X-Plain

LASIK
Reference Summary

Introduction
LASIK surgery is a procedure that improves vision and can decrease or eliminate the
need for eyeglasses or contact lenses. If you and your doctor decide that LASIK
surgery is right for you, it is important to know the benefits and risks of this procedure
before consenting to it. This reference summary explains what LASIK surgery is and
covers the benefits and possible risks of the surgery.
Anatomy
The eyes are very sophisticated optical organs that collect light and focus it, allowing
us to see. The cornea is the front, transparent part of the eye. The cornea allows light
to enter and starts to focus it as the
light moves to the back of the eye.
Cornea
Iris
Lens
Vitreous
Retina
Macula
After entering through the cornea, light
hits the iris, which is the colored part of
the eye. The opening in the middle of
the iris is called the pupil. The iris
controls the amount of light entering
the eye by changing the size of the
pupil.
As light passes through the pupil, it
goes through a clear lens. Like the
lens of a camera, the lens of the eye
further focuses the light onto the back
of the eye, called the retina.
The capsule holds the lens in place. After hitting the lens and before reaching the
back of the eye, light rays travel through a transparent fluid called vitreous. The back
of the eye is called the retina. The retina changes light signals into electric signals.
These electric signals are sent through the optic nerve to the brain, which translates
these signals into the images that we see.

This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice
of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over
time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition.

1995-2008, The Patient Education Institute, Inc. www.X-Plain.com ot040103
Last reviewed: 4/25/2008 1


Refractive Errors
The shape of the cornea and eye can cause blurry vision. Ideally, we should see
images that are sharp as a result of being focused on the retina.
When an image gets focused in front of or behind the retina, the result is blurry vision.
This produces astigmatisms, near-sightedness, and far-sightedness. These
abnormalities are called refractive errors. People who are near-sighted are able to
clearly see things near them, but cannot see things that are far away very well. This
condition is also called myopia. Far-sighted people are able to clearly see things far
away but have difficulty seeing things that are close. This
condition is also called hyperopia.

This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice
of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over
time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition.

1995-2008, The Patient Education Institute, Inc. www.X-Plain.com ot040103
Last reviewed: 4/25/2008 2


Astigmatism causes images to appear distorted and
happens when there are irregularities in the cornea or in
the lens of the eye. Contact lenses and eyeglasses
refocus images on the retina, which restores normal
vision.
Many surgical procedures have been developed to help
refocus images onto the retina. Among them, LASIK is
the one that is currently used the most in the United States. The following section will
review some of the various surgical procedures that improve vision; they are known as
refractive surgery.
Refractive Surgery
The goal of refractive surgery is to refocus images onto the retina. The most common
way of doing this is by reshaping the cornea. Photo
Refractive Keratectomy, or PRK, reshapes the cornea
using a laser light. Laser is a focused ray of light that,
in medicine, is used to destroy various types of tissues
with extreme precision. In this case it is used to
reshape the cornea. The healing cornea is very painful
and itchy. To avoid the bothersome healing process,
LASIK was developed.
LASIK stands for laser assisted in situ keratomileusis and it means the use of a laser
to reshape the cornea without disturbing nearby cells. The main way that LASIK is
different than PRK is that LASIK creates a small flap in the cornea before reshaping it.
The flap is placed back over the reshaped cornea, decreasing the symptoms of pain
and itching in the eye.
Another type of refractory surgery is called thermokeratoplasty." This surgical
procedure uses heat to reshape the cornea and a different laser than the ones used in
PRK and LASIK.
There are other surgeries that can reshape the cornea using various other materials.
Such surgeries use ring-like structures that are implanted in the cornea or special
contact lenses that temporarily reshape the cornea.
LASIK
Not everyone who uses eyeglasses or contact lenses is a good candidate for LASIK.
Patients should be older than 18 before LASIK is considered. This is the guideline
because it is possible for the eyes to change until around the age of 18. If LASIK
surgery is an option for you, your eye doctor should be sure that your eye condition
has not changed over the last few years.
Other eye conditions can make LASIK unsuitable for certain patients, including
diabetes
cataracts
herpes infection of the eye
rheumatoid arthritis.
If your doctor recommends LASIK surgery for you, be sure to check with your health
insurance. Many health insurance companies consider this procedure to be elective
and do not cover the expenses.
Preparing for LASIK
Before choosing to have LASIK surgery, you must see
an optometrist or an ophthalmologist for a very
thorough eye exam. With the results of your exam, the
doctor will be able to tell you whether or not LASIK
surgery is suitable for you. If you could benefit from
LASIK surgery and choose to do so, you will be
scheduled for the actual procedure.

This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice
of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over
time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition.

