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Before
Surgery
If you are considering
LASIK eye surgery, your first step is to choose a good
surgeon.
Your doctor will examine
your eyes to determine exactly what kind of vision
correction you need, and how much laser ablation is
required. A corneal topographer will be used; this
device photographs your eye and creates a kind of "map"
of your cornea. No one has a perfectly rounded cornea,
and the topographer will display the corneal
irregularities and the actual steepness or flatness that
the surgeon must correct.
Patients may not use soft
lenses for at least ten days or use gas permeable lenses
for three weeks prior to treatment.
During Surgery
LASIK is an ambulatory
procedure; you walk into the surgery center, have the
procedure, and walk out again. In fact, the actual
surgery usually takes less than a minute, and you're
awake the whole time. Occasionally, a mild oral sedative
is given beforehand.
Most people don't feel pain
during LASIK surgery. Your eyes are first anesthetized
with special drops ensuring that the patient feels
absolutely no pain during the procedure. The doctor will
have you lie down, then make sure your eye is positioned
directly under the laser. (One eye is operated on at a
time.) A kind of retainer is placed over your eye to
keep your eyelids open -- normally, this is not
uncomfortable. It has a suction ring that keeps your eye
pressurized, important in LASIK for allowing the surgeon
to cut the corneal flap. The surgeon will use an ink
marker to mark where the flap should be placed. The cut
is then made with the keratome. During the procedure you
won't actually see the creation of the flap, which is
very thin.
The doctor uses a computer
to adjust the laser for your particular prescription.
The laser �locks� onto the eye during the procedure so
that the treatment �s not disrupted, eve if the patient
moves the eye. You will be asked to look at a target
light for a short time while he or she watches your eye
through a microscope to make sure it remains in the
correct position while the laser sends pulses of light
to your cornea that painlessly remove the tissue. The
higher your prescription, the more time the surgery will
take.
Different types of
corrective eye surgery require different kinds of post-operative
treatment, because each procedure has its own healing
issues and potential side effects.
What is true for all
surgery is that you follow your doctor's instructions to
the letter! Get proper rest, don't drive if you're not
supposed to, fill and use any necessary prescriptions,
and call your doctor immediately if you suspect a
problem. What occurs after the surgery can affect your
vision just as much as the surgery itself.
What Happens Right After
Laser Eye Surgery?
After resting, you can go
home, where you should relax for at least a few hours.
Someone else must drive you home. You may be able to go
to work the next day, but many doctors advise a couple
of days of rest instead. They also recommend no
strenuous exercise for up to a week, since this can
traumatize the eye and affect healing.
The corneal flap should re-adhere
to the eye right after LASIK (Your doctor will check
this.) You shouldn't rub your eye, but if you
accidentally do, the chance of dislodging the flap is
low. The day after surgery, patients also return to the
clinic for a follow-up examination
Longer Term
If you had PRK, avoid
rubbing your eye for a much longer time (your doctor
will tell you how long). In fact, you will be examined
just about every day to make sure the epithelium is
healing properly. You will probably wear a special "bandage"
contact lens, use antibiotic drops for a few days, and
apply anti-inflammatory drops for several weeks.
With LASIK surgery, you
will probably notice improved vision right away; some
people see their vision gradually improve even more over
the next few days or even months. On a rare occasion,
people will experience improvement, then notice a
gradual worsening of vision (called "regression"). If
this happens, you'll want to discuss it with your
surgeon to determine if more surgery (referred to as
enhancements or "touch-ups") will be necessary.
Most people achieve 20/20
or better vision with LASIK and PRK. Some may achieve
only 20/40 or not quite as good. They may still need
glasses or contact lenses, though their prescription
level will be much lower than before.
Post-operative
complications can include infection and/or night glare (starbursts
or halos that are most noticeable when you're viewing
lights at night).
Even if you see perfectly
after laser eye surgery, or another type of corrective
eye surgery, you may still need reading glasses or
bifocal contact lenses once you hit your 40s. This is
because your eyes will continue to change as you age,
and no one can avoid presbyopia, which occurs when the
crystalline lens in your eye becomes stiffer. Your
distance vision will probably remain crisp, but seeing
up close will be more difficult. However, researchers
are studying ways to correct presbyopia surgically, so
it is possible that you could have one of those
procedures later, once they are FDA-approved.
All of these are important
topics to discuss with your surgeon before deciding on
the surgery. |
