Laser In situ Keratomileusis - Laser Eye Surgery Guide

A commonly used procedure used to improve eyesight is LASIK, which is an abbreviation for Laser in situ keratomileusis. This method of corrective surgery can be used to improve the vision of those who have astigmatism or who are long- or short-sighted. As a rule, laser eye surgeries like LASIK act by altering the shape of your cornea to ensure that the light that enters you eye can be directed to the retina.

LASIK eye surgery was introduced after PRK although in recent years it has overtaken it in popularity as a result of faster healing as well as less post-procedure discomfort. Unlike PRK, LASIK can be performed either using lasers or a blade.

The difference between 'blade' and 'bladeless' LASIK

The most commonly used form of LASIK is the 'blade' version. In such procedures, a microkeratome is employed to cut a very thin fold on the epithelium of your cornea. This fold is manoeuvred out of the way to allow the rest of the procedure to be performed. Once this has been done, an excimer laser is used to reshape the cornea appropriately to your eye condition so that light can be directly focussed onto the retina. The flap of epithelium is then repositioned and the procedure is over.

The alternative 'bladeless' version of LASIK only uses lasers. These lasers administer a high level of energy and are either femtosecond or excimer lasers. Such procedures are advertised as either 'Intralase' or 'Wavefront' treatments and may be explained in more detail during your consultation. This type of LASIK is more expensive than the 'blade' version as it is more innovative, advanced and technological.

Am I a suitable candidate for LASIK?

Like with other elective surgical procedures, LASIK has a minimum age and at many clinics this is 21 years old. If you are over this age and are considered mentally and physically healthy then there is reason to believe you may be able to undergo LASIK. You will be considered even more suitable for this particular method of eyesight correction if your glasses or contact lens prescription has remained the same for the past year.

The types of eye problems that LASIK have been proven useful for are long-sightedness, short-sightedness and astigmatism. However, you should note that LASIK is not able to cure the long-sightedness that is associated with getting older.

You should be aware and understand that due to the more advanced nature of LASIK compared to procedures such as PRK, it carries with it a higher risk of complications. Also, you may not be considered suitable for LASIK if your cornea is too thin. This will be determined by the use of tests during your consultation. If this is the case, you may be able to undergo methods such as implantable contact lenses or Epi-LASEK instead.

Advantages of LASIK

There are a number of benefits that are associated with LASIK eye surgery. For a start, it has been claimed that approximately 80% of individuals who have undergone the procedure have come out of the procedure with the desired result. This percentage can be increased more if further enhancement is performed.

Another advantage of the LASIK procedure is that the majority of patients experience a very low level of pain and discomfort afterwards. This benefit can be further enhanced by the fact that you will not be required to wear any bandages like in PRK and you should not need stitches either. Not only that but the results can often be noticed immediately or within 24 hours and the recovery time is usually very speedy.

LASIK can be performed more than once so if you do not get the results you hoped for after the first procedure, it does not have to be like that forever. You can have further adjustments in the future once your eyes have recovered. When the level of eyesight you desire has been achieved, you will not need to wear glasses or contact lenses.

Disadvantages of LASIK

You should always weigh up the advantages and disadvantages of elective surgery before you commit yourself to undergoing it. Something you should note about LASIK is that although you can have further procedures to improve your eyesight, you cannot have the procedure reversed as the cornea's shape is permanently changed.

The procedure is expensive and may not be affordable by all, which can be considered as a disadvantage for many. This is especially a negative point if you are an unsuitable for alternative procedures such as PRK.

In terms of the results of LASIK, you should note that there has been known for vision to be affected in an undesirable way. Eyesight can be permanently affected if the epithelium is cut incorrectly. Also, within the year following the surgery, you may lose your optimal vision, which if the level of vision you saw prior to the surgery when you wore your glasses or contact lenses (provided your prescription was accurate).

Potential Risks of LASIK

At present, the US Food and Drug Administration (FDA) has expressed that there are no long-term side effects of LASIK eye surgery. The vast majority of patients obtaining the desired result from their procedure are able to complement this claim. Despite this, as with all surgical procedures, there are some side effects you should be aware of. First thing to note is that many individuals who have undergone LASIK experience some pain and/or discomfort for up to 48 hours after the treatment. Less common side effects include:

  • Infection of the eye that underwent LASIK
  • Unsatisfactory night vision or sight in generally dark environments
  • Your vision may fluctuate
  • You may see haze or halos when looking at certain images
  • Your eyes may become dry although this can be resolved with eye drops

How expensive is LASIK?

As stated previously, LASIK is more expensive than some other eye laser surgery methods. The cost varies depending on the surgeon and the clinic as well as the method used. In general, the 'blade' version of LASIK is priced at around £850-£1300 per eye. In addition, the 'bladeless' version can cost you somewhere between £1500-£1900 per eye. The price of the 'bladeless' LASIK is further dependent on whether you have Intralase or Wavefront, often Intralase is slightly more pricey.

The Procedure

The LASIK procedure is normally performed while you are under local anaesthetic and it generally takes about 10 minutes. During this time you will be required to sit in a specially designed chair that is reclined so that you are directly under the laser.

Your eye surgeon will carefully but thoroughly clean the eyeball with an antiseptic. This is followed by the administration of the local anaesthetic, which are often given in the form of eye drops. These numb the eye so the procedure will lack pain. Once numbed, the surgeon will apply a specialised clamp to hold the eye open and prevent you from blinking.

During the 'blade' version of LASIK, you surgeon will take the microkeratome and use it to make a small cut in the epithelium surface of your cornea. This creates a flap, which is folded back away from the cornea leaving it open to the laser. The laser is then used to adjust the shape of the cornea so that it is more able to focus light onto your retina. Once this has been completed, the flap of epithelium will be put back in place to heal naturally in the days following the procedure. Steroid eye drops and a plastic shield that is attached to cover the eye and protect it aid this healing process.

Alternatively, you may have elected to undergo 'bladeless' LASIK. This procedure is very similar to the 'blade' version however, rather than a microkeratome, the eye surgeon will use a laser to create the flap. This laser can be either an excimer laser or a femtosecond laser.

After your procedure

Generally speaking, the recovery time associated with LASIK is extremely fast. Many individuals who have undergone LASIK notice the benefits within days after the procedure. Although saying this, it is common to have somewhat blurry vision for the 24 hours following the LASIK eye surgery. Due to this, it is vital that you have someone present who is able to transport you home and stay with you until your eyesight has fully recovered.

You may not notice, but your eyes will be rather dry after the surgery. To help with this, your surgeon should give you some special eye drops that provide lubrication and infection prevention.

Your LASIK procedure will not be the last time you see your surgeon. You will be required to attend a number of check ups after the treatment to ensure you eyes are recovering appropriately. The first check up is usually one or to days after the procedure and this is followed by subsequent regular appointments for half a year after the LASIK.