1995-2008, The Patient Education Institute, Inc. www.X-Plain.com ot040103
Last reviewed: 4/25/2008 3


A few days before the LASIK procedure, you will meet with the ophthalmologist who
will perform the surgery. He or she will review your previous exam and obtain a
detailed, computerized map of your cornea. The computerized map is made using a
special machine; it is a short, painless procedure.
Using the map of your cornea, a computer determines where the laser beam should be
used on the cornea to reshape it and improve the vision. You will not be able to wear
contact lenses for a certain amount of time prior to the LASIK procedure; your doctor
will tell you how long. Contact lenses affect the curvature of the cornea and, therefore,
could affect the result of the LASIK surgery.
You will also be asked not to wear any make up, lotion, or other similar products on
your face for a few days before the procedure. This precaution decreases the chances
of infection at the time of surgery.
The best results for LASIK are seen in patients with moderate vision problems.
Patients with very severe myopia can benefit from LASIK but may still need to wear
glasses or contacts after the procedure.
Procedure
LASIK is an outpatient procedure. Patients go home the same day. You should
arrange to have someone drive you home after a LASIK procedure, since your vision
might be blurry at first.

This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice
of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over
time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition.

1995-2008, The Patient Education Institute, Inc. www.X-Plain.com ot040103
Last reviewed: 4/25/2008 4


While in the operating room, the eye is
anesthetized with special eye drops to
eliminate pain.
The cornea is held in place with a vacuum
device. The ophthalmologist makes a flap in
the cornea using a special instrument. The flap is lifted out of the way of the laser.
The laser is then used to reshape the cornea.
After the cornea is reshaped, the ophthalmologist replaces the flap over the cornea,
which completes the procedure. The flap does not need to be stitched; it sticks to the
underlying cornea on its own. The whole procedure only takes about 15 minutes.
Some ophthalmologists encourage patients to have both eyes operated on at the same
time and others prefer to do each eye separately.
After The Procedure
You will be given eye drops to moisturize and lubricate your eye.
It takes 1-2 days for the flap to stick securely to the cornea. During that time, you
should not rub your eye at all.
Your ophthalmologist will probably give you an eye shield to prevent accidents during
the first few nights. Sunglasses may also help if it is sunny or you encounter bright
light. You will be given antibiotic and anti-inflammatory eye drops.
Most patients see great improvement in their vision within the first few days after a
LASIK operation. However, immediately after the procedure, vision may be slightly
blurry.
Here are some tips to help you through the first week of recovery:
Rest as much as possible for the first few days.
Refrain from swimming or using a hot tub.
While bathing, avoid getting water or shampoo in
your eye.
Avoid using make-up, as well as activities that
expose your eyes to smoke, dirt, or dust.
Avoid activities that might strain your eyes, such
as watching TV for long periods of time.
You may be able to drive after a few days, depending on how your eyes feel and how
clear your depth perception is.
You will need to return for a follow up visit with your ophthalmologist.
Risks & Complications
LASIK is a very safe procedure; risks and complications are rare but possible.
Knowing about them will help you identify them and treat them early in case they
happen.
The cornea could get infected, requiring antibiotics.
Scarring of the cornea and surrounding structures could lead to permanent vision
problems that may not be correctable with glasses or lenses. Such scarring may
prevent the future use of contact lenses. This is extremely rare.

This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice
of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over
time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition.

1995-2008, The Patient Education Institute, Inc. www.X-Plain.com ot040103
Last reviewed: 4/25/2008 5


Sometimes there is a decrease in visual sharpness and, even with corrective lenses
things may look hazy around the edges.
Occasionally, patients experience what are called halos or starbursts. These
sensations make it look like a halo of light is surrounding bright objects. For example,
stars might appear as small circles of light rather than points of light. Flap problems
are rare but possible; they could lead to more surgery and decreased vision. Flap
complications include:
irregular flap
incomplete flap
cut off flap
growth of cells under the flap.
In extremely rare cases, the cornea may be perforated
during or after surgery. This could lead to a more
complicated eye surgery, the need to replace the lens of
the eye, or stitching the cornea back on. It is extremely
rare for the cornea to become perforated.
Rarely, the eye may permanently feel dry, scratchy, or
painful. LASIK surgery cannot be reversed. However, it
can be repeated in order to improve the results. If you
choose to have LASIK surgery to correct your distance
vision, you may still need reading glasses when you are around 45 or so.
Summary
LASIK surgery is a very common and safe procedure. It allows doctors to correct a
wide range of vision problems using a laser beam.
Seventy percent of patients who undergo LASIK end up
with 20/20 vision. LASIK surgery is a relatively safe
procedure. Some complications and risks are possible. It
is important to have realistic expectations regarding how
much better you will see after LASIK surgery.
LASIK surgery is not for everyone. If you are eligible,
your doctor will answer any questions you may have and
give you answers that are specific to your condition.

This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice
of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over
time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition.

1995-2008, The Patient Education Institute, Inc. www.X-Plain.com ot040103
Last reviewed: 4/25/2008 6