LASIK has always been minimally invasive and outpatient because using local anesthesia and being a very quick procedure reduce recovery time, meaning the person gets to enjoy their improved vision faster. (Learn more) Many people are squeamish about being awake while a laser is pointed at their eye. (Learn more) For some people, there is worry over the risk of accidentally moving and damaging their eye, and for others, the thought of being awake during any surgical procedure causes anxiety. (Learn more) Surgeons are familiar with these feelings in their patients and often give a low-dose sedative before the procedure to keep their patients calm. (Learn more)

Most people have found this useful to keep them both awake and soothed while they undergo the short procedure. For a 30-minute procedure, there is no reason to go through the long and expensive process of general anesthesia unless there is a very specific medical reason for doing so. Reduced complications and lower cost are both benefits of using local anesthesia and being awake during LASIK. (Learn more)

Rear View Of Loving Couple Walking Towards House

Outpatient LASIK Is Convenient for Many Reasons

LASIK has been a wonderful procedure for many people all over the world. The procedure itself is fast, and healing does not take very long. Many surgeons report that their patients experience improved vision after just a few hours, and many side effects like discomfort, dryness, and glares or halos are gone in a matter of days.

During the procedure, you will receive anesthetic eye drops; then, you’ll look at a point of light while the surgeon shapes your cornea. One of the qualifications for LASIK is that you can stare at a fixed point for at least one minute. If you are unable to do this for a specific (often medical) reason, you may not be a good candidate for LASIK.

The whole procedure happens so fast, you will hardly know it is occurring. The primary impact of the procedure occurs afterward when you have bandage contact lenses, a mask to wear for a few days to sleep, and several follow-up appointments to ensure the surgery’s success.

Do I Need to Be Awake During LASIK?

 

Since the surgery was approved by the U.S. Food and Drug Administration (FDA) 20 years ago, the procedure has involved the patient remaining awake, largely because the surgery is so fast. Even in its earliest days, LASIK took less than 30 minutes total, and currently, most of that time is preparation for the application of the laser to the cornea, which actually takes about five minutes per eye.

Does this mean you are awake during LASIK? Yes, you will remain conscious during the procedure.

The thought of being conscious while having surgery on one’s eye creates anxiety in a lot of people. Fortunately, eye surgeons are used to hearing this, and there are several procedures for ensuring an easy, safe experience with LASIK while avoiding general anesthesia.

Shot of an attractive young woman relaxing on her bed in the morning at home

What Are My Options for Anesthesia During LASIK?

 

The reason you will remain awake through the LASIK procedure is two-fold. First, the procedure is very short, so general anesthesia is not appropriate. Second, the cost of LASIK is significantly increased if you undergo more intensive medication before surgery.

General anesthesia requires more preparation and recovery time than local anesthesia, so many types of surgery, including LASIK, are trying to incorporate local anesthesia as much as possible. This is because there are several risks to using general anesthesia (GA.

  • The whole body is affected by the drugs, especially the heart, lungs, and brain.
  • A specialist will need to be brought in to monitor your vital signs during surgery to ensure no complications from GA occur.
  • System toxicity is a slightly higher risk with GA, leading to vomiting, nausea, confusion, and agitation.
  • Rare instances of complications include problems with higher levels of toxins in the blood.
  • Respiratory depression is a risk after being taken off ventilation.

While GA and localized anesthesia (LA) are both very safe for any medical procedure in which they are needed, the risks are slightly higher with GA. There is also a higher risk of complications like underlying medical conditions, allergic reactions, or problems with anesthesia that run in families popping up during GA compared to LA.

For a surgery like LASIK, which takes well less than an hour, putting a person under GA is not a good solution. Many people report feeling anxious that they must be awake during the surgery, but most eye surgeons will administer a sedative like Valium to calm the patient. The vast majority of people who undergo LASIK report that this is sufficient treatment to calm their nerves, so they can get through the surgery easily.

What if I Accidentally Move While I’m Awake?

Another reason people are often concerned about being awake during LASIK is potentially moving their eye and causing the surgery to go wrong. The anesthetic eye drops reduce any pain that may occur during the short procedure itself, and many people either receive a prescription for painkillers or can take over-the-counter pain medications to reduce their experience of pain after the procedure.

But the thought of moving while a laser is shaping their cornea scares many people. They believe that, if they are unconscious during the procedure, they won’t accidentally shake, look away, or blink in a way that may cause a problem.

The topical anesthetic will eliminate any pain or discomfort during the procedure that may cause eye movement, the eyes will be kept hydrated, and the eyelids are held open. Additionally, modern LASIK devices are typically equipped with a safety shutoff. In the event that you do move accidentally during the procedure, which is very unlikely, the device will shut off very quickly, avoiding any accidental changes or nerve damage to the eye. The device is designed to react well before your surgeon can.

LASIK Is Safe and Effective With Local Anesthetic?

For most people who undergo LASIK to improve their vision, they barely even notice the procedure itself. With the help of a mild, short-term sedative, they are able to sit through the 10 to 30 minutes of prep time and the very short amount of time it takes the laser to shape their cornea. Side effects do not last long, with most people experiencing improved vision within a day or two and being able to return to work (unless it is physically taxing) within a few days or a week. Rates of complications and side effects are very low.

References

LASIK Eye Surgery. (December 30, 2017). Mayo Clinic.

What Should I Expect Before, During, and After Surgery? (July 11, 2017). U.S. Food and Drug Administration (FDA).

Medical Devices: What Is LASIK? (July 11, 2017). U.S. Food and Drug Administration (FDA).

Do I Have to Be Awake During LASIK? (March 2018). All About Vision.

What to Know About LASIK Surgery. (September 21, 2017). U.S. News.

Anesthesia for Adults Having Eye Surgery. (July 2018). American Association for Pediatric Ophthalmology and Strabismus (AAPOS).

Frequently Asked Questions: LASIK & Advanced Vision Correction. University of Rochester Medicine, Flaum Eye Institute.