LASIK (laser-assisted in situ keratomileusis) is an outpatient refractive surgery procedure used to treat nearsightedness, farsightedness and astigmatism. A laser is used to reshape the cornea — the clear, round dome at the front of the eye — to improve the way the eye focuses light rays onto the retina at the back of the eye.
How do you know LASIK is right for you?
The latest developments in our technology mean that 91% of the people we see are suitable for laser eye treatment or one of our other treatments. Even people who were considered unsuitable a few years ago can now benefit from enhanced techniques today.
At a glance
LASIK – Further details
LASIK is the most popular laser eye treatment method, routinely performed throughout the world. LASIK is carried out without the need for a general anaesthetic, as eye drops are all that’s required to prevent any pain during the treatment.
Your eye surgeon delicately creates a thin layer of corneal tissue on the front of the eye. This layer, the corneal flap, is then lifted to expose the middle section of the cornea. The laser treatment is then applied to remove a pre-calculated amount of corneal tissue, and the flap is gently eased back into place. Treatment is usually performed on both eyes on the same visit, and you will be in the treatment room for about 20 minutes.
How the LASIK procedure works
LASIK is performed while the patient reclines under a surgical device called an excimer laser in an outpatient surgical suite. First, the eye is numbed with a few drops of topical anesthetic. An eyelid holder is placed between the eyelids to keep them open and prevent the patient from blinking. A suction ring placed on the eye lifts and flattens the cornea and helps keep the eye from moving. The patient may feel pressure from the eyelid holder and suction ring, similar to a finger pressed firmly on the eyelid.
From the time the suction ring is put on the eye until it is removed, vision appears dim or goes black. Once the cornea is flattened, a hinged flap of corneal tissue is created using an automated microsurgical device, either a laser or blade. This corneal flap is lifted and folded back. Then the excimer laser preprogrammed with the patient’s unique eye measurements is centered above the eye.
The surgeon checks that the laser is positioned correctly. The patient looks at a special pinpoint light, called a fixation or target light, while the excimer laser sculpts the corneal tissue. Then the surgeon places the flap back into position and smoothes the edges. The corneal flap sticks to the underlying corneal tissue within two to five minutes, and stitches are not needed.
The patient should plan to have someone drive him or her home after the procedure and then take a nap or relax. To help protect the cornea as it heals, the surgeon may place a transparent shield over the eye(s) to protect against accidental bumps and to remind the patient not to rub the eye(s). The patient may need to wear the shield only when sleeping. The surgeon will provide eye drops to help the eye heal and relieve dryness. It may take three to six months after LASIK surgery for the improvements in a person’s vision to fully stabilize and any side effects to go away.
LASIK risks and side effects
LASIK, like any surgery, has potential risks and complications that should be carefully considered. Since it was approved by the FDA in 1998, LASIK is has become a popular treatment in the United States and the overall complication rate is low. Infection and inflammation are possibilities, as with any surgical procedure, and usually can be cleared up with medications.
Problems with the corneal flap after surgery sometimes make further treatment necessary. There is a chance, though small, that vision will not be as good after the surgery as before, even with glasses or contacts.
Some people experience side effects after LASIK that usually disappear over time. These side effects may include hazy or blurry vision; difficulty with night vision and/or driving at night; scratchiness, dryness and other symptoms of the condition called “dry eye”; glare, halos or starbursts around lights; light sensitivity; discomfort or pain; or small pink or red patches on the white of the eye. In a small minority of patients, some of these effects may be permanent.
Sometimes a second surgery, called a retreatment or enhancement, may be needed to achieve the desired vision correction. This is more likely for people who were more nearsighted, farsighted, or had higher astigmatism before LASIK — those whose vision originally needed more intensive correction. Approximately 10.5 percent of LASIK patients in the United States require a retreatment.
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Memberships and Accreditations
About the author
Consultant Ophthalmic Physician and Surgeon |MBChB, FRCS(G), MBA, FWACS, FGCS, DCEH (Lond), Postgraduate Diploma in Cataracts and Refractive Surgery
I am Leonard Teye-Botchway and I am the Medical Director and Consultant Ophthalmologist at Bermuda International Institute of Ophthalmology in Bermuda. The joy and elation I get from seeing patients who are very happy they can see after surgery is almost unimaginable. This is what really drives me to carry on being an ophthalmologist.
We have sourced some or all of the content on this page from The American Academy of Ophthalmology, with permission.