What is LASIK Eye Surgery?

LASIK (Laser-Assisted in Situ Keratomileusis) eye surgery is a popular and widely performed procedure aimed at correcting refractive vision problems, particularly nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. It is a revolutionary method that has transformed the lives of countless individuals by reducing or even eliminating their dependence on glasses or contact lenses.

LASIK involves the use of an excimer laser to precisely reshape the cornea. Before the surgery, the eye is numbed with anesthetic eye drops to ensure the patient’s comfort. A thin flap is then created on the cornea’s outer layer, which can be done using a microkeratome blade or in bladeless LASIK, a femtosecond laser. LASIK.com is strictly a modern LASIK network, meaning we only refer to doctors who offer custom, bladeless LASIK Eye Surgery.

Once the flap is created, the surgeon uses the excimer laser to remove a predetermined amount of corneal tissue. This reshaping process is customized based on the patient’s specific refractive error. For nearsightedness, the cornea is made flatter, while for farsightedness, it is made steeper. Astigmatism is corrected by smoothing out irregularities on the cornea.

Advanced LASIK techniques include wavefront-guided and topography-guided LASIK, which create a personalized treatment plan based on the unique imperfections in each patient’s eye. This level of customization enhances the potential for achieving excellent visual outcomes.

After the cornea is reshaped, the flap is carefully repositioned. It naturally adheres without the need for stitches. The flap serves as a protective layer that minimizes discomfort and accelerates the healing process.

One of the key advantages of LASIK is its rapid recovery time. Most patients experience improved vision within hours after the procedure, with optimal results often achieved within a few days. This quick turnaround time is one reason why LASIK is so popular.

LASIK is not suitable for everyone. Candidates must meet certain criteria, including stable vision for a minimum period and good overall eye health. While LASIK is generally safe, it carries some risks, including dry eyes, glare, halos, and the potential need for enhancement surgeries.

LASIK eye surgery has revolutionized the field of vision correction by offering a quick, effective, and relatively painless way to reduce or eliminate the need for glasses or contact lenses. LASIK has a high success rate and offers a potentially life-changing improvement in vision for many individuals, allowing them to enjoy greater freedom and clarity in their everyday lives. It is essential to consult with an experienced eye surgeon to determine whether LASIK is a suitable option for your specific vision needs.

What To Expect in a LASIK Procedure?

1. Preoperative Evaluation: Before undergoing LASIK, patients undergo a comprehensive eye examination to assess their candidacy for the procedure. This evaluation includes measuring the prescription needed for vision correction, mapping the cornea’s topography, assessing the thickness of the cornea, and evaluating the overall health of the eye.
   • Eye Examination: A comprehensive eye examination to assess your current prescription, the overall health of your eyes, and any pre-existing eye conditions.
   • Corneal Mapping: The measurement of your corneal curvature and thickness. This information helps guide the surgical planning.
   • Pupil Size Measurement: Measurement of your pupil size in different lighting conditions, which can impact the treatment plan.
   • Tear Film Evaluation: Assessment of your tear film to ensure it is sufficient for a smooth healing process.
   • Medical History: Review of your medical history, including any medications you are taking and any previous eye surgeries or conditions.
2. Anesthesia and Medication:
   • Anesthetic Eye Drops: On the day of the LASIK procedure, you will receive numbing eye drops to ensure that you do not experience pain or discomfort during the surgery.
   • Anxiety Medication (Optional):For some patients who experience significant anxiety or nervousness about the procedure, anxiety or calming medication may be administered before the surgery. This medication helps alleviate stress and discomfort, ensuring a more relaxed experience.
3. LASIK Eye Surgery Procedure: The LASIK procedure typically follows these steps:
   • Creation of the Corneal Flap: The first critical step in LASIK is creating a thin, protective flap on the cornea’s surface. This flap can be fashioned using two methods:
     • a. Microkeratome: A microkeratome is a mechanical surgical instrument that creates the corneal flap by carefully cutting a precise layer of corneal tissue. This is
     • b. Femtosecond Laser: Alternatively, a femtosecond laser, a highly precise and computer-controlled laser, can be used to create the corneal flap. This advanced technology offers greater precision and customization in flap creation. This is a required offering for qualification in the LASIK.com network as it is the recommended modern LASIK procedure.
   • Corneal Reshaping with the Excimer Laser: Once the corneal flap is created and gently lifted, an excimer laser comes into play. This precise ablation process reshapes the cornea according to the patient’s specific prescription. For nearsightedness, the cornea is flattened, while for farsightedness, it is steepened. Astigmatism is corrected by smoothing out irregularities in the corneal shape.
   • Flap Repositioning: After corneal reshaping is complete, the corneal flap is carefully repositioned onto the eye’s surface. It adheres naturally, without the need for sutures, and acts as a protective covering during the initial healing phase.
4. Postoperative Care: Following the LASIK procedure, patients are provided with postoperative instructions and eye drops to aid in healing and reduce the risk of infection. Most individuals experience improved vision within a day or two, and visual acuity continues to improve over the following weeks

