The LASIK Procedure

Laser in situ keratomileusis (LASIK) uses the excimer laser to correct refractive errors (nearsightedness, farsightedness, and astigmatism) by removing a small amount of tissue beneath a thin flap of corneal tissue. The LASIK procedure is essentially a combination of two refractive surgical procedures, which have been performed for some time: Excimer laser photorefractive keratectomy (PRK) and automated lamellar keratoplasty (ALK).

In the LASIK procedure, a pancake-like flap of the cornea is fashioned with a microkeratome, which works somewhat like a carpenter's plane. After the flap is prepared, the excimer laser is used to remove a small amount of tissue from the remaining cornea beneath the flap. The LASIK procedure is concludes when the corneal flap is replaced on the eye. This changes the shape of the corneal surface with the effect of better focusing incoming light and decreasing refractive errors.

LASIK procedures are performed under topical anesthesia (eyedrops). A lid speculum holds your lids open to avoid blinking during the procedure. At the end of the procedure, a clear protective shield is placed over your eye. You will use topical drops to avoid infection and control inflammation for about one week.

You are generally comfortable after the LASIK procedure. Vision usually begins to improve the morning after the treatment. Most people can work the next day depending on their occupation; however, you will be seen for an examination on that day.

There are two basic types of possible side effects with LASIK. Because patients may respond and heal differently, it is possible that the entire refractive error may not be corrected or that there might be some overcorrection. If you are undercorrected, your vision will be clearer without glasses, but less powerful glasses may still be necessary to fine tune to your best vision. For some patients who are overcorrected, especially those patients who are some patients who are somewhat older, up-close vision might be difficult without glasses. In addition, older patients who are corrected for distance vision will still need reading glasses. We will discuss what vision you may reasonably expect to achieve. In addition, other optical side effects include haloes around lights, and glare, especially at night.

The other group of relatively rare complications may be secondary to problems with the LASIK surgery itself and subsequent corneal healing. We will discuss these possibilities in detail.

Possible benefits of LASIK, as compared with PRK, include:

1. Tissue removal beneath a flap rather that at the surface may preserve the surface corneal cells (epithelium) with the possible advantage of faster visual recovery
2. Post-operative discomfort is reduced
3. Tissue removal beneath a flap may decrease the risk of haze or scarring

Palisades Laser Eye Center