How Does LASIK Work? Everything You Need to Know About LASIK

By Refractive Surgery Council/ Dr Andrew Holzman on August 09, 2019

An illustration if the LASIK flapApproved by the FDA nearly 20 years ago, LASIK is a household name around the conversation of vision. Need glasses? You better get LASIK eye surgery. Did the ref make a bad call? He definitely needs LASIK. Want to be a super hero and shoot lasers from your eyes? Get LASIK.

But, contrary to popular belief, LASIK is not for everyone nor does it fix every vision problem. Here, Dr. Andrew E. Holzman and the team from our Washington, DC, practice discuss everything you need to know about LASIK surgery.

Let’s Start with the Basics About LASIK Eye Surgery

LASIK is an acronym for laser in situ keratomileusis and is a two-step procedure.

The first step involves a micron-thin, circular flap in the cornea - the surface of the eye. This takes just a few seconds and the surgeon uses either a microkeratome or femtosecond laser. Then, the surgeon gently lifts the flap to expose where the actual vision correction treatment will happen, just under the surface of the eye.

In the second step, a computer-guided excimer laser is used to permanently remove the microscopic pieces of tissue creating the patient’s vision problems. The flap is then laid back in place to act as a natural bandage and protect the reshaped portion of the cornea while it heals.

Since LASIK eye surgery was first approved by the FDA, more than 19 million LASIK procedures have been performed in the United States. Further, LASIK has received more than 45 FDA approvals, treating myopia, hyperopia, presbyopia, astigmatism and more.

Do They Actually Shoot Lasers into Your Eyes?

Yes (and it’s pretty cool). First of all, lasers are simply beams of light that move together within the same wavelength at different speeds. For example, the femtosecond laser that is sometimes used to create the flap is an infrared laser that pulses at one quadrillionth of a second to create microscopic tissue disruptions within the cornea. The excimer laser used to correct your vision is a cool, ultraviolet light beam with a pulse rate of up to 1000 Hz. Notice each laser references a different color? That is because any given laser uses exactly one color of light from the wavelength spectrum.

Lasers are used in surgeries of all types because they are incredibly precise. This is important because people often refer to LASIK as “slicing” or “cutting” into the eye. The descriptions are not quite accurate. The entire LASIK procedure occurs entirely within the layers of the cornea, no other part of the eye is involved. This is only possible because lasers can be used safely without damaging surrounding tissues.

Does it Hurt?

LASIK eye surgery is relatively painless because numbing drops are used to anesthetize the eye before and during the procedure. Patients generally experience some pressure for a few seconds, but otherwise they are usually very comfortable with the numbing and lubricating drops. After the procedure some patients will have mild discomfort that on average lasts about 3-5 hours, however a nap eliminates most of all of the discomfort post operatively. 

Are You Awake?

Yes, and that usually makes some people cringe a bit. But, in addition to the numbing drops, you are given a Xanax (or other sedative) to help keep you calm. Further, there is nothing that you as the patient could do while being awake that would be harmful to you. If your eye moves, the laser’s tracking capabilities follow your eye. If you sneeze or abruptly move your body too much, the laser automatically turns off.

Is LASIK safe?

Is LASIK safe? This is one of the number one questions people ask about LASIK. And, it’s a good one.

LASIK is among the most studied elective procedures. More than 7,000 clinical studies have been conducted and published about LASIK. As a result, there is a tremendous amount of data supporting its safety and effectiveness.

LASIK eye surgery has one of the highest patient satisfaction rates of any elective procedure: more than 96 percent.

Many LASIK patients have better vision than they did with their best glasses prior to surgery.

In more than 40 million procedures performed worldwide, there has never been a case of blindness because of LASIK in anyone who is a healthy, good candidate.

What Are the Side Effects?

It is normal to experience some symptoms during the healing period after LASIK. After all, it is a surgical procedure even if it only took 15 minutes. This recovery period is to be expected and your eyes may feel a little dry, light sensitive, or irritated while they heal. Be sure to talk with your doctor about your symptoms during your post-LASIK visits.

Some patients experience side effects from LASIK, which generally include night vision visual symptoms such as glare, halos, ghosting, starbursts, and dry eye. Typically, glare, halos, ghosting, and starbursts gradually resolve by themselves over a period of a few weeks or months, perhaps as long as a year. Some people require additional courses of eye drops to help reduce inflammation or dry eye that can contribute to visual symptoms. In rare cases ( in our office less than 1 percent of the time), additional LASIK treatment could be wanted to address residual prescription in the eyes or of course you can wear much thinner glasses or contact lenses.

Can Anyone Have LASIK Eye Surgery?

No. In fact, most surgeons report that upwards of 20 percent of their LASIK consultations are not eligible. In our offices, approximately 20-25% of all patients seen at our centers are turned away, as they are deemed to be  something other than low risk candidates.   Thin or irregular corneas, as well as certain eye diseases like glaucoma, are likely to disqualify patients for LASIK. Certain autoimmune diseases like lupus or rheumatoid arthritis, and medications, like corticosteroids, that can impair the healing process, sometime make laser vision correction procedures a less-than-ideal choice.

Can I Go Anywhere and Have LASIK?

A refractive surgeon (a board-certified ophthalmologist who has completed additional surgical training) performs LASIK, as well as other vision correction procedures.  It is nice to know that Dr Holzman is a Refractive Surgeon that is also a Fellowship-Trained Corneal Specialist. 

Is it for Me?

Only you can decide if LASIK eye surgery is right for you. Once you have determined if you are a good candidate and found a surgeon you trust and feel comfortable with, you have to make the decision if it’s right for you and your lifestyle. For those patients who want to be less dependent on glasses or contacts, LASIK technologies and outcomes are better than they’ve ever been and there is a huge body of clinical research and literature that backs it up.

To learn more about LASIK and schedule an appointment in Washington, DC, or at one of our other locations, contact us online or call us at (703) 556-9155.

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