Types of LASIK Eye Surgery

There are several different types of LASIK procedures and variations, each designed to address specific vision issues or to offer personalized treatment. Here are some common types of LASIK eye surgery:

1. Modern LASIK (Wavefront + Bladeless): This is the LASIK.com recommended LASIK Eye Surgery Procedure that is a requirement for our partners to offer. This type of LASIK involves Custom LASIK which utilizes wavefront technology to create a personalized map of the eye’s unique imperfections and Bladeless LASIK which uses a femtosecond laser to create the corneal flap instead of a microkeratome blade. This may reduce the risk of flap complications and offer greater precision.
2. Traditional LASIK (Standard LASIK): This is the most common type of LASIK surgery. It involves the creation of a corneal flap using a microkeratome or a femtosecond laser. The surgeon then uses an excimer laser to reshape the underlying corneal tissue based on the patient’s prescription.
3. Custom LASIK (Wavefront LASIK): Custom LASIK utilizes wavefront technology to create a personalized map of the eye’s unique imperfections. This map is used to guide the excimer laser in reshaping the cornea, potentially providing better vision correction and reducing higher-order aberrations.
4. Bladeless LASIK (All-Laser LASIK): Bladeless LASIK uses a femtosecond laser to create the corneal flap instead of a microkeratome blade. This may reduce the risk of flap complications and offer greater precision.
5. PRK (Photorefractive Keratectomy): This is also a LASIK.com recommendations for those who might not qualify for Modern LASIK. PRK is a surface ablation technique where the corneal epithelium is removed entirely, and then the excimer laser reshapes the underlying corneal tissue. PRK is used when a corneal flap is not advisable due to thin corneas or other factors.
6. LASEK (Laser Epithelial Keratomileusis): LASEK combines elements of LASIK and PRK. The epithelial layer is preserved but treated with alcohol to make it easier to lift and reposition after laser treatment. It is suitable for patients with thinner corneas or other contraindications for LASIK.
7. Epi-LASIK: Epi-LASIK is similar to LASEK but uses an epikeratome, a special instrument, to separate the epithelial layer. It is an alternative to LASIK for patients with certain corneal characteristics.
8. Monovision LASIK: Monovision LASIK is designed for patients who want to correct one eye for distance vision and the other for near vision, reducing the need for reading glasses or bifocals.
9. PresbyLASIK: PresbyLASIK is a type of LASIK specifically for correcting presbyopia, an age-related vision condition that affects near vision. It often involves creating a multifocal cornea.
10. Topography-Guided LASIK: This procedure uses corneal topography to guide the laser treatment. It is particularly beneficial for patients with irregular astigmatism or corneal irregularities.
11. SMILE (Small Incision Lenticule Extraction): SMILE is a minimally invasive refractive surgery that uses femtosecond laser technology to create a lenticule within the cornea, which is then removed through a small incision. It’s primarily used for nearsightedness.

