About LASIK surgery

Millions of people wear glasses or contacts to correct their vision, and for many, laser eye surgery has become a quick fix. It is worth mentioning that getting rid of eyeglasses is not only about cosmetic concern but also career maker since many profession's occupations require that good candidates should be free of any type of corrective eyeglasses or contact lenses with good visual acuity. "I ski, I scuba dive, I sail, I run, I,,,,", it's been a real improvement in terms of quality of life," and undoubtlessly, the surgery provides career condense and better work outcomes with tremendous life style enhancement and in some circumstances, the procedure might be a lifesaver. So, what is about of this "completely painless and amazingly quick" LASIK procedure that has such an impact in our life style?

What is LASIK refractive surgery? In the past, refractive surgery was performed only with incisions using the surgeon knife. Now, laser technology has been developed for a new type of very refined, computer controlled refractive surgery. Laser assisted in-situ keratomileusis, or LASIK, the most commonly performed type of laser surgery, is a relatively new procedure involving the eye's cornea which is the transparent surface that covers the pupil and iris and provides most of the eye's optical power to improve focus by altering the shape of the cornea. LASIK is generally a safe and effective treatment for a wide range of common vision problems such as myopia (nearsightedness, blurred distance vision), hyperopia (farsightedness, blurred near vision) or astigmatism (uneven curvature of the cornea that distorts vision). LASIK involves the use of a laser to permanently change the shape of the cornea, and is a quick and often painless procedure, and for the majority of patients, the surgery improves vision and reduces the need for corrective eyewear. To perform the procedure, a qualified ophthalmologist uses a microkeratome (an automated microsurgical instrument similar in concept to a carpenter's plane) to create a thin, circular corneal flap, exposing the internal layers of the cornea, much like opening a book. The surgeon will then fold the flap back, removing very tiny bits of tissue from the cornea with a computer-controlled laser to reshape it. The flap is then laid back in place, covering the area where the corneal tissue was removed. When the flap is replaced, the surface assumes the new curvature that has been calculated to correct the vision.  In essence the laser has engraved the shape of the contact lens permanently in the eye. The flap is stable within minutes and is healed by the next morning. LASIK procedure is completed in a matter of minutes on an outpatient basis using only topical anesthesia "eye drops" while the patient is fully awake, with no need for injection or any kind of general anesthesia and both eyes are done at the same time in most of the cases.

What to expect post surgery? Following surgery, patient leaves the clinic and will be given specific information about any prescribed eye medications and initial follow-up appointment (regularly will be the second day after surgery) will be scheduled. The same day after the surgery patient can have functional vision but "foggy", and he should exercise only moderate activities while avoiding direct eye contract (eye rubbing) and it is also recommended that the patient briefly wear protective eye shields during the first night after surgery. It is also recommended to absolutely not to wear eye make up on the day after surgery and it is advisable to avoid it for several days and also to avoid participating in contact sports. And it is very important to keep all scheduled follow-up appointments even if patient feels that he is doing fine and are not experiencing any problems. These visits will allow the doctor to monitor the recovery and check for subtle changes that might not be noticed by the patient. Visual recovery is rapid and majority of patients will notice a significant visual improvement and gain most of their vision the first day following LASIK and they can resume normal daily activities including office work, driving, shopping etc. However, for at least one week following surgery patient should avoid activities that would cause perspiration to enter the eyes and should also wear safety glasses while playing contact sports. Patient will also need to avoid swimming and any water activities for several weeks following surgery. Minimal fluctuation of vision might happen during the first week in which patient recover most of his visual acuity. It is worth mentioning that the effects of LASIK are permanent and do not wear off over time. However, a person's eye can still change internally (even after refractive surgery) and this is why many surgeons recommend proceeding only if a stable prescription exists. Patients should also note that while results are stable long-term, a mild regression of the laser effect may occur during the first few post-operative months. This occurs in very little percentage and if noted, may require an enhancement procedure (touch up) which is a simple procedure and easier than the conventional LASIK and without any additional fee charge. Furthermore, patients over 40 to 45 years may need to wear reading glasses when they experience difficulties in reading to overcome the natural aging process of the eye, which is cold presbyopia (difficulty for seeing near objects which happens with age) and is not corrected by LASIK.

Does LASIK surgery suit everyone's eyes? The convenience of LASIK (quick procedure, minimal to no discomfort during and after the procedure, numbing drops only with no injection, brief recovery, high degree of predictability, lower infection risk than contact lenses and preservation of corneal integrity) is what has made it a popular option for many patients. But still, not everyone's eye can undergo LASIK surgery to correct the refractive error. Many eye and general health condition (very thin and irregular cornea, cataract, ocular inflammation, collagen diseases, etc) may be considered as contraindication to LASIK surgery and there are a number of factors that doctors must evaluate before they can determine who is eligible for LASIK. Some doctors deem certain pre-existing conditions to be contraindications to the procedure and will not perform surgery if patient possesses them. Other conditions may complicate the surgery and increase the risk of having post-operative problems. Patients with these conditions need to have a thorough conversation with their doctors regarding eligibility and expectation levels. Beside medical and vision history, the personal goals and expectations play an important role in determining whether LASIK surgery is right for an individual candidate. Maintaining realistic expectations about the procedure's outcome is very essential

Is LASIK surgery risk free? LASIK is a surgical procedure conducted on a delicate part of the eye and as all surgical procedures, has the risk of complications. Fortunately, the likelihood of visual loss with LASIK is very small. In the many millions of LASIK procedures done so far, very few minorities of patients have experienced serious, vision threatening problems and most of these complications represent delays in full recovery and resolve within several months of surgery.