The LASIK Procedure in Detail
Step One: Preoperative preparation and measurements: In our practice, LASIK is performed on an outpatient basis at the Arizona Eye Laser Center on Campbell Avenue. Although the procedure itself takes only a few minutes to complete, you should plan to spend a couple of hours at the center. Some of this time will be spent preparing you and your eyes for the procedure, while a few minutes will be required afterwards for postoperative instructions and departure preparation.
Before the procedure begins, a nurse or technician will talk to you about any immediate health problems that may affect your readiness for the surgery. At this point, additional eye measurements will be taken if you are undergoing wavefront LASIK (read about wavefront technology below). Anesthetic eye drops will be given to completely numb your eyes during the entire procedure.
Step Two: Creating the Flap: Currently, we create most LASIK flaps using the IntraLase® laser.This advanced technology “femtosecond laser” allows the formation of a corneal flap of any shape and size with tremendous precision, virtually eliminating the blade-related complications of a metal microkeratome. All cutting is done by laser, with no sharp instruments ever touching the eye. IntraLase LASIK has now been approved by the U.S. military for Air Force pilots, and by NASA for astronauts due to its precision and safety.
You will be comfortably positioned under the IntraLase device and a suction ring will be moved into place around your eye. Using a vacuum, this ring will hold your eye perfectly still while the laser creates the flap, a process that takes about 10-15 seconds. During this time you might feel a slight pressure, but no pain, and your vision will be diminished. Once the suction ring is released, you will notice a diffuse haze over your vision as the flap fully develops over the following few minutes. The procedure is then repeated on your second eye, if both are being treated.
In occasional cases, a microkeratome might still be used to create the flap. The overall process is similar, with placement of a suction ring. The microkeratome, which functions somewhat like a carpenter’s plane with a rapidly oscillating blade, passes over the cornea to cut the flap. This takes about 10 seconds, with no pain.
Click here to learn more about IntraLase technology.
Step Three: The Excimer Laser: Your eye is now ready for the final phase of LASIK- administration of the laser pulses to reshape the cornea. You will lie comfortably below the laser aperture and the area around your eyes will be prepared with a sterile cleanser. A plastic or paper drape will be placed around the eye, and a small eyelid separator will be placed to keep the eye open. Your surgeon will use an instrument to gently lift up and fold back the previously created corneal flap. You will not feel any discomfort. The surgeon will ask you to look towards a fuzzy, blinking red light above you. You do not need to worry about small eye movements, as the laser tracks the movement of your eye and adjusts its aim accordingly. It will stop firing completely if you move too far off track. As the surgeon activates the laser, you will hear a rapid “clicking” or “tacking” sound. Again, you should feel no discomfort whatsoever. The total number of laser pulses required depends upon the amount of refractive error being corrected, with most treatments completed within 10 to 15 seconds. When the laser is complete, your physician will irrigate away any debris with a sterile solution and then carefully reposition the flap. A contact lens may be placed on the eye to help the flap heal more quickly.
Step Four: Postoperative Measures: When the procedure is complete, antibiotic drops will be given and your surgeon will cover your eye with a clear plastic shield. For a short time after the surgery, you will not have much sensation due to continued numbness. However, later in the day you may experience some light sensitivity and a scratchy or dry sensation as though you have dust in your eye. This usually resolves within a few hours. You should plan to have someone drive you home from your procedure, as you will most likely be given medication to help relax prior to surgery.
You will return to our office the following day for a postoperative examination. The flap will be checked to assure that it is healing properly. If present, the contact lens will be removed at this time. Vision at this time is usually between 20/20 and 20/40, depending on the degree of refractive error corrected. Vision may continue to improve over the next few weeks before stabilizing fully. At this point you should be able to go about your business as usual… with one exception- no more glasses or contact lenses!