What is the “Best” Type of LASIK Surgery?

The “best” type of LASIK surgery depends on individual factors, including your specific eye prescription, corneal thickness, eye health, and personal preferences. What might be the best choice for one person may not be ideal for another. It’s crucial to consult with an experienced LASIK.com ophthalmologist or refractive surgeon who can evaluate your eyes and recommend the most suitable LASIK procedure for your needs. The best way to find out the best procedure for you is by scheduling a free consultation. Factors to consider include the following:

1. Prescription: The type and severity of your refractive error (nearsightedness, farsightedness, astigmatism) play a significant role in determining the appropriate LASIK procedure. Some procedures may be better suited for certain prescriptions.
2. Corneal Thickness: The thickness of your cornea is an important factor. Thinner corneas may limit the choice of LASIK procedures, and your surgeon will need to ensure there’s enough tissue to safely perform the surgery.
3. Eye Health: The overall health of your eyes, including conditions like dry eye or corneal diseases, can influence the choice of LASIK procedure. Some eye conditions may make certain procedures more suitable than others.
4. Age: Your age and whether you have age-related vision changes like presbyopia (difficulty focusing on near objects) can impact the choice of LASIK procedure. PresbyLASIK or other multifocal options may be considered for those over 40.
5. Lifestyle and Preferences: Your lifestyle and preferences also play a role. For example, if you’re highly active in sports, you may prefer LASIK over PRK due to the shorter recovery time. If you want to reduce or eliminate reading glasses, procedures like PresbyLASIK or monovision LASIK may be more suitable.
6. Wavefront Technology: Some people may benefit from custom LASIK (wavefront-guided) procedures, which can provide a more personalized treatment based on the unique characteristics of their eyes.
7. Corneal Topography: For individuals with irregular corneas or significant astigmatism, topography-guided LASIK might be recommended.
8. Personal Goals: Discuss your visual goals and expectations with your surgeon. They can help you choose the procedure that aligns with your vision goals.
9. Surgeon’s Expertise: The experience and expertise of the surgeon are crucial. Make sure your surgeon is experienced in the specific LASIK procedure recommended for you.

Ultimately, there isn’t a universally “best” LASIK procedure. It’s about finding the best procedure for your unique eyes and vision needs. A thorough consultation with a LASIK.com doctor will help determine the most appropriate LASIK option for you. They will assess your individual factors and guide you toward the procedure that offers the best chance of achieving your desired outcome with minimal risk.

What are the Long-Term LASIK Eye Surgery Results?

LASIK often provides long-lasting vision correction. However, it’s important to note that the aging process can affect your eyes, and you may require reading glasses as you get older (presbyopia). Some individuals may experience minor changes in vision over time, which can usually be addressed with enhancements or other vision correction options.

LASIK has a high success rate and has improved the vision and quality of life for millions of people worldwide. However, outcomes can vary depending on individual factors, so it’s essential to have realistic expectations and follow your surgeon’s recommendations for a successful LASIK experience.

LASIK is a precise surgical procedure that aims to correct these vision problems by reshaping the cornea, thereby improving the eye’s ability to focus light accurately. The surgery involves several key steps:

The History of LASIK Eye Surgery?

The development of LASIK eye surgery is a fascinating journey that has its roots in various scientific discoveries and technological innovations.

