LASIK

LASIK is a surgical procedure intended to reduce a person's dependency on glasses or contact lenses. LASIK stands for Laser-Assisted In Situ Keratomileusis and is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser. A knife, called a microkeratome, is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middle section of the cornea. Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced.

Issues to Consider Beforehand

If you decide to go ahead with LASIK surgery, you will need an initial or baseline evaluation by your eye doctor to determine if you are a good candidate.

You should tell your doctor:

• about your past and present medical and eye conditions
• about all the medications you are taking, including over-the-counter medications and any medications you may be allergic to

Your doctor should perform a thorough eye exam and discuss:

• whether you are a good candidate
• what the risks, benefits, and alternatives of the surgery are
• what you should expect before, during, and after surgery
• what your responsibilities will be before, during, and after surgery

You should have the opportunity to ask your doctor questions during this discussion. Give yourself plenty of time to think about the risk/benefit discussion, to review any informational literature provided by your doctor, and to have any additional questions answered by your doctor before deciding to go through with surgery and before signing the informed consent form.

Are You a Good Candidate?

You are probably not a good candidate for refractive surgery if:

• You are not a risk taker.
• Cost is an issue
• You required a change in your contact lens or glasses prescription in the past year
• You have a disease or are on medications that may affect wound healing.
• You actively participate in contact sports.
• You are not an adult.

What to Expect During Surgery

The surgery should take less than 30 minutes. You will lie on your back in a reclining chair in an exam room containing the laser system. A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. A ring will be placed on your eye and very high pressures will be applied to create suction to the cornea. Your vision will dim while the suction ring is on and you may feel the pressure and experience some discomfort during this part of the procedure. The microkeratome is attached to the suction ring. Your doctor will use the blade of the microkeratome to cut a flap in your cornea.

The microkeratome and the suction ring are then removed. You will be able to see, but you will experience fluctuating degrees of blurred vision during the rest of the procedure. The doctor will then lift the flap and fold it back on its hinge, and dry the exposed tissue.

When your eye is in the correct position, your doctor will start the laser. A computer controls the amount of laser energy delivered to your eye. Before the start of surgery, your doctor will have programmed the computer to vaporize a particular amount of tissue based on the measurements taken at your initial evaluation. After the pulses of laser energy vaporize the corneal tissue, the flap is put back into position.

A shield will be placed over your eye at the end of the procedure as protection, since no stitches are used to hold the flap in place. It is important for you to wear this shield to prevent you from rubbing your eye and putting pressure on your eye while you sleep, and to protect your eye from accidentally being hit or poked until the flap has healed.

You should plan to see your doctor within the first 24 to 48 hours after surgery and at regular intervals after that for at least the first six months.