LASIK 

What is the procedure and how is it performed?

LASIK is a surgical procedure that improves vision by changing the shape of the cornea. The cornea is a clear lens-like structure the sits in the center of the eye. The procedure is done under local anesthesia by placing a drop of numbing medication unto the eye. You are awake but should not feel any pain. An incision (cut) is made in the cornea to create a hinged flap that is then lifted up. A computer-guided laser is used to remove lens tissue until the desired shape is achieved. During the procedure, which takes about 30 minutes, you will be sitting in a reclining chair. There will be some discomfort and a sensation of pressure. You will be asked to stare into a light and you will experience blurred vision but the procedure is usually well tolerated by most patients.

Why is the procedure performed?

The procedure is done to reduce the need for glasses or contact lenses. The benefit is that vision can be corrected surgically and the need for glasses or contact lenses may be reduced or eliminated. In most cases both eyes will need to have the procedure done and this may mean you will have to go through the procedure twice. There are surgeons who prefer to do both eyes at the same time. There are both advantages and disadvantages to this and you should discuss them with your surgeon. You should know that there is no guarantee that your vision will improve. Complications are rare but possible and there is a small chance your vision could get worse. Even when surgery goes well some patients still require glasses or contact lenses. It is very important to have realistic expectations. You should discuss the goals, limitations, and risks of the procedure openly with your surgeon. Finally, be aware that insurance plans usually do not cover this procedure.

What should I expect during the post-operative period?

After surgery a shield is placed over the eye. You will need to have someone drive you home. There may be a sensation of itching, burning or a foreign body in the eye. It is very important to avoid the temptation to rub the eye. There may be mild pain. You should take pain medication as prescribed by your doctor. Your surgeon will see you after the first day to remove the patch and check your vision. You will be given eye drops and/or ointment to use in the eyes. Follow the instructions carefully. Eye discomfort will clear in about 3 days. Blurred vision, sensitivity to light, and tearing are to be expected in the first few days after surgery. You may experience a glare or halo effect around bright lights. This may be especially bothersome if you are driving at night. Most of these visual distortions will clear in about a week. If at any time you experience severe pain or notice your vision getting worse you should call your doctor. You will be able to return to work in 2 to 3 days. You should avoid any strenuous activity for the first week and any contact sports for the first month. You should also avoid swimming, saunas, or hot tubs for the first month. Because your eye has changed shape you will not be able to use your old contact lenses after LASIK. Avoid creams, lotions or eye make-up for about two weeks after surgery. It may take 3 to 6 months until you vision is completely stabilized after LASIK. During this time you may experience some episodes of mild visual fluctuation or distortion.

What are the risks and complications of this procedure?

There are also particular risks associated with the procedure(s) proposed. These risks include but are not limited to:

• Infection
• Delayed Healing
• Undercorrection/Overcorrection of Vision
• Decreased Vision: Some patients may actually lose vision in such a way that correction with glasses, or surgery is not possible.
• Abnormal Visual Symptoms: In some cases glare, halos, double vision and decreased ability to see at night develop and persist after surgery.
• Regression of Improvement: Some may find that the benefits achieved gradually lost over several months following surgery.
• Dry Eye: In some cases the surgery results in an inability to produce enough tears to keep the eye moist. This may cause irritation, blurred vision and require permanent use of moisturizing eye drops.
• Flap Damage, Displacement, and Distortion: The surgical flap created on the cornea may become damaged, displaced or distorted during healing or may fail to heal properly.
• Corneal Scarring: The surgical flap created on the cornea may become displaced during healing or may fail to heal properly. This may result in scarring of the cornea and may require another surgical procedure.
• Incomplete Procedure: May require additional procedures.
• Long Term Safety: It is important to be aware that this is a relatively new procedure. Therefore, the effectiveness and safety of this procedure can not yet be evaluated by long-term data.

Before you agree to any operative procedure it is important to remember that each patient is different and that the outcome of any surgical procedure can never be guaranteed. You should understand that there may be complications that have not been mentioned and that it is not possible to anticipate all complications or to answer each and every question. Again, you should be aware that in the practice of medicine unforeseen and unexpected risks or complications not previously discussed may occur. You should also understand that during the course of the proposed procedure(s), unforeseen conditions may be revealed requiring the performance of additional procedures, and such procedures may need to be performed.

Keep in mind that there is no substitute for an open and honest discussion with your own surgeon/physician regarding this procedure.

You should also be given any available treatment alternatives to this procedure by your doctor. Be sure to discuss any questions or concerns with your doctor.

Copyright 2007, MD Kiosk