Name of the Procedure:

Laser in situ keratomileusis (LASIK)

Summary

Laser in situ keratomileusis (LASIK) is a popular eye surgery that uses a laser to correct vision problems such as nearsightedness, farsightedness, and astigmatism. The procedure reshapes the cornea, allowing light entering the eye to be properly focused onto the retina for clearer vision.

Purpose

LASIK is intended to reduce or eliminate the need for glasses or contact lenses by correcting refractive errors that cause blurry vision. Its primary goals are to provide improved visual acuity and greater independence from corrective eyewear.

Indications

LASIK is indicated for patients who:

• Are at least 18 years old
• Have a stable prescription for at least a year
• Suffer from myopia (nearsightedness), hyperopia (farsightedness), or astigmatism
• Do not have significant eye diseases or conditions such as glaucoma or cataracts

Preparation

Before undergoing LASIK, patients typically need to:

• Stop wearing contact lenses for a specific period (usually a few weeks) before the initial evaluation and surgery.
• Undergo a comprehensive eye examination to determine suitability, which may include corneal thickness measurement, mapping, and assessing the size of the pupil.
• Avoid using eye makeup, creams, and perfumes on the day of the surgery.
• Arrange transportation, as they will not be able to drive immediately after the procedure.

Procedure Description

1. The patient is positioned under the laser system.
2. Numbing eye drops are applied to prevent discomfort.
3. A hinged flap is created on the cornea using either a microkeratome blade or a femtosecond laser.
4. The surgeon folds back the flap to access the underlying cornea.
5. An excimer laser is used to reshape the cornea's stroma based on precise measurements.
6. The corneal flap is gently repositioned without stitches.

Duration

The actual laser reshaping process takes less than a minute per eye, while the entire procedure typically lasts about 15 to 30 minutes for both eyes.

Setting

LASIK is usually performed in an outpatient setting, such as an ophthalmologist's office or a specialized eye surgery center.

Personnel

• Ophthalmologist (Eye Surgeon)
• Ophthalmic technicians and nurses
• Possible presence of an anesthesiologist, though typically not needed

Risks and Complications

While generally safe, LASIK does carry potential risks, including:

• Dry eyes
• Halos, glare, or double vision
• Overcorrection or undercorrection of vision
• Flap complications, such as infection or irregular healing
• Regression, where vision slowly deteriorates again

Complications are rare and often manageable with follow-up care or additional treatments.

Benefits

• Significant improvement in vision
• Reduced dependence on eyeglasses or contact lenses
• Most patients achieve 20/20 vision or better
• Quick recovery, with most patients experiencing improved vision within 24 to 48 hours

Recovery

• Avoid rubbing eyes and use prescribed eye drops to prevent infection and promote healing.
• Follow-up exams typically occur within 24-48 hours, and periodically for several months.
• Most normal activities can resume within a day or two, but strenuous exercise and swimming should be avoided for a few weeks.
• Full visual stabilization usually occurs within 3-6 months.

Alternatives

• Photorefractive keratectomy (PRK): Similar to LASIK but does not involve creating a corneal flap.
• Contact lenses or eyeglasses: Non-surgical options for vision correction.
• Small Incision Lenticule Extraction (SMILE): A newer laser procedure with a less invasive corneal incision.

Each alternative has its own pros and cons in terms of recovery time, risk, and suitability.

Patient Experience

During the procedure, patients might feel slight pressure but generally no pain due to numbing drops. Afterward, they may experience:

• Mild discomfort or irritation for the first few hours
• Sensitivity to light and watery eyes
• Blurred vision immediately post-procedure, improving rapidly
• Over-the-counter pain medication and rest typically suffice for managing initial discomfort.