Understanding Lasik Eye Surgery Basics

Lasik (Laser-Assisted In Situ Keratomileusis) is a refractive surgery that permanently changes the shape of the cornea, the clear covering of the front of the eye. This reshaping allows light entering the eye to be properly focused onto the retina for clearer vision.

The procedure typically takes less than 30 minutes for both eyes. During surgery, a specialized laser creates a thin flap in the cornea. This flap is folded back, and another laser precisely removes microscopic amounts of corneal tissue to reshape it according to your specific vision prescription. The flap is then repositioned, acting as a natural bandage as healing occurs.

Lasik can correct several common vision problems:

  • Nearsightedness (myopia) - difficulty seeing distant objects
  • Farsightedness (hyperopia) - difficulty focusing on near objects
  • Astigmatism - blurred vision due to irregular cornea shape

Most patients experience improved vision within 24 hours after surgery, with vision continuing to stabilize over several weeks. The success rate is remarkably high, with over 96% of patients achieving their desired vision correction.

Are You a Good Candidate for Lasik?

Not everyone is an ideal candidate for Lasik eye surgery. Ophthalmologists evaluate several factors to determine suitability:

  • Age - Candidates should be at least 18 years old, though many surgeons prefer patients to be 21 or older when vision has fully stabilized
  • Stable vision - Your prescription should remain unchanged for at least one year
  • Corneal thickness - Sufficient corneal tissue is necessary for safe reshaping
  • Eye health - Free from conditions like severe dry eye, keratoconus, or glaucoma
  • Overall health - Certain autoimmune disorders or medications may interfere with healing
  • Realistic expectations - Understanding potential outcomes and limitations

During a pre-operative consultation, your eye surgeon will perform a comprehensive eye examination, including corneal mapping, pupil dilation, and refraction tests. They will measure corneal thickness and evaluate tear production to assess dry eye risk.

If you wear contact lenses, you may need to stop wearing them for several weeks before your evaluation and procedure, as contacts can temporarily change your cornea's shape. The consultation also provides an opportunity to discuss your expectations and address any concerns about the procedure.

The Lasik Procedure: What to Expect

Knowing what happens before, during, and after Lasik can help ease anxiety about the procedure.

Before Surgery:

  • Avoid wearing makeup, creams, or perfumes on surgery day
  • Arrange for someone to drive you home afterward
  • Take any prescribed pre-operative medications

During the Procedure:

The actual Lasik procedure involves these steps:

  • Numbing eye drops are applied (no injections or general anesthesia needed)
  • An eyelid holder prevents blinking
  • A suction ring stabilizes your eye while the corneal flap is created
  • You may feel pressure but not pain during this step
  • The surgeon folds back the flap and asks you to focus on a target light
  • The excimer laser, which tracks your eye movements, reshapes your cornea
  • You might notice a clicking sound and smell as the laser works
  • The flap is repositioned and naturally adheres back in place

After Surgery:

Immediately after the procedure, your vision will be blurry. You might experience burning, itching, or a feeling like something is in your eye. These sensations typically subside within a few hours. Most people notice improved vision within 24 hours, though complete stabilization may take several weeks.

Your surgeon will provide detailed aftercare instructions, including eye drop schedules and activity restrictions. Follow-up appointments are essential to monitor healing and address any concerns.

Recovery and Results from Lasik Surgery

The recovery process after Lasik is relatively quick compared to other surgical procedures. Most patients return to normal activities within 24-48 hours, though complete healing takes longer.

Immediate Recovery (First 24-48 Hours):

  • Rest with eyes closed for several hours after surgery
  • Use prescribed eye drops to prevent infection and inflammation
  • Wear protective eye shields, especially while sleeping
  • Avoid rubbing your eyes
  • Expect some discomfort, light sensitivity, and tearing

First Week After Surgery:

  • Vision continues to improve and stabilize
  • Avoid swimming, hot tubs, and contact sports
  • Limit screen time to prevent eye strain
  • Use artificial tears for dryness
  • Attend your first follow-up appointment

Long-Term Results:

Most patients achieve 20/20 vision or better after Lasik. However, results vary based on your initial prescription and individual healing patterns. Some patients may still need reading glasses as they age due to presbyopia, a natural age-related condition affecting near vision.

While Lasik creates permanent changes to your cornea, your vision may change over time due to aging or eye disease. A small percentage of patients may need an enhancement procedure (sometimes called a touch-up) if their vision changes or if the initial correction was insufficient.

Potential Risks and Side Effects of Lasik

While Lasik has a strong safety record, like any surgical procedure, it carries potential risks and side effects that patients should understand before proceeding.

Common Side Effects:

  • Dry eyes - The most common side effect, usually temporary but sometimes lasting months
  • Glare, halos, or starbursts around lights, especially at night
  • Reduced contrast sensitivity
  • Difficulty driving at night
  • Under-correction or over-correction requiring glasses or additional surgery

Less Common Complications:

  • Flap complications - Wrinkles, incomplete flaps, or flap dislocation
  • Epithelial ingrowth - Cells growing under the flap
  • Diffuse lamellar keratitis (DLK) - Inflammation under the flap
  • Ectasia - Progressive corneal thinning
  • Infection (extremely rare with proper care)

Advances in technology have significantly reduced complication rates. Modern Lasik uses wavefront-guided technology and eye-tracking systems that adjust for tiny eye movements during surgery. These innovations have improved outcomes and reduced side effects.

Choosing a qualified, experienced surgeon is perhaps the most important factor in minimizing risks. During your consultation, ask about the surgeon's experience, complication rates, and how they handle complications if they occur.