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Q. What is Lasik?
Today, many people with vision problems may improve their eyesight through refractive surgery procedures – allowing greater freedom from glasses or contact lenses. Even people who do not totally eliminate their need for glasses may be able to reduce the thickness and strength of cumbersome eye wear that can interfere with an active lifestyle.
Refractive surgery is a general term for surgical procedures designed to improve or correct the focusing ability of the eye. It is estimated that nearsightedness and astigmatism affect over 60 million people in the United States. A person’s inability to see clearly can be caused by nearsightedness (myopia), farsightedness (hyperopia), and/or astigmatism. In most cases, these three types of refractive errors can be corrected through refractive surgery.
Laser in situ keratomileusis (LASIK) is a highly effective surgical technique intended to reduce a person’s dependency on glasses or contact lenses – in many cases allowing their elimination altogether. This technique has the broadest range of potential correction for myopia, or nearsightedness and astigmatism.
In this microsurgical procedure, a surgeon utilizes an Excimer laser and Microkeratome to permanently change the shape of the cornea. Anesthetic drops numb the patient’s cornea so there is no feeling during surgery. Using a Microkeratome, a precision device used to create the “flap”, the surgeon first fashions a thin flap in the cornea (see figure 1). The Excimer laser is used to remove subsurface tissue (see figure 2), and the surgeon replaces the flap (figure 3) which adheres so readily that stitches are not needed. There is little or no postoperative pain because the protective surface of the cornea is undisturbed.
Visual recovery is usually very quick after LASIK. Most patients see clearly and are back at work within the first 24 to 48 hours. Since LASIK does not remove the surface layer of the cornea (called the epithelium) there is rapid healing with minimal discomfort. Temporary side effects following LASIK are generally minimal. Patients may experience temporary symptoms such as slightly drier eyes and minor increases in light scattering. These effects are more common in people with very large pupils and high refractive corrections. These side effects generally diminish as the eye heals.
LASIK has the shortest time to vision recovery of all the refractive procedures. The protective corneal flap allows for overnight sealing of the corneal surface which brings an end to the typical scratchiness and irritation after surgery. Patients may be given protective transparent shields to wear over the eyes, so as not to inadvertently rub the eyes while sleeping, and topical eye drops are used for the first four to five days. Women are instructed not to wear mascara for two to four weeks to avoid disturbing the flaps and LASIK patients should avoid water sports for several weeks following the procedure to permit healing.
Follow up visits typically take place one day, one week, one month and three months after surgery, usually with your optometrist. Most patients are stable at three months, however, your optometrist may decide to continue tracking results for at least six and then again at twelve months.
Q. Will I need glasses after Lasik surgery?
Some patients will still need or want to wear glasses and/or contacts following refractive surgery even though almost everyone will see vastly better without glasses than they did before surgery. Not everyone will see as well without glasses as they did before surgery with glasses. In a few cases, patients will still need glasses or contact lenses to function adequately or safely in certain activities. For example, some people may still need corrective lenses to drive safely. Some patients, especially those over 40, will want to continue to wear glasses for close work such as reading, sewing, or computer use. Some patients will be able to see adequately, but may want to wear glasses to see better even though they can function adequately without them.
Q. How do I know if I’m a candidate for Lasik surgery?
For consideration, patients should be at least 18, and in some cases 21 years old, depending on the treatment and laser type. Patients must also show stability in their refractive prescription. It’s best that patients do not have any significant diseases of the eye, like keratoconus or herpetic keratitis, nor any systemic conditions such as lupus, scleraderma, dermatomyositis, and depending on the severity, rheumatoid arthritis. Women will not be considered a candidate during or immediately following pregnancy.
For additional questions about Lasik and to determine if Lasik is right for you or members of your family, contact one of our Lasik partners or your Optometrist.
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