What Happens During LASIK Surgery

LASIK (Laser-Assisted In Situ Keratomileusis) is a refractive surgery that reshapes the cornea to correct vision problems such as nearsightedness, farsightedness, and astigmatism. The procedure typically takes less than 30 minutes for both eyes.

During the surgery, the ophthalmologist creates a thin flap in the cornea using either a microkeratome blade or a femtosecond laser. The flap is folded back, and an excimer laser precisely removes microscopic amounts of corneal tissue to reshape it according to the patient's vision prescription. Once complete, the flap is repositioned to act as a natural bandage.

The actual laser treatment usually lasts less than 60 seconds per eye. Patients remain awake during the procedure, with numbing eye drops applied to eliminate pain. Most people report feeling only slight pressure during the surgery, with minimal discomfort.

Immediate Post-LASIK Recovery (First 24-48 Hours)

The first 24-48 hours after LASIK surgery are the most critical for proper healing. Immediately after the procedure, patients may experience:

  • Burning or itching sensation
  • Watery eyes
  • Blurry or hazy vision
  • Light sensitivity
  • Mild pain or discomfort

These symptoms are normal and typically subside within the first day or two. Patients receive protective eye shields to wear while sleeping for the first week to prevent accidental rubbing or pressure on the eyes.

Most surgeons prescribe medicated eye drops to prevent infection and inflammation and to keep the eyes lubricated. Following the prescribed eye drop schedule is essential for proper healing.

Patients should arrange for someone to drive them home after surgery and should rest with eyes closed for several hours afterward. Many people report significant vision improvement within hours of the procedure, though complete stabilization takes longer.

One Week to One Month Recovery Phase

During the first week after LASIK, the corneal flap begins to adhere and heal. Patients typically attend a follow-up appointment 24-48 hours after surgery, where the doctor checks healing progress and vision improvement.

Common experiences during this phase include:

  • Decreasing light sensitivity
  • Improving visual clarity
  • Reduced dryness and irritation
  • Ability to resume most normal activities

Most patients can return to work within 1-3 days, though this varies based on occupation and individual healing. Computer work may cause eye strain, so frequent breaks are recommended.

By the one-month mark, many patients achieve their final vision outcome, though some continue to see improvements for up to six months. During this period, patients should:

  • Avoid swimming pools and hot tubs for 2-4 weeks
  • Refrain from contact sports for at least one month
  • Avoid eye makeup for 1-2 weeks
  • Use preservative-free artificial tears for dryness
  • Wear sunglasses outdoors to protect from UV exposure

Long-Term Results and Vision Stability

Most LASIK patients achieve 20/20 vision or better after full recovery. According to clinical studies, approximately 96% of patients are satisfied with their results, making LASIK one of the most successful elective procedures.

Vision typically stabilizes between 3-6 months post-surgery, though minor fluctuations may occur during this time. Factors affecting long-term results include:

  • Pre-surgery prescription strength
  • Corneal thickness and healing patterns
  • Age (patients under 40 typically have more predictable outcomes)
  • Following post-operative care instructions

The permanence of LASIK results varies. The corneal reshaping is permanent, but natural age-related vision changes still occur. Some patients may experience slight regression over time, particularly those with high prescriptions before surgery.

Presbyopia, the age-related difficulty focusing on close objects that typically begins around age 40, is not corrected by standard LASIK. Some patients may need reading glasses later in life, regardless of having had LASIK surgery.

Potential Side Effects and Complications

While LASIK has a high safety profile, potential side effects can occur during recovery. Most are temporary but some patients may experience:

  • Dry eyes (most common, typically resolving within 3-6 months)
  • Night vision disturbances (halos, glare, or starbursts around lights)
  • Under-correction or over-correction requiring enhancement
  • Temporary or permanent light sensitivity

More serious but rare complications include:

  • Corneal flap complications (displacement, wrinkling, or abnormal healing)
  • Corneal infection (occurs in less than 1% of cases)
  • Corneal ectasia (progressive thinning and bulging of the cornea)

The risk of complications decreases significantly when patients choose experienced surgeons, follow pre-qualification guidelines, and adhere to post-operative care instructions. Most side effects improve substantially within the first six months after surgery.

Enhancement procedures (retreatment) may be necessary for about 5-10% of patients whose vision does not meet the desired outcome. These are typically performed after vision has stabilized, usually 3-6 months after the initial procedure.