Before LASIK: Vision Correction Methods

1. Spectacles (Glasses):
   • Spectacles have a long history as a means of vision correction and were the most common method before the advent of modern refractive surgeries.
   • Concave lenses were used to correct nearsightedness (myopia) by diverging incoming light, while convex lenses corrected farsightedness (hyperopia) by converging light. Cylindrical lenses were employed for astigmatism.
2. Contact Lenses:
   • Contact lenses, both rigid gas permeable (RGP) and soft lenses, provided an alternative to glasses for vision correction.
   • RGPs, made of hard plastic, offered better visual acuity but required adaptation. Soft lenses were more comfortable but had limitations in correcting certain refractive errors.
3. Radial Keratotomy (RK):
   • RK was one of the earliest surgical methods for vision correction, primarily used to treat myopia.
   • It involved making radial incisions in the cornea, flattening it to reduce nearsightedness.
   • RK was effective but had limitations, including long-term stability issues and the potential for under or overcorrection.
4. Photorefractive Keratectomy (PRK):
   • PRK was developed as a precursor to LASIK in the 1980s.
   • In PRK, the corneal epithelium (outer layer) was removed, and an excimer laser was used to reshape the cornea to correct vision.
   • Visual recovery was slower compared to LASIK, and postoperative discomfort was a common complaint.
5. Orthokeratology (Ortho-K):
   • Ortho-K involved the use of specially designed rigid contact lenses worn overnight to reshape the cornea temporarily.
   • It was primarily used for myopia control in children and myopia management in adults.
6. Phakic Intraocular Lenses (IOLs):
   • Phakic IOLs were implanted in the eye to correct refractive errors while leaving the natural lens intact.
   • These were often used for individuals with high myopia or other refractive issues that couldn’t be fully corrected with corneal procedures.

LASIK’s Emergence:

LASIK Eye Surgery had its roots in the development of excimer lasers in the 1970s. These lasers emitted precise ultraviolet light, making them ideal for reshaping the cornea without generating heat or damaging surrounding tissue. LASIK, developed in the early 1990s, combined the principles of PRK and the advantages of creating a corneal flap.This innovative approach allowed for rapid visual recovery, reduced discomfort, and precise corneal reshaping, making it a groundbreaking advancement in vision correction.

Early Days of LASIK (1980s-1990s):

• LASIK was developed in the 1980s, primarily building upon earlier techniques like radial keratotomy (RK) and photorefractive keratectomy (PRK). RK involved making radial incisions in the cornea to reshape it, while PRK involved removing the corneal epithelium before using an excimer laser to reshape the underlying cornea.
• In 1989, Dr. Lucio Buratto in Italy performed the first excimer laser-assisted keratomileusis procedure.
• The first LASIK procedure as we know it today was performed in 1990 by Dr. Ioannis Pallikaris in Greece, and it quickly gained attention for its precision and faster visual recovery compared to PRK.

Late 1990s – Early 2000s:

• In the late 1990s and early 2000s, LASIK gained widespread popularity. The technology transitioned from mechanical microkeratomes for flap creation to femtosecond lasers, which provided greater precision in flap thickness and size. This innovation reduced the risk of complications.
• Wavefront-guided LASIK was introduced in the late 1990s, allowing for customized treatments based on each patient’s unique visual imperfections. This marked a significant advancement in visual outcomes.

Mid-2000s to Present:

• Intraoperative pachymetry, which measures corneal thickness during surgery, became a standard practice to ensure safe levels of tissue removal.
• Bladeless LASIK, using femtosecond lasers for both flap creation and corneal reshaping, became the norm, reducing the risk of flap-related complications.
• The introduction of topography-guided LASIK further improved visual outcomes by addressing higher-order aberrations.
• Improved patient screening and selection criteria, along with a better understanding of corneal biomechanics, enhanced safety and reduced the risk of complications.
• Techniques for managing dry eye symptoms post-LASIK have evolved, including the use of punctal plugs and advanced lubricating eye drops.
• Enhancements and touch-up procedures have become more precise, allowing for fine-tuning of vision when necessary.

Future Directions:

• Research and development in LASIK and refractive surgery continue, with a focus on improving patient outcomes, expanding the range of treatable vision conditions, and reducing any remaining side effects.

In summary, LASIK eye surgery has come a long way since its inception in the 1980s. Advances in technology, surgical techniques, patient selection, and postoperative care have made LASIK a safer, more precise, and highly effective procedure for vision correction. Its evolution over the last four decades has improved the lives of millions of individuals by providing clearer, more comfortable vision.