On the day of your LASIK procedure, it is natural to experience both excitement and nervousness. Patients who feel most at ease on that day are those who have asked questions, read about the LASIK procedure, and perhaps talked with former patients. Understanding LASIK and trusting your surgeon are important to helping you feel confident, calm, and prepared on the day of your procedure. You won't be able to drive immediately after the procedure, so it is recommended that you have someone drive you to the surgery center and pick you up when you're ready to leave.
How should I prepare for the day of my surgery?
Make an effort to arrive at the center rested and relaxed. You should plan to spend up to three hours at the laser center, although this amount of time varies from center to center. Wear comfortable clothing the day of your surgery. Do not wear makeup, skin moisturizer, perfume, or cologne, since LASIK requires clean, sterile conditions. Earrings should not be worn.
How the LASIK procedure performed?
LASIK is performed while the patient is awake. However, if you are experiencing anxiety, the surgeon may give you a mild oral sedative. Many surgeons talk to the patient throughout the procedure, so the individual knows what is happening and what to expect next.
What happens before the surgery?
Before the surgery begins, your face will be cleaned with a disinfectant, and you will be asked to wear a surgical cap. You will be given an antibiotic eye-drop and possibly an anti-inflammatory eye-drop. These may sting for a few seconds.
What happens during the procedure?
Once in the laser suite, you will be positioned comfortably on your back, under the excimer laser. Your surgeon will give you anesthetic eye-drops to numb the surface of your eyes. Your eyelashes will be taped out of the way, and an eyelid speculum will be placed between your eyelids, to keep you from blinking. The speculum sometimes causes mild pressure or discomfort to your eyelids at first, but with the numbing drops, these sensations dissipate.
The surgeon will make small reference marks on your cornea with water-soluble ink. These marks will serve as positional guides when it is time to realign the corneal flap. A suction ring is then placed on your eye to hold it in position to maintain pressure within the eye. Keeping the eye pressurized is essential for the keratectomy, or flap-making process, which comes next. Your vision will dim during this step.
Next the surgeon will create the corneal flap, using the microkeratome, the small instrument with a blade that passes over the eyeball. The extremely thin flap is made from the outermost 25 percent of the cornea. (The average cornea is only about the thickness of a credit card.) This flap-making process takes about thirty seconds. When the microkeratome is making the flap, you may feel slight pressure and the instrument will block out light as it passes over your pupil.
Next, the surgeon will ask you to fix your vision on a target light - usually red, green, or yellow. Then, the surgeon will gently lift back the hinged flap. At this point your vision will become blurry.
The surgeon will now perform the laser procedure. This usually takes twenty to ninety seconds. You will not feel any pain as the laser sculpts the cornea by vaporizing small amounts of tissue. This process is called photoablation. You will also hear a clicking or buzzing sound with each pulse of the laser. The surgeon is reshaping your cornea.
During the laser procedure, individuals have different responses to staring at the fixation light. Some patients report that the fixation light becomes a blur. Others report that it seems to momentarily disappear. If this happens and your eye starts to wander, the surgeon will stop the laser. You will be coached to look again at the target light so the laser procedure can resume.
Once the process of reshaping your corneal tissue is complete, the excimer laser will be turned off. Using a sterile saline solution, the surgeon will flush the treated surface of the eye to ensure that any debris is washed away. The surgeon then carefully replaces the corneal flap to its original position, using the ink marks as guides.
It takes about one to five minutes for the eye to create a natural vacuum to hold down the flap. The cornea has the unique ability to seal itself back into place. No sutures are necessary. Your eyes will be dried with a sterile cloth, and the eyelid speculum will be removed. You will now be able to blink normally. At this point, you will be asked to sit with your eyes closed for about thirty minutes. Then your physician will examine your eyes one more time to ensure that the corneal flap is properly positioned.
Patients who have undergone LASIK experience some discomfort, which may last six to eight hours. Patients describe this as a sensation of having sand or a dirty contact lens in their eye. Tylenol, aspirin, ibuprofen, or similar over-the-counter pain medications can help. By the following day, this sensation is usually gone.
Immediately after surgery, expect your vision to be somewhat blurred, similar to looking through a glass of water or wearing a dirty contact lens. However, upon awakening later in the day or the next morning, you should experience improved vision. Most patients report dramatic improvement within twenty-four hours.
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