A: A complete eye exam will confirm whether the patient is nearsighted, farsighted and/or has astigmatism. There must be no ocular health problems present, such as cataracts or untreated glaucoma. Additional measurements are needed, such as the thickness of the cornea and a corneal surface mapping. A qualified ophthalmologist can ultimately determine whether the patient is a candidate for LASIK.

A: The success of any LASIK procedure depends more on the skills and experience of the surgeon than other surgical procedures. A qualified surgeon should meet the following basic criteria: board certification by the American Board of Ophthalmology with advanced training in cornea and refractive surgery; skills and experience with a prominent ophthalmology practice; and the ability to help patients understand potential outcomes and complications. While the proliferation of LASIK ad campaigns may tempt price-conscious consumers, remember this: LASIK is a lifetime investment. Taking the time to research the credentials and experience of the surgeon is important in achieving the best results.

A:

The LASIK procedure is a 3-step procedure:

1) A flap is created on the surface of the cornea.

2) A computer-controlled excimer laser is then used to remove the proper amount of corneal tissue. In less than one minute, the excimer laser reshapes the internal cornea.

3) The thin flap of corneal tissue is then folded back into its original position, where it bonds after only a few minutes of drying. No stitches are needed.

In a sense, the surgery is analogous to lifting up the top pancakes in a stack to pour syrup on the middle pancake and then placing the top pancakes back. The entire LASIK procedure usually takes about ten minutes per eye.

A: The excimer laser uses a cold light beam to sculpt the cornea's surface to the desired shape, correcting nearsightedness, farsightedness and/or astigmatism.

A: The cornea is easily numbed with eye drops during the procedure. Most patients say they have little to no discomfort both during and after LASIK.

A: Recovery is fast. The first couple of hours after surgery, the eye feels somewhat irritated, with a burning sensation and some tearing. Vision is typically blurry during this time. Most patients nap for a couple of hours to rest the eyes. After several hours, the irritation goes away and the vision begins to clear.

A: A mild sedative is available prior to surgery to encourage relaxation during the procedure and to encourage sleep afterwards. The surgeons and operating room technicians often talk throughout the procedure to put patients at ease.

A: Some patients may prefer to have each eye done on different days. In most cases, however, both eyes are done on the same day. This avoids the period of imbalance that occurs if one eye still needs correction while the other one doesn't.

A: You will be lying back in a comfortable chair, staring up into a fixation light. During the procedure, a speculum, or lid separator, is used to hold the eyelid open comfortably and to prevent blinking. You will not feel the need to blink. There is a tracking mechanism on the laser and the laser will not fire unless it is able to reach its target. The surgeon has complete control of the laser at all times and, if the need should arise, can stop the procedure until the patient can focus on the fixation light.

A: With any medical procedure, there is no guarantee of perfect vision. Almost everyone experiences improved vision, however, and most see well enough to pass a drivers' test without corrective lenses. It is important to know that LASIK does not eliminate the need for reading glasses. Beginning at around the age of 40, a condition called presbyopia usually appears, requiring reading glasses or bifocal correction. If this is an issue for you, monovision-LASIK can be considered.

A: Most patients return to work within two days; some even go back the day after surgery.

A: You must wear a protective shield to bed for the first week. You should not swim for one week after surgery, although bathing and showering is fine. No eye makeup should be applied for 7 days. Other activities—including moderate exercise—may be resumed 2-3 days following surgery.

A: LASIK is a permanent procedure. In some cases, however, an enhancement procedure may be required. Some patients' eyes may change throughout their lifetime, which can happen with glasses or contact lenses as well.

A: Fluctuation can occur, but visual improvement is almost immediate following the procedure. Most patients feel that major fluctuations have stopped after two weeks. At the same time, it may take additional time for all of the swelling in the eye to resolve and fluctuations to cease. Many patients do have healing that, in a minor sense, may continue to improve over six to nine months.

A: The procedure is very safe, and that is why it has been so readily accepted. With any surgical procedures, however, there may be complications. Vision-threatening complications do exist, but they are extremely rare. These include infections (an incidence of 1 in 5,000) and “ectasia” (also about 1 in 5000) which is a progressive thinning of the cornea post-operatively. There are also complications, which may lead to temporary blurriness, temporary dependence on glasses or contact lenses or a need for additional surgery. In most cases, the patient can still do well and recover with good vision. It is for this reason that LASIK patients should confirm the experience of their surgeon to determine if he or she has specialized training in cornea surgery. Because LASIK is performed on the cornea, knowledge of the healing properties of the cornea and management of any complications are critical to the patient's well being. Knowing how to handle a complication, should one occur, can make a significant difference in the patient's outcome.

A: Success depends on several factors, the most important being the degree of nearsightedness, farsightedness or astigmatism. Depending on the prescription, the surgeon can help determine the likelihood of reaching 20/20 or greater vision. While there can never be a guarantee of specific visual outcome, the vast majority of vision correction patients see extremely well after surgery, often better than 20/20.

A: In the low and moderate ranges, LASIK can treat farsightedness. For high levels of farsightedness, LASIK does not work as well and other refractive procedures may provide a better level of correction.

A: Astigmatism occurs when the eye is oval rather than round. The laser can treat most levels of astigmatism. The laser does this by removing more tissue in one direction of the eye than another to make it more round.

A: Many patients who desire LASIK surgery have mild dry eyes. These patients have become intolerant to their contact lenses because the dryness makes them uncomfortable. LASIK occasionally worsens dry eye, but typically, this is a temporary effect and can be treated with frequent artificial tear lubrication, additional medication or a simple plugging of the lower eyelid tear ducts. Patients with sever dry eye may not be a good candidates for the procedure.

A: LASIK usually corrects for distance vision. If LASIK is performed to eliminate distance glasses, and the patient is over 40, it is likely that they will need a pair of glasses for reading. The exception to this is when patients opt to have monovision-LASIK, when one eye is corrected fully for the distance and the other is left nearsighted. Only about 10 to 20 percent of patients opt to have monovision correction, and it is only recommended in patients who have tried it with contact lenses and liked the results.