LASIK Surgery Procedure: A Step-by-Step Guide

LASIK has been performed on millions of people for the past 30 years, with more than a 90 percent success and satisfaction rate. If you want to correct your refractive error, this is one of the best options available.

Before the operation, stop wearing contact lenses, makeup, and eye cream. Afterward, rest your eyes for 24 hours. Then, you can return to moderate activity. You should wait several weeks to resume regular exercise, when your eye surgeon clears you for these activities.

The procedure itself takes about 15 minutes per eye, including the administration of eye drops and creation of the corneal flap. You may spend some time in the waiting room and recovery room as well.

This guide will help you understand the LASIK surgery process.

LASIK: One of the Most Successful Eye Surgeries in the World

LASIK, which stands for laser-assisted in situ keratomileusis, was approved by the United States Food and Drug Administration (FDA) in 1999. It has since become one of the most popular, common, and simple eye surgeries.

Millions of people around the world have undergone LASIK treatment to correct refractive errors. These are differences in the shape or thickness of the cornea that cause nearsightedness, farsightedness, or astigmatism.

Eye care professionals perform as many as 600,000 LASIK procedures every year, and over 90 percent of those procedures result in excellent uncorrected distance vision. Even when patients do not get 20/20 vision, which is rare, 95 percent report that they are happy with the results.

The LASIK procedure has been refined over 30 years. It is simple and effective, requiring very little time both in surgery and healing later.

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Preparing for Your LASIK Procedure

During your initial LASIK consultation with your surgeon, you will receive specific, personalized instructions about preparing for this procedure. However, there are some standard steps you can take to set yourself up for faster healing once the procedure is complete.

Here are common recommendations for preparing for LASIK:

• Stop wearing your contacts. Many people with refractive errors wear contact lenses rather than glasses since they more easily create the appearance of 20/20 vision. Wearing contact lenses consistently can slightly change the shape of your corneas, which will affect the measurements taken during your LASIK consultation.
  
  Stop wearing your contacts for a couple weeks before your consultation, so your corneas are their natural shape.
• Consider your medical history. Most people are good candidates for LASIK, but your eye surgeon should know about any underlying conditions that might affect your vision and healing time. This includes any history of eye infections or damage, as well as other medical conditions like diabetes or high blood pressure.
  
  You might not be a good candidate for LASIK if you:
  
  • Have a history of dry eye.
  • Have a changing refractive error.
  • Have a high level of refractive error.
  • Have corneal abrasions or disease.
  • Have a significant eye condition like cataracts or glaucoma.
  • Have keratoconus (a cone-shaped cornea).
  • Have an uncontrolled underlying health condition like heart disease or diabetes
  • Are pregnant or nursing.
  • Have thin corneas or have undergone a previous LASIK procedure.
    
• Arrange transport to and from the surgery. Once this surgical procedure is complete, you will need to rest your eyes for at least one full day. This means you will not be able to drive yourself home afterward. It is best to have a loved one drive you to and from the procedure, so you can relax when you leave.
• Stop using products around your eyes. One day before LASIK, stop using any products that are applied around your eyes. This includes eye cream, makeup, or perfume. These products can leave debris in or around your eye that can scratch your cornea and complicate the LASIK procedure.
  
  Your eye surgeon may ask you to scrub your eyelids and lashes for a period of time before the operation as well, to fully remove any debris.

LASIK Is a Rapid Outpatient Procedure

LASIK itself takes about 20 minutes — about 10 minutes per eye. This estimate does not include waiting and recovery time, which can add about an hour to your total visit.

Expect to be in the medical center for 1.5 to 2 hours, at most. It is unlikely that you will wait this long or need such a long recovery time after the procedure, though.

Your in-office wait time may include:

• Finishing paperwork related to the procedure.
• A final check-in and examination with your eye surgeon.
• Cleaning the area around your eye.
• Adding numbing drops to your eyes and waiting for them to work.
• Sitting in the darkened recovery room until your surgeon is satisfied that you are in good shape to leave.

Steps to Expect During LASIK

Here is what you can expect during your LASIK procedure:

1. Numbing eye drops will be put in your eyes.
2. You will recline in an exam room chair.
3. A lid speculum will be applied to keep you from blinking during the procedure.
4. A very small suction device will attach to your cornea, which can temporarily dim your vision.
5. Your surgeon will cut a flap in your cornea using either a microkeratome blade or a laser microkeratome. You may feel some pressure during this part of the procedure, but it should not hurt.
6. If a traditional microkeratome blade was used, this and the suction device will be removed and thrown away. They are only used once for patient health and safety.
7. Your surgeon will lift your corneal flap and dry the tissue.
8. The laser to reshape your cornea will be placed over your eye.
9. You will be asked to stare at a light as the guided, programmed laser reshapes the inside of your cornea. This takes about 60 seconds per eye.
10. The corneal flap will be put back into place.
11. A shield will be placed over your eye since no stitches or sutures are used in this procedure, allowing the cornea to heal without clouding or scarring.
12. Your other eye will be treated, and/or you will be moved to the recovery room for a few minutes.

Healing Times After Your LASIK Procedure

You should plan to take the whole day off after your LASIK procedure to rest your eyes, but many people are able to return to work or school the day after their procedure. However, you should avoid certain activities that might slow your eyes’ healing until your eye doctor clears you for these activities.

You will return 24 to 48 hours after your eye surgery to check in with your eye surgeon so they can examine your healing progress. If you are a fan of non-contact sports like running or yoga, your doctor may clear you to enjoy these exercises after this initial visit. You should generally wait between one and three days to return to a moderate exercise routine.

Other activities that might jostle or shift your cornea should be avoided for at least four weeks (one month) after the operation and sometimes for up to six months. These include:

• Strenuous physical activity, including martial arts or boxing.
• Contact sports like football or baseball.
• Swimming in any water, including pools or lakes.
• Soaking in warm spa pools or hot tubs.

You must wait up to two weeks before you can begin wearing makeup or using eye creams again. Your doctor may advise you on how to safely wash your eyes while you wait for them to heal, which can also prevent the buildup of grit around the eye that might impact healing. You may receive prescription eye drops to use for a week or two after LASIK to prevent infection as your eyes heal.

The day following LASIK, you should be able to see clearly enough to perform basic activities like driving, reading, watching television, and using a computer.

It can take up to six months for your vision to fully stabilize as your corneas completely heal. During this time, you might experience some side effects like poor night vision, glares or halos around lights, and dry eyes.

Go to all your scheduled follow-up visits with your eye doctor and report any of these side effects. If they are serious, do not get better, or get worse, this could indicate a rare problem with LASIK. Your eye doctor can then schedule a corrective surgery, prescribe eye drops, or take other steps to improve your vision.

LASIK Surgery FAQs

Will my eyes be open during LASIK?
Yes, your eyes will be open during LASIK, but the procedure is very fast. You will not see much other than some flashing lights, and you will receive numbing eye drops, so you will not feel sensations other than a little pressure at the beginning.

Can I drive home after LASIK?
No, you cannot drive home after the LASIK procedure. In the first 