LASIK (laser in-situ keratomileusis) is a vision correction surgery in which the cornea is reshaped to correct refractive errors including nearsightedness, farsightedness and astigmatism.
To determine your eligibility for LASIK, your eye doctor will need to evaluate your medical history and conduct a comprehensive eye exam. After taking measurements for your corneal thickness, refraction, corneal mapping, eye pressure and pupil dilation, your eye doctor will refer you to a surgeon, who will answer your questions and schedule the procedure.
Follow-up care is as important as the actual procedure itself. Post-operative measures are recommended to better eliminate the risk of complications and increase the chances for a successful recovery. Post-operative examinations are crucial to proper healing and will allow your doctors to better monitor the health of your eyes.
A LASIK MD co-managing Lorton, VA, optometrist or your own eye care professional can perform these post-operative examinations for you.
To determine whether you’re a good candidate for the procedure, a baseline or initial evaluation needs to be done by your eye doctor in Lorton, VA. Below, we cover a few things you will need to know before the exam.
Stop wearing your contact lenses before your baseline evaluation — instead, wear your glasses full-time. The reason is that contacts can change the shape of your cornea, and do so for up to several weeks after you have stopped using them. Your cornea must be allowed to assume its natural shape before surgery. If not, measurements may be inaccurate and the surgery may not be as effective.
Measurements will be taken to determine how much corneal tissue needs to be removed. These measurements will be taken at least a week after the initial evaluation and right before surgery to ensure that there have been no changes, especially if you wear RGP or hard lenses.
Wearers of Soft contact lenses must stop wearing them two weeks prior to the initial evaluation. If you wear toric soft lenses or rigid gas permeable (RGP) lenses, you should stop wearing them at least three weeks prior to initial evaluation. For those who wear hard contact lenses, you need to stop wearing them at least four weeks before your initial evaluation.
Other important things you should let your doctor know about are:
- Current as well as past medical and eye conditions
- Prescribed medications you are taking, over-the-counter medications and any medications you’re allergic to
After conducting a thorough eye exam your doctor should discuss:
- If you are a good candidate for the procedure
- The risks, benefits and alternatives that you can consider in lieu of surgery
- What to expect before, during and after surgery
- Your responsibilities before, during and after surgery
Don’t hesitate to discuss any concerns with your doctor. Make sure that you thoroughly touch on the risks and benefits, and that you’ve read through all the informational literature provided by your doctor. Ask your doctor to answer any additional questions before you commit to going through with surgery and prior to signing the informed consent form. Do not undergo the surgery simply because you feel pressured to do so.
On the day before your surgery, stop using creams, lotions, makeup and perfume — all of which could lead to an increased risk of infection during and after surgery. You should also scrub your eyelashes thoroughly.
Make sure to arrange for transportation to and from your surgery and your first follow-up visit. Your doctor may prescribe some medication before surgery to help you relax. This medication may temporarily cause blurred vision that can impair your ability to drive, so it’s important to arrange for alternative transportation.
The surgery will take no more than 30 minutes. You will be asked to lie back on a reclining chair in an exam room containing the laser system, which will include a large machine with a microscope and a computer screen attached to it.
The procedure will begin with the application of eyedrops to numb your eye. The area surrounding the eye will then be cleaned, and a lid speculum will be used to hold your eyelids open.
Your optometrist in Newington, VA, may then use a mechanical microkeratome (a cutting instrument) or a laser keratome (a laser device) to cut a flap in your cornea.
A ring will then be placed on your eye, after which very high pressures will be created to provide suction for the cornea. Your vision may dim, and you may feel some pressure and discomfort at this time. The microkeratome (a one-time-use cutting instrument which is attached to the suction ring) will be used to cut a flap in your cornea. The microkeratome and the suction ring will then be removed.
The procedure be slightly different if a laser keratome is used, in hat your cornea will be flattened with a clear plastic plate. Your vision will dim and you may feel the pressure and experience some discomfort during this part of the procedure. Laser energy will be focused inside the corneal tissue to create thousands of small bubbles of gas and water. These bubbles will expand and connect to separate the tissue underneath the corneal surface, creating a flap. The plate will then be removed.
You will experience blurred vision during the rest of the procedure; during this time the doctor will lift the flap, fold it back, and dry the exposed tissue. They will then position the laser over your eye, and you will be asked to stare at a light (not the laser light), keeping your eye fixed on one spot once the laser comes on. To be considered a good candidate for this surgery, you should be able to stare at a fixed object for at least 60 seconds.
Once your eye is correctly positioned, your doctor will start the laser, which will have been programmed to vaporize the amount of tissue based on the measurements taken at your initial evaluation. A computer will control the amount of laser energy delivered to your eye. After the laser energy has vaporized the corneal tissue, the flap will be placed back into position.
A shield should then be placed over your eye as protection, as there will be no stitches made to hold the flap in place. This shield is meant to prevent you from rubbing your eye and putting pressure on it while you sleep. It is also meant to protect your eye from accidentally being hit or poked.
It isn’t unusual after a laser procedure for your eyes to burn, itch or feel like there is something inside them. In some cases, you may feel mild pain, or your eyes may be hazy or blurry or may tear or water. Expect sensitivity to light and glare and your eyes may seem bloodshot. Don’t rub your eye as this can cause damage. The symptoms should go away within a few days.
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 your first visit after the surgery, your doctor will remove the eye shield, test your vision and examine your eyes. You may be given eye drops to prevent infection and may be advised to use artificial tears for additional eye lubrication. Do not resume wearing contact lenses.
You may need to wait for up to two weeks after surgery or until your doctor advises you otherwise before using lotions, creams or eye makeup. Continue scrubbing your eyelashes for a period of time after the surgery, and avoid swimming or using hot tubs or whirlpools for one to two months.
Avoid any strenuous contact sports for at least four weeks after surgery, and protect your eyes from anything that might get in them and from being hit or bumped.
Your vision may fluctuate for three to six months after surgery. Glare, haloes, difficulty driving at night and other visual symptoms may persist during this period. Further correction may be necessary, but can only be done once your eye measurements have been shown to be consistent for two consecutive visits at least three months apart. What’s more, while distance vision may improve after re-operation, it is unlikely that other visual symptoms such as glare or haloes will improve — in fact, the safety or effectiveness of enhancement surgery remains inconclusive at this time.
Inform your eye doctor immediately if any new, unusual or worsening symptoms develop at any point after surgery. Timely treatment can prevent potential problems from worsening.
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