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LASIK Surgery - Laser Vision Process

What is LASIK?

LASIK is a procedure in which the curvature of the eye is altered to reduce nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. LASIK stands for Laser In-situ Keratomileusis. In this procedure, a thin peel is created from the surface of the cornea with an instrument. After the peel is made, it is turned back to expose the inner layer of the cornea, which is then reshaped with the laser. Finally the top layer is put back into place.

What you can expect - The Laser Vision Process

Your pathway to visual freedom is made up of five distinct phases; The Screening Evaluation, The Pre-surgical Evaluation, The Surgical Procedure, Recovery and Follow-up Care.

The Screening Evaluation

This evaluation takes sixty to ninety minutes and is available at either office by appointment. Upon arrival, a brief registration will be obtained. There will be several tests, including creating a map of your eyes with an Orbscan® and another checking your current visual status with an autorefractor. Based on these results, we are able to rule out most people who would not be candidates for surgery. We will then have a chance to sit down and talk about the surgical process and answer any questions that you have.

The Pre-surgical Evaluation

The pre-surgical evaluation gives us a chance to thoroughly understand your eyes and will give us a chance to take the measurements needed for surgery. We will discuss all aspects of the surgery and help you to decide whether or not corrective surgery is your best option. The concern of the Doctors For Visual Freedom team is to recommend what is best for you whether that be surgery or another option.

Depending on your needs, this comprehensive evaluation takes about an hour and a half and includes a wide dilation of your pupils. Your vision up close will be blurry for about four to six hours and your pupils are usually dilated until the next day.

In order to have final surgical results you should not wear your daily wear soft contacts for one week before your evaluation or surgery and two weeks for extended wear or toric soft lenses. If you chose, you may wear your extended wear lenses only during the day for a week and then get out of them entirely for the last week. Gas permeable lens wearers typically take about one month per decade for the corneas to stabilize and you should be out of these lenses for a minimum of three weeks. It may be possible for you to switch into soft contact lenses until the corneas stabilize and then just stay out of even soft lenses for the last week.

The Surgical Procedure

The day of surgery, feel free to shower or bathe. There is no limitation to shampoos or scrubbing of the face. Do not use eye make-up, perfumes or strong smelling hair sprays or deodorants as they may affect the ability of the laser to give you a good treatment. You can eat normally before and after the procedure but limit your caffeine intake as you need to be relaxed during your procedure and sleep afterwards. Take all of your usual medications. Please arrange to have someone drive you home after your procedure.

When you get to the laser center you will meet with our surgeon, Dr. Mark Golden. He will check your eyes at the slit lamp to make sure that you have no eye infection and then you will have a chance to ask any questions that you might have. He will highlight the important steps of the surgical procedure.

When all of your questions have been answered, you will be asked to sign your informed consent form. You will then be offered Valium, sedative to make you more comfortable and relaxed. The sedation takes 20-30 minutes to take affect and you will sit in a quiet room with your eyes closed until ready.

Dr. Golden talks non-stop during the entire procedure. He will tell you what is going to happen, what is happening and then how you did. If there are any problems, he will just stop the procedure, talk with you and then start up again when you are ready. Once in the laser suite, you will receive drops to numb your eyes. These ensure that the procedure itself is painless although you will still have a strong pressure for a short time. The area around the eyes is cleaned with a cold antibiotic soap. The left eye is covered and a special device is placed to keep the eye from blinking. The microkeratome is then placed on the eye and the vision goes dark for a few seconds. During this time the flap is being made. The flap is then examined and assuming that it looks good it is reflected out of the way. The laser treatment is then performed. You will see a pulsing red light and it is critical for you to hold the light as still as possible during the procedure. Dr. Golden will guide you through this portion telling you of how you are doing and let you know if there is too much movement. There is a safety feature on the laser called a tracker. This means that if you move a little bit, the laser will move with you. If you move too much then the laser will automatically stop. When this is completed, the flap is replaced in to position and it is cleaned allowed to stick down.

Lastly, drops will be placed in your eye and a similar procedure will be performed on the left eye. When surgery is completed, you will be taken to the slit lamp to ensure that the flaps are clean and in good position. Amazingly, patients immediately notice that their nearsightedness is gone, but the vision is always very cloudy.

Recovery

You should arrange to have someone to drive you home. Your vision will be blurry and you will be groggy from your sedation. On the way home it is best if you keep your eyes closed. About 30 minutes after you leave, the numbing drops wear off and may be sore. The best way to get rid of the discomfort is to lie down and sleep for four to five hours. Sleeping is not necessary, but it is important to keep your eyes closed as much as possible until the next morning. When you wake up, place your drops in your eyes without touching the eyes. The easiest way to place drops is to lean back or even lie down on a bed. Wait five or ten minutes between drops. Preservative free tear drops will make your eyes feel better and the more that you the faster that your vision will stabilize and the faster that you will feel better. Use preservative free tears for the first week and after that most people can use any tear drops. You will be given special shields to protect your eyes while you sleep. These should be used for the week after your procedure.

Initially after the local anesthesia has worn off, your eyes may experience some discomfort and medicines like Advil, Aspirin or Tylenol may help. The best way to manage this irritation is to sleep through the first few hours while it is most prominent.

Your vision will also be initially cloudy, as though looking through a thick fog. By the time you awaken after this nap, it should be markedly improved. Your vision will get better throughout the day and will be much better by morning. Some fluctuation of vision is expected over the first several weeks. The frequent use of tear drops will help the vision stabilize more quickly.

You may shower the morning after surgery including washing your hair and letting the water run over your face and closed eyes. You should not use a wash cloth or use a towel to dry your face. If your vision is clear enough, you may drive and return to work the day after your procedure.

Please wear sun glasses when outside for the next three months when exposed to sunlight. It is best to avoid pregnancy for three months.

Follow-up Care

It is critical that you keep your scheduled appointments. You will be seen at the center the day after the procedure, then at one week, one month, three months, six months and one year. If you are having problems, there will be more visits and they are included in your surgical fee. These visits usually take only a few minutes. If you are having a problem during the follow-up period, please feel free to contact us at any time.