(Laser-Assisted In Situ Keratomileusis)
LASIK is a surgery that uses a laser to reshape the cornea of the eye. This reshaping changes focusing power and usually corrects vision. Surgery may be done on both eyes, either at the same time or on separate occasions.
Cornea of the Eye
Reasons for Procedure
LASIK is done to eliminate the need for glasses or contact lenses.
Most people who get LASIK will still need reading glasses at middle age and beyond to correct for presbyopia (decreased ability to focus due to age). Be sure to discuss presbyopia with your doctor prior to getting LASIK so that you understand how it will affect your vision.
LASIK eye surgery has a relatively low complication rate, but they can occur. Possible complications include, but are not limited to:
- Under- or over-correction of the cornea shape
- Fuzzy or blurry vision
- Poor night vision
- Seeing halos or sunbursts around light/glare
- Long-term dryness, scratchiness, or pain in eyes
- Correction may not last
- Permanent decrease or loss of vision that cannot be corrected with glasses or contact lenses
- Need for additional laser or surgery
Some factors that may increase the risk of complications include:
- Pre-existing eye disease, such as glaucoma, or abnormalities in the shape of the cornea, such as keratoconus
- Persistent eye infections, such as blepharitis
- Dry eyes
- Thin cornea
- Large pupil size
- Autoimmune disease, immunodeficiency, and other conditions, or use of medications that alter wound healing
- Any other form of fluctuating vision
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Complete eye exam
- Review of medications
Leading up to your procedure:
- It is best to stop wearing your contact lenses at least 2-4 weeks before surgery. The length of time depends on the type of contact lenses and your doctor’s preference.
- Arrange for a ride to and from the procedure.
- Do not wear lotion, cream, make-up, or perfume the day before or day of surgery.
- You may be asked to scrub your eyelashes and/or use eye drops before the surgery.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Blood thinners
Drops are given to numb the surface of the eye. You may be given a sedative to help you relax during the procedure.
Description of Procedure
You will be positioned on your back in a reclining chair. The area surrounding your eye will be cleaned. Numbing drops will be placed in your eye. The eyelid will be held open with a special device. A ring will be placed on the eye and pressure is applied to create suction. A blade will then be attached to the suction ring. The doctor will use the blade to cut a flap in the cornea. The doctor will fold back the flap.
You will look into a light (not the laser). A laser will be directed to remove a specific amount of corneal tissue. The laser will make a ticking sound as it reshapes the cornea. At this point, some patients report a smell similar to burning hair. Once the laser is finished, the corneal flap will be gently placed back into position. Antibiotic drops will be put in the eye. A shield will be placed over the eye.
There are other ways to do laser vision correction surgery. One includes using a laser to make the flap in the cornea. The other includes removing the top layer of the cornea with a special device or chemical, then using the laser. Ask your doctor which procedure is best for you.
How Much Will It Hurt?
You will likely feel some discomfort when the suction ring is applied. Just after the procedure, expect a burning or itching sensation or the feeling that there is a foreign object in your eye. Your eye may tear and be red and bloodshot. You will most likely have a loss of vision at times during the procedure. This is normal.
You will wear a shield to protect your eye from injury or pressure, even while sleeping. When you return home, do the following to help ensure a smooth recovery:
- Do not rub your eyes.
- Limit physical activity, especially contact sports for up to one month.
- Wear the eye shield at night as instructed.
- Take pain medication as recommended by your doctor.
- Use eye drops prescribed by your doctor to prevent infection and decrease inflammation.
- Do not put a contact lens or anything else in the operative eye unless instructed by your doctor.
- Do not swim in a pool, or use a whirlpool or hot tub for 1-2 months.
- Do not use cream, lotion, or make-up near the eye for at least two weeks.
Vision may be hazy or cloudy; you may see starbursts or halos around lights. Vision changes and redness should gradually improve over several days. However, it may take up to six months for your vision to completely stabilize. Your doctor will schedule follow-up visits.
Additional surgery may be necessary to further correct or enhance vision. If more surgery is needed, wait until your eyesight has stabilized. It is usually considered stable when you have consistent measurements on at least two consecutive exams several months apart.
Call Your Doctor
Contact your doctor if any of the following occurs:
- Redness, swelling, increasing pain, bleeding, or discharge from the eye
- Signs of infection, including fever and chills
- Vision worsens
- Any other problems or concerns
If you think you have an emergency, call for medical help right away.
American Optometric Association
Eye Smart—American Academpy of Ophthalmology
Canadian Ophthalmological Society
Lasik-Laser eye surgery. American Academy of Ophthalmology website. Available at: http://www.geteyesmart.org/eyesmart/glasses-contacts-lasik/lasik.cfm. Accessed July 16, 2013.
Medical devices. United States Food and Drug Administration (FDA) website. Available at: . http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/SurgeryandLifeSupport/LASIK/ucm061270.htm. Updated March 22, 2013. Accessed July 16, 2013.
Last reviewed June 2014 by Eric Berman, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.