The Procedure - Before and After
What to expect before, during, and after surgery will vary
from doctor to
doctor and patient to patient. This section is a
compilation of patient information developed by manufacturers and
healthcare professionals, but cannot replace the dialogue you should have
with your doctor. Read this information carefully and
with the checklist,
discuss your expectations with your doctor. Before Surgery If you wear contact lenses, it is a good idea to stop
wearing them before your
baseline evaluation and switch to wearing your glasses full-time.
Contact lenses change the shape of your cornea for up to several
weeks after you have stopped using them depending on the type of
contact lenses you wear. Not leaving your contact lenses out long
enough for your cornea to assume its natural shape before surgery can
have negative consequences. These consequences include inaccurate
measurements and a poor surgical plan, resulting in poor vision after
surgery. These measurements, which determine how much corneal tissue
to remove,
may need to be repeated at least a week after your initial evaluation
and before surgery to make sure they have not
changed, especially if you wear RGP or hard lenses. If you wear: You should tell your doctor: Your doctor should perform a thorough eye exam and discuss: 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. You should not feel pressured by your doctor, family, friends, or
anyone else to make a decision about having surgery. Carefully
consider the pros and cons. The day before surgery, you should stop using: These products as well as debris along the eyelashes may increase
the risk of infection during and after surgery. Your doctor may ask
you to scrub your eyelashes for a period of time before surgery to
get rid of residues and debris along the lashes. Also before surgery, arrange for transportation to and from
your surgery and your first follow-up visit. On the day of surgery,
your doctor may give you some medicine to make you relax. Because
this medicine impairs your ability to drive and because your vision
may be blurry, even if you don't drive make sure someone can bring
you home after surgery. During Surgery 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, a cutting instrument, 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. The laser will be positioned over your eye and you will be asked
to stare at a light. This is not the laser used to remove
tissue from the cornea. This light is to help you keep your eye
fixed on one spot once the laser comes on.
NOTE: If you cannot stare at a fixed object for at least 60
seconds, you may not be a good candidate for this surgery. When your eye is in the correct position, your doctor will start the
laser. At this point in the surgery, you may become aware of new sounds
and smells. The pulse of the laser makes a ticking sound. As the laser
removes corneal tissue, some people have reported a smell similar to burning
hair. 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 should 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. After Surgery You should 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. At the first postoperative visit, your doctor will
remove the eye shield, test your vision, and examine your eye. Your
doctor may give you one or more types of eye drops to take at home to
help prevent infection and/or inflammation. You may also be advised
to use artificial tears to help lubricate the eye. Do not resume
wearing a contact lens in the operated eye, even if your vision is
blurry. You should wait one to three days following surgery before
beginning any non-contact sports, depending on the amount of activity
required, how you feel, and your doctor's instructions. To help prevent infection, you may need to wait for up to two
weeks after surgery
or until your doctor advises you otherwise before using lotions,
creams, or make-up around the eye. Your doctor may advise you to
continue scrubbing your eyelashes for a period of time after surgery.
You should also avoid swimming and using hot tubs or
whirlpools for 1-2 months. Strenuous contact sports such as boxing, football, karate, etc.
should not be attempted for at least four weeks after
surgery. It is important to protect your eyes from anything that
might get in them and from being hit or bumped. During the first few months after surgery, your vision may
fluctuate. Contact your eye doctor immediately, if you develop any
new, unusual or worsening symptoms at any point after surgery. Such
symptoms could signal a problem that, if not treated early enough,
may lead to a
loss of vision.
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. This is what you need to know to prepare for the
exam and what you should expect:
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. The laser system includes a large machine with a microscope
attached to it and a computer screen.
Immediately after the procedure, your eye may burn, itch, or feel
like there is something in it. You may experience some
discomfort, or in some cases, mild pain and your doctor may suggest
you take a mild pain reliever. Both your eyes may tear or water.
Your vision will probably be hazy or blurry. You will instinctively
want to rub your eye, but don't! Rubbing your eye could dislodge the
flap, requiring further treatment. In addition, you may experience
sensitivity to light, glare, starbursts or haloes around lights, or
the whites of your eye may look red or bloodshot. These symptoms
should improve considerably within the first few days after surgery.
You should plan on taking a few days off from work until these
symptoms subside. You should contact your doctor immediately
and not wait for your scheduled visit, if you experience severe pain,
or if your vision or other symptoms get worse instead of better.
