How long does LASIK last?
With LASIK the laser is reshaping the cornea to give it the power that is similar to your contact lenses or glasses. This reshaped cornea is permanent. The power placed in the cornea will be there the rest of your life. If someone has a shift in their prescription needs, that may lead to an enhancement later in life, which is why it is recommended a person wait for LASIK until their prescription for glasses has not changed much in over 1 year which is typically by age 18. Some people will experience glasses change into their 20’s. This is best evaluated with your current eye doctor, or by bringing your prescription records of the last year or two with you for your LASIK evaluation.
I have astigmatism, can I still have LASIK?
While the word itself may be misleading, Astigmatism is simply a description of a curve in the cornea. The cornea is the clear dome over the iris where you place a contact lens if you wear one. This structure is the first part where light enters the eye. If the corneal dome is round like a marble then light with enter and bend to a focused point as it travels through the eye to the retina. If the cornea has this extra curve called Astigmatism, then it will spread the light along an angle and cause letters and lines to appear smeared. Since LASIK is reshaping the cornea, then during the LASIK procedure, the laser will reshape and reduce that extra curve so that there is a better apex for focusing the light rays. There’s a limit for the amount of curve on the cornea the laser can correct with LASIK, but it is a large amount of up to 5 diopters. With astigmatism, each patient heals differently so if anyone were to be more likely to have and enhancement after the procedure, the higher the astigmatism would be the person to have one. That being said, it is perhaps one in every 10 high astigmatism patient who may benefit from a touch-up after 3 months of healing.
What is a complication from LASIK that may occur?
Beside the dry eye complication that is temporary as earlier discussed, there is short-term halo and glare increase or the loss of suction during the flap creation that are the most typical complications. How serious are they?
The halo and glare are temporary as the flap heals and usually last maybe 6 weeks. While the eye is healing from the procedure everything will appear relatively sharp, but the light sources, like headlights or street lamps or digital clock numbers may have starbursts or streaks. These glare issues are temporary as the layers of the cornea are healing. After a few weeks they will shrink and continue getting smaller until they are back to normal or better than before (with Custom treatment.)
Loss of suction during laser flap creation is minor compared with the loss of suction with the blade method of flap creation. As you can imagine a blade immediately creates a plane in the area through which it is passing. Now with the femtosecond laser creating the flap, only bubbles are passing through the treatment area for flap creation. This means if suction is lost, there are only bubbles that will disappear in about 5 -10 minutes. Until the eye doctor lifts the flap, it is literally only a potential space. The cornea is completely intact. Afterwards depending on the appearance and position of the bubbles, the surgeon may decide to either repeat the flap creation immediately, wait a few weeks and then repeat flap creation, or opt for PRK instead. This is a huge safety feature which we all love. The only thing that results is a delay in your vision correction for a few hours or weeks. No permanent distortion from irregular flap cutting anymore with this all laser LASIK. Ask your surgeon how they handle these temporary complications with LASIK and what you can expect from your care team. Ideally they will be available for you every day of the week to help answer any questions or problems that may arise.
What about blurry vision during recovery after LASIK?
Blurry vision is typically experienced for 2-8 hours after LASIK with All-laser LASIK. Blurry vision will appear as foggy vision, things are more defined and yet still smoky. If you have had LASIK with PRK and no flap was created then the blurry vision stage will last about 4-5 days, less smoky and more out of focus. Once the “bandage” contact lens has been removed the vision clears up within another 1-2 days typically. Everyone has a different rate of healing and it may be normal for someone to have blurry vision for another few days.
You will have a number of visits after your LASIK procedure, please be sure to show up for all of them so that your LASIK post-op care team may best monitor your healing and vision recovery to assess the situation. Your vision may be clear one day and feel a little foggier the next, this fluctuation is normal. If there is a significant decrease in what in you see, and artificial tears are not helping, we always want to hear from you to make sure this change is within normal limits. For a few months, the vision may fluctuate slightly throughout the day and this is to be expected. As the surface heals and normal moisture levels return, vision will remain more consistent. The most fluctuation occurs typically by the end of the day when you are tired and the eyes are more dry. Typically at 6 months everything has settled down and vision is more stable.
I have heard that having LASIK means you will not be a candidate for cataract surgery later… Is this true?
Having LASIK will reshape the cornea permanently. Later in life the natural lens inside of the eye may become cloudy and require removal. Being post-LASIK does not mean you will not be able to have cataract surgery. Years ago the lens calculations were more difficult post-LASIK but now there is so much technology and so many new formulas to make the calculations for the proper lens. There are a few exception to this as with any surgery, things may be more complicated for some people. A LASIK enhancement after cataract surgery may be of benefit or a lens exchange, depending on the needs of the patient. This may occur whether or not a person has ever had LASIK. Each person is different so each case requires thought and planning, as with any surgery. As technology progresses the process will likely be even more precise. LASIK will not ever prevent someone from having cataract surgery in the future
I have heard people need LASIK enhancements or touchups, is this common?
One reason for needing an enhancement, which is rare but does occur, is after a medical condition or certain medication. Some people find with hormonal changes or long-period of constant near-focus, their vision needs may change. This is not common, but a possibility with pregnancy or a high-stress close-focus job. Another reason for a change in the power needed after age 20 is from an illness. If someone has high-blood sugars for a month or more, their vision needs may change. It is also possible for someone with asthma or pneumonia to need steroids for a long period of time. These medications may affect the vision as well. So if anyone you know has experienced a change in vision and they are over 20, they should see their doctor to rule out any underlying illness or side-effect from a medication.
Another reason someone may need an enhancement, is from the normal age-related change of presbyopia. This is the need for reading glasses as your natural lens inside the eye loses it’s flexibility with age. Typically as you reach age 40, you will notice that you must hold thing further out to focus. With LASIK, a person can change the focus of one eye to near work which will give them about 10 years before needing reading glasses. As the years pass, this person may decide the benefits from redoing LASIK for more near out-weight the risks, and elect to have an enhancement for more near vision. This is not common, but another reason you may have heard about enhancements.
How soon can I go back to work after LASIK?
Most patients return to work the next day after their one day post-op when having LASIK. We can see patients as early at 8 am so that they can get to work as soon as possible. Typically you are able to drive yourself, but if the valium from the night before is still affecting you, we ask that you have a driver available or simply delay the post-op visit until later in the day.
If someone has had PRK we ask them to plan on 4 days off from work after the procedure. The eyes will feel more scratchy and teary making work difficult. Also there is a contact lens on the eye as a bandage, and if it falls out they would not be able to drive due to discomfort and tearing. As a rule we recommend planning on returning to work the day after the contact lens has been removed. If a PRK post-op patient feels fine after the contact removal, then he or she is welcome to return to work early.
Rarely someone will have received more power from the correction or less power from the correction than anticipated resulting in blurry vision. We like to trouble shoot that after a few days and determine the best way to help someone see well for work and driving while we wait for healing time to allow the vision to settle. Typically we will know for sure after 4-6 weeks the correction adjustment that will be needed with an enhancement, but it is best practices to wait until 3 months post-op before doing anything more to the eye. We can measure how far from target a person landed and then us that information to adjust the treatment for the enhancement. read more about this in the “Enhancement” question above.
Can I swim after LASIK?
Immediately after your procedure the epithelial layer must heal before exposing yourself to water which may contain microorganisms. The doctors recommend waiting 1-2 weeks before swimming in lakes or going in hot tubs or pool to be safe. Some people do push the boundaries and go swimming within a week without any trouble, but why push? After making such an investment into your vision, I would recommend following the guidelines and avoid swimming for 1-2 weeks to be safe.