LASIK Eye Surgery

What is LASIK eye surgery?

LASIK eye surgery is a refractive eye surgery that uses lasers to fix problems with your vision. This surgery is an outpatient procedure, meaning that you can go home the same day. LASIK corrects refractive errors, which happen when your eye can’t refract (bend) light as it should. Refractive errors lead to blurry vision. LASIK can help you see more clearly and enjoy a better quality of life.

LASIK may be a treatment option for people who don’t want to rely on glasses or contacts to improve their vision. After LASIK, you may not need your glasses or contacts at all. Or, you may need them only in certain situations, like when driving at night or reading. If you’re considering LASIK, it’s important to learn how it works and its benefits and drawbacks so you can make an informed decision. For example, not everyone is a candidate for LASIK. Also, LASIK is typically not covered by insurance.

What does LASIK eye surgery do?

LASIK changes the shape of your cornea to improve how light hits your retina. This, in turn, allows you to see more clearly. The name LASIK stands for “laser-assisted in situ keratomileusis.” The term “in situ” means “in position” or “in place.” The word “keratomileusis” is the medical term for reshaping your cornea.

Your cornea is the outermost layer of your eye. It’s dome-shaped and made of clear tissue. It works together with another part of your eye called your lens to bend light before it hits your retina. Your retina lines the back of your eye. When light hits your retina, your retina sends electrical signals to your brain that tell you what you’re seeing.

To see an object clearly, you need all the parts of your eye to work together. Think of an assembly line, with your cornea as the person responsible for the first step in making a product. If that person makes a mistake, it throws off the entire process and affects the outcome.

Similarly, when light enters your eye, it goes through your cornea first. Problems with the shape of your cornea prevent light from taking the correct path to your retina.

So, by reshaping your cornea, LASIK allows light to enter your cornea how it should and take the proper path to your retina.

What conditions does LASIK treat?

LASIK treats the following conditions:

• Nearsightedness (myopia). You can see objects better if they’re up close, but those far away are fuzzy or blurred.
• Farsightedness (hyperopia). You can see objects better from far away but struggle with those up close.
• Astigmatism. This is blurred vision when viewing objects at any distance. It’s due to an irregularly shaped cornea and occurs along with myopia or hyperopia.
• Presbyopia (age-related hyperopia). As you get older, the lens of your eye grows less flexible. As a result, it’s harder for you to see things close to your face. LASIK, which targets your cornea, can’t correct presbyopia. But with a technique called monovision (blended vision), LASIK can correct one eye for distance and the other eye for near vision. This improves your close-up vision and helps with tasks like reading.

Does LASIK permanently fix your eyesight?

LASIK permanently changes the shape of your cornea. This improves your eyesight so it’s normal or near normal. However, because your eyes naturally change as you get older, your vision can change in the years following LASIK. This is a normal part of the aging process. Presbyopia usually starts around age 40. At some point, you’ll likely need reading glasses to help you with close-up vision.

What happens before LASIK eye surgery?

Your ophthalmologist or optometrist can tell you how to prepare. In general, you should stop using lotion, makeup and perfume the day before your surgery. These products can get into your eyes and raise your risk of infection. Also, ask someone to drive you to and from your surgery.

What happens during the surgery?

During LASIK, a refractive surgeon will:

1. Put drops into your eyes. These drops numb your eyes so you won’t feel pain.
2. Place a suction ring and eyelid speculum on your eye. These painless devices keep your eye in the proper spot and stop you from blinking. You may feel pressure on your eyelid like someone is pressing on it. Your vision will grow dim.
3. Make a thin flap in your cornea. This is called a corneal flap. Your surgeon lifts and folds the flap back, like turning the page of a book.
4. Ask you to focus on a light aimed toward your eye. As you stare at the light, your surgeon uses a laser to reshape your cornea. You may hear a clicking sound. You may also notice an unusual smell. This isn’t the laser burning your eyes. It’s simply a chemical reaction from the laser shaping your cornea. During the laser treatment, your eye’s position is measured 500 times a second. The laser will stop if you move too much.
5. Put the corneal flap back in place. It begins reattaching right away and continues to heal after you go home.

Will I be awake during LASIK?

You’ll be awake, but you won’t feel pain. You may receive a mild sedative to help you relax.

How long does LASIK take?

