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LASIK is a surgical procedure, used to correct focus issues that can lead to blurred vision. LASIK eye surgery is meant to help people who struggle to see clearly without the use of glasses or contacts.
LASIK is one of the safest and most effective surgical procedures available. LASIK has a 96% patient satisfaction rate. Current research indicates that LASIK has a 99% success rate in achieving 20/40 vision or better, and a 90% success rate in achieving 20/20 vision or better.
The risk of potential complications is quite low, and your doctor can help you to better understand the risks versus benefits.
LASIK Eye Surgery Explained
Every image we see begins with light. That light is bent and focused by the cornea, and it is directed toward the retina at the back of the eye. If the focus of the light is not precise, the images we perceive can be hazy or fuzzy.
During laser-assisted in situ keratomileusis (LASIK) procedures, surgeons reshape the cornea. The goal of this surgery is to reduce focusing errors, so images are sharper than they were prior to surgery. As the American Academy of Ophthalmology points out, LASIK allows most people to perform everyday tasks without glasses or contacts. People may not have perfect 20/20 vision after surgery, but they may be able to see well enough that they will not need to wear corrective devices all the time. However, most patients do achieve 20/20 vision or better.
During the procedure, a surgeon creates a thin flap in the cornea and lifts that flap back. A laser beam is focused on the stromal bed and a precise amount of tissue is removed painlessly within a few seconds. The flap is placed back down at the end of the procedure. Corneal tissue heals quickly, so surgeons do not need to use stitches or bandages to hold the flap in place. Tissues will knit together in time.
All LASIK eye surgeries follow this same basic procedure, but there are some forms of LASIK that have subtle variations. For example, according to the U.S. Food and Drug Administration (FDA), some LASIK surgeons use a microkeratome or similar cutting tool to create the corneal flap at the beginning of the procedure. Those who use all-laser LASIK use a laser to create that flap. Wavefront LASIK procedures involve personalized mapping and treatment of the cornea, allowing for tiny imperfections in corneal shape to be corrected, resulting in sharper vision.
LASIK is not the only surgery available to help with vision issues. There are other procedures that can help to reshape eye anatomy and ensure that light is focused as precisely as possible. Some ophthalmologists offer a full suite of surgeries, so they can match the proper type of procedure to a patient who needs help while others specialize in just one type of surgery.
Who Can Benefit From LASIK Eye Surgery?
LASIK is meant to help people who struggle to see clearly without the help of glasses or contact lenses. According to research conducted in 2013 by Consumer Reports, 80 percent of people who had LASIK were either "very satisfied" or "completely satisfied" with the results of their surgery.
Nearsightedness, or an inability to see things at a distance without the help of glasses or contact lenses, is a common focus of LASIK procedures. Nearsightedness stems from a light focus that is too short. The focused image lands in the center of the eye rather than on the back of the eye. Removing corneal tissue with LASIK can move the focus of light to the retina, resulting in sharper images.
In a study in the journal Clinical Ophthalmology, researchers found that 99 percent of people with nearsightedness treated with LASIK achieved 20/20 vision without glasses. These people reported few post-operative complications, and they were satisfied with their ability to see after surgery.
Farsightedness, or an inability to see things close up without glasses or contact lenses, stems from a light focus that is too long. The focus is behind the retina, so the resulting image seems blurry and indistinct. Farsightedness can be caused by a cornea that is flat, rather than round, and that surface can be adjusted with LASIK.
In a study of the efficacy of LASIK eye surgery on different types of vision problems, researchers found that 97.4 percent of people with farsightedness had corrected vision with LASIK. Research like this suggests that LASIK can be an excellent option for some people who struggle with farsightedness.
Other studies suggest that a small number of people who are farsighted might not have as much benefit from surgery when compared to people who are nearsighted. According to Graefe's Archive for Clinical and Experimental Ophthalmology, the unusual shape of the eye that causes farsightedness can, at times, return after LASIK surgery. When that happens, people might need to undergo another enhancement to amend the issue. People with nearsightedness have a lower risk of this concern.
Regardless of the issue that causes a vision problem, glasses and contact lenses have been considered traditional tools that can sharpen vision. While they are effective, these tools can be a hassle for some people. Glasses are sometimes heavy, and they can fog up in warm rooms or slip down during exercise. Contact lenses require cleaning and disinfection, and they can be uncomfortable for some people to wear. In addition, contacts and glasses could be poor choices for people with:
- Allergies of any kind.
- Skin or eye sensitivities.
- An active lifestyle.
- Anatomical issues that make glasses hard to wear and contacts hard to fit.
In a study of the issue, published in Ophthalmology, researchers compared visual satisfaction among people who wore contact lenses and those who once wore contacts or glasses but who had LASIK. After three years, 88 percent of former contact wearers and 77 percent of former glasses wearers were strongly satisfied with their LASIK results. Just 54 percent of those who stayed with contacts were satisfied with their continued use of those devices.
