this incredible freedom after having been limited by their vision for so long.
After LASIK, patients claimthe view is better than they could have imagined. They enjoy the beach more than ever, because they are confident about seeing their kids in the water. The athlete discovers new-found confidence on the field or court, no longer tentative and having to be so cautious, free from the worry of their glasses getting broken.
And then there are the less obvious benefits that people don’t anticipate. It may not be important to see in the shower, but it is nice! It is also so nice for people to see in the mirror without glasses on. And for those who live active lifestyles and struggle to put glasses on under motorcycle or athletic helmets, corrected vision is freeing beyond words.
Now that you know vital things about the LASIK procedure, what’s keeping you from scheduling a consultation? Make an appointment at Delray Eye Associates today. Our team of professionals wants nothing more than for you to see clearly.