LASIK usually takes 30 minutes or less. During this time, you can expect to look at a light for less than 30 total seconds.

What happens after the surgery?

After the procedure is finished, your vision will be relatively clear. People describe their vision as being similar to looking through a dirty window. Your glasses or contact lenses will no longer help you see well after the procedure is completed.

LASIK is an outpatient procedure, so you can go home afterward (but someone else will need to drive you). Your surgeon will give you:

• A shield to protect your eyes and stop you from touching your eyes. You won’t have any stitches in your eyes. So, it’s essential to avoid touching or bumping your eyes, which could disrupt the healing of the corneal flap.
• Lubricating eye drops to manage dry eye symptoms.
• Antibiotic eye drops to prevent infection.
• Steroidal eye drops to prevent inflammation.

Most people have 90% of their best vision possible after the procedure. Most are able to drive in safely for their post-operative visit, which is typically the next day.

For the first week after your surgery, you may have:

• Discomfort or mild pain in your eyes.
• Dry eyes.
• Watery eyes.
• Puffy eyelids.
• Sensitivity to light (photosensitivity).

You might be tempted to rub your eyes because they’ll burn or feel itchy. This irritation is normal. It’s essential you avoid touching your eyes at all during the first week so they can heal.

What are the advantages of LASIK?

LASIK may give you crisp, clear vision without relying on glasses and contacts. About 96% of people who have LASIK are happy with the results. Those who are unhappy may have hoped for perfect vision and zero reliance on glasses, which isn’t always possible. It’s important to talk to an ophthalmologist about the level of vision correction that’s possible for you.

About 99% of people have vision that’s 20/40 or better (without glasses) after their LASIK surgery. This is good enough to pass the eye exam for a driver’s license. More than 90% end up with 20/20 vision (without glasses).

What are the side effects of LASIK?

It’s common to have some side effects from LASIK. These aren’t the same as complications. Side effects usually aren’t serious and go away on their own.

Dry eye is the most common side effect. It affects about 30% of people who have LASIK. The discomfort is most bothersome about three months after your surgery, but it usually goes away after six to 12 months.

Other possible side effects include:

• Starbursts or glare around lights, which can be most disruptive when driving at night.
• Reduced night vision.
• Blurred vision.
• Tiny red or pink spots on the white of your eye (sclera).
• Sensitivity to light.

Most side effects occur within the first three months. By six months after your surgery, your side effects should mostly be gone.

What are the risks or complications of LASIK?

Complications are more serious than side effects and may require treatment. More than 99% of people experience no complications. However, it’s important to be aware of the possible complications, including:

• Issues with your cornea that require treatment or surgery.
• Corneal ectasia (weakening of your cornea that causes it to bulge).
• Inflammation or infection. This usually goes away with medication.
• Vision that’s worse than before you had LASIK. This is usually treatable.

LASIK surgery itself hasn’t caused any cases of blindness in people who are appropriate surgical candidates. However, rarely, an untreated infection can lead to vision loss.

Is LASIK safe?

Clinical trials and research studies have proven that LASIK eye surgery is safe. Over 9,000 people participated in clinical trials in the U.S. from 1993 to 2005. Plus, over 7,000 research studies have confirmed LASIK is a safe surgery. New technology continues to lower the risk of complications (which is already below 1%).

All surgeries come with some risks. That’s why it’s important to talk to an ophthalmologist or optometrist to learn more about LASIK and whether the benefits outweigh the risks for you. For example, LASIK may not be an option if you have medical conditions like damaged corneas or chronic medical conditions that affect healing. It may be upsetting to learn you can’t have a surgery you want, but eye doctors put your safety first.

What is the LASIK eye surgery recovery time?

Recovery from LASIK is quick. Many people can return to work or drive within a few days. However, use caution before getting behind the wheel. Blurred vision is a common side effect of LASIK, so you shouldn’t drive until your vision has cleared.

Will I have to limit my activity?

You should limit some activities as your eyes heal. Follow your ophthalmologist’s advice based on your specific situation. Some general guidelines include:

• Wait three days before exercising (non-contact sports).
• Wait two weeks to use makeup or lotions near your eyes.
• Wait at least one month to play contact sports (like football or karate).
• Wait one to two months to swim or use hot tubs or whirlpools.

When should I see my ophthalmologist or optometrist?