Clearly, some people who have LASIK are much more satisfied with their vision after surgery than they would have been had they skipped the procedure.
LASIK Is Not Right for Everyone
While LASIK is certainly powerful, and has the ability to make life a lot easier for people who cannot tolerate glasses or contacts, it is not the right solutions for every person and every vision issue. In fact, there are some people who should not consider LASIK eye surgery.
After LASIK, the cornea is left to heal without sutures. The cells will knit back together after surgery, but that healing works best when the eye is bathed in tears. According to the National Eye Institute, millions of adults have dry eye issues. They can be caused by:
- Certain medications.
- Disease, such as rosacea, eyelid inflammation, and autoimmune disorders.
- Seasonal allergies.
- Advancing age.
People with dry eye may not heal as quickly after LASIK, and the surgery can make some dry eye symptoms worse. Luckily, most symptoms of dryness are only temporary. Moreover, studies show that many patients actually experience less dry eye after LASIK than before because they no longer need to wear contact lenses, which are a top reason for dryness.
Since LASIK eye surgery involves removing tissue from the cornea, those with thin corneas may also need to avoid this surgery. They may not have enough tissue to allow surgeons to perform the procedure properly. Similarly, people with a very high prescription may require the removal of a great deal of tissue to correct vision. A surgeon may not be able to remove enough tissue, which would result in an improvement in vision but not a correction of the entire problem. Removing too much tissue could also leave the cornea thin and vulnerable, which may cause vision problems later on.
People with changing glasses prescription may also be poor candidates for surgery. The American Academy of Ophthalmology reports that most prescriptions stabilize by the time people reach their mid-20s, but some people have prescriptions that shift later in life.
LASIK is meant to be a precise correction for a specific loss of visual acuity. People with shifting prescriptions may not experience the real benefit of the surgery since their need for correction may also bend with time. Waiting until the prescription is stable may be a wise move.
Some diseases, including diabetes, can impact healing ability. People with an underlying medical condition like this may also be considered a poor candidate for surgery, as they may not heal as quickly as a surgeon considers appropriate. That slow healing could lead to infections and other complications.
An Exam Starts the Process
According to the Eye Surgery Education Council, anyone considering LASIK eye surgery should begin with a thorough, comprehensive examination performed by an ophthalmologist. During that exam, the doctor will:
Assess vision history.Diseases, medications, and prior injuries could all impact the success of surgery.
Measure current correction needsA measurement of corrected and uncorrected vision will happen at this step.
Measure pupil size and cornea thickness.People with large pupils and thin or irregular corneas might not get the maximum benefit from surgery.
Assess overall eye health.The eyelid placement, the ability to move the eyes, the health of the front and back of the eye, and eye pressure may all be assessed.
At the end of an exam like this, a doctor should have a good recommendation about whether or not LASIK might be right for your eyes and your health. The measurements taken during this exam can also help the doctor to plan for your surgery.
Preparing for Your LASIK Surgery
A typical LASIK surgery takes just minutes to complete, and you are awake during the procedure. Your doctor may provide you with medications to help you stay calm and relaxed during the surgery, and those medications can impair your ability to drive. As part of your surgical preparations, you should determine how you will get to your appointment and home again.
You may need to take a few days or weeks away from work, depending on the tasks you perform at work each day. Scheduling that time away from work should also be part of your surgery preparation process.
The FDA reports that contact lenses can change the shape of your eyes and should be removed weeks before your exam with your doctor. You should keep those lenses out of your eyes leading up to surgery too.
The day before surgery, stop using creams, lotions, or makeup on your face or around your eyes. Your doctor may also ask you to wash your face and eyelashes with a special soap the day of the surgery.
LASIK is a medical procedure, and as this article demonstrates, it can be remarkably helpful. However, insurance companies often consider this an optional procedure, and that means you might be required to pay for the cost of your surgery without using your insurance benefits.
For example, the insurance provider Cigna says that LASIK is an "elective, cosmetic procedure," and "most" insurance companies will not cover the cost. Insurance agents might prefer for you to continue to use glasses or contact lenses rather than participating in surgery.
An ophthalmologist interviewed by Michigan Health suggests that LASIK eye surgery typically costs about $2,200 per eye. To take advantage of the benefits of surgery, you may need to pay this cost out of pocket. Some companies offer financing, so you can make affordable payments each month until the final sum is paid. You might also use funds from a health savings account (HSA) to cover your costs.
Questions to Ask a LASIK Surgeon
Your eye is an incredibly delicate part of your body. Before you submit to surgery on that eye, you should ensure that the surgeon you choose is one who is both qualified and trustworthy.
The Federal Trade Commission recommends asking your surgeon questions about:
Experience.Find out how long your surgeon has been in practice and how many surgeries they have performed during that time.
Success.Find out how long your surgeon has been in practice and how many surgeries they have performed during that time.
Treatment program.Ask about the care you will be given both before and after surgery.
Complications and risks.Learn more about the issues your surgeon thinks might happen to you, and ask how your surgeon might work with you to reduce those risks.
The American Academy of Ophthalmology also recommends asking your surgeon to describe how your vision might change after surgery. Your ophthalmologist should be able to describe those issues to you in words you can understand so you can make an informed decision about surgery.
You should also ask your surgeon to tell you more about the tools used during your surgery. The FDA approves devices for use during LASIK eye surgery, and some devices are approved for some types of patients while others are not. Ask your surgeon to provide you with the formal device name of the tool to be used during your surgery, and look for it on the FDA website to make sure it's approved for eyes like yours.
Understand Your Risk of Complications
The risk of potential complications is quite low, and your doctor can help you to better understand the risks versus benefits. Although rare, those risks may include:
- Undercorrection or overcorrection, requiring another surgery.
- Poor vision at night.
- Reduced closeup vision, which could impact your ability to do crafts and other close work.
- Lack of the clear vision you expect with glasses or contacts.
It is possible to experience other temporary surgery complications, such as infections. Even rarer, there is the potential to have an unusual corneal healing process, resulting in a bump in your cornea that can impact your vision.
You may experience a small type of pain or discomfort similar to dry eye for a short period after your surgery. According to the journal Molecular Pain, current research suggests that some feelings of dry eye are similar to feelings of pain people might feel after a different type of surgery. Disturbing the nerves, which can happen with any type of surgery, can lead to feelings of discomfort that are slow to fade even when the surgical site has healed. You may experience pain that your brain interprets as a dry eye feeling.
Overall, all surgery comes with some level of risk. In 2020, however, LASIK is one of the safest surgical options available. If you are looking to correct your vision permanently, then you can be comfortable knowing that you have a ~99% chance of successful surgery. With reputable doctors at a quality eye care clinic, the likelihood of a satisfactory procedure should be even higher.
Early Recovery: Steps to Take After Surgery
If you decide to move forward with LASIK surgery, you will need to take special care of your eyes in order to heal. Your doctor may ask you to use eye drops for several days after surgery to help your tissues heal, and you may be given an eye shield to protect your cornea from pokes and prods.
The FDA reports that you should see your doctor 24 to 48 hours after surgery to ensure that you are healing well. Your doctor may also give you instructions about when you can go back to work, and you might be given instructions about when you can engage in hobbies and sports like jogging.
Late Recovery: Protecting Your Investment
Within a few weeks, your eye might be healed from surgery. But you may still be encouraged to take special care of your eye to ensure that you have the biggest benefit from surgery.
For example, you might be encouraged to wear protective eyewear while tackling tasks such as gardening. Though extremely rare, a corneal flap can dislodge even years after surgery, so it will be vital for you to protect your eyes from accidental pokes and scrapes.
You will also need to avoid scratching or rubbing your eyes. Wearing a sleeping mask at night might be a wise way to protect your eyes if you find that you rub them in your sleep or snuggle them into your sheets and blankets.
Make the Decision That Is Right for You
LASIK surgery is permanent, and the work done during a procedure cannot be undone. It is wise to do your homework and conduct research before any medical procedure. It is also wise to make sure you are working with a trusted professional who has the equipment and the expertise you can trust.
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Visual, Aberrometric, Photic Phenomena, and Patient Satisfaction After Myopic Wavefront-Guided LASIK Using a High-Resolution Aberrometer. (December 2016). Clinical Ophthalmology.
Visual Outcomes After LASIK (Laser-Assisted In-Situ Keratomileusis) for Various Refractive Errors. (2017). Ophthalmology Pakistan.
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Three-Year Longitudinal Survey Comparing Visual Satisfaction with LASIK and Contact Lenses. (August 2016). Ophthalmology.
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Should I Worry That My Eyeglass Prescription is Increasing? (August 2015). American Academy of Ophthalmology.
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Lasik: What Should I Expect Before, During, and After Surgery? (July 2018). U.S. Food and Drug Administration.
Pros and Cons of LASIK: Are the Risks Worth the Cost? (December 2017). Michigan Health.
The Basics of LASIK Eye Surgery. (August 2012). Federal Trade Commission.
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List of FDA-Approved Lasers for LASIK. (September 2018). U.S. Food and Drug Administration.
Journal of Cataract & Refractive Surgery, Vol. 42, Issue 8, August 2016, Pages 1224-1234
Chronic Dry Eye Symptoms After LASIK: Parallels and Lessons to be Learned from Other Persistent Post-Operative Pain Disorders. (February 2015). Molecular Pain.