You’ll return to your ophthalmologist or optometrist 24 to 48 hours after your surgery so they can test your vision and make sure your eyes are healing. Your provider will tell you how often you should come in for follow-up appointments after that.

Call your ophthalmologist or optometrist immediately if you experience:

• Severe pain.
• Side effects that get worse.

What questions should I ask my provider as I recover?

Questions you may want to ask include:

• How long should I expect side effects to last?
• What is my new vision prescription?
• Do I still need to wear glasses sometimes?
• How often should I come back for follow-ups?

How do I decide if LASIK is right for me?

The first step is learning whether you’re a candidate. To have this surgery, you must:

• Be at least 18 years old (but preferably in your early- to mid-20s when your eyes are fully mature and your vision is stable).
• Have a stable vision prescription that hasn’t changed by much in the last 12 months.
• Have thick and healthy corneas.
• Have healthy eyes overall.

You need a comprehensive eye exam to see if you meet these criteria. At your exam, your refractive surgery team will:

• Perform a test called corneal topography to evaluate the shape of your cornea.
• Perform additional tests (corneal tomography, epithelial thickness mapping and corneal biomechanical metrics) as needed to make sure you can safely have LASIK. These tests evaluate the thickness, shape and strength of your eyes.
• Measure your pupil size.
• Check your vision.
• Check for dry eye disease.
• Ask about your medical history to learn if you have conditions that would make LASIK unsafe or unsuccessful for you.

To get the most accurate results from your exam, you must stop wearing contact lenses for several weeks beforehand. Contacts change the shape of your cornea and can lead to inaccurate cornea measurements. Your ophthalmologist or optometrist will tell you how long you should go without wearing them.

If you’re a candidate for LASIK, it’s time to learn more about what you’ll gain from the surgery. You can then make a final decision. Your provider will discuss expected outcomes based on your eyes and current vision. Don’t feel rushed or pressured. Take your time and make sure you’re comfortable with all aspects of the surgery.

What would disqualify me from LASIK?

About 1 in 5 people who want LASIK have medical or eye conditions that prevent them from receiving LASIK. Those conditions may include:

• Unstable vision (your prescription keeps changing).
• Extreme nearsightedness, farsightedness or astigmatism.
• Corneas that aren’t thick enough for the procedure.
• Severe dry eye disease.
• Keratoconus.
• A cataract.
• Glaucoma, diabetes or an autoimmune disease that’s difficult to manage.

Which is better, LASIK or another type of laser eye surgery?

Each type of refractive laser eye surgery has its own benefits and drawbacks. One type isn’t universally best for everyone. The best type of surgery for you depends on many factors, including:

• The thickness of your cornea.
• The health of your eyes.
• Your job or lifestyle.

Several types of laser surgery don’t create a corneal flap that goes back to its original position after the surgery (as LASIK does). So, these surgeries might be better for you if you’re not a candidate for LASIK (for example, if your corneas are too thin or your job puts you at risk of eye trauma). Laser surgery alternatives to LASIK include:

• Photorefractive keratectomy (PRK).
• Small incision lenticule extraction (SMILE).
• Implantable Collamer Lens (ICL).

Talk to an eye care provider about these options and which is best for you.

What is a LASIK enhancement?

A LASIK enhancement is a touch-up procedure that’s done after your initial surgery. It may happen about three months after your surgery or several years later.

An enhancement a few months after your surgery helps you get closer to your vision goal if your initial surgery didn’t correct your vision as much as you’d hoped. This doesn’t mean something went wrong with the surgery. It means everyone’s eyes respond differently, so you can’t always predict how much your vision will improve. An enhancement surgery makes a small change to help refine your vision.

An enhancement can also happen years later due to changes in your vision over time. Again, this doesn’t mean LASIK didn’t work. It means your eyes get older and change just like other parts of your body. As you age, your vision naturally changes. A LASIK enhancement can help correct vision changes that occur after your initial surgery.

A note from Cleveland Clinic

LASIK can give you a whole new view of the world around you. It can improve your vision and reduce your reliance on glasses and contacts for many years to come. But not everyone is able to have LASIK. LASIK is an elective procedure that insurance may not cover. If you’re interested in LASIK, talk to your eye care provider. Together, you and your provider can discuss LASIK and determine if it’s the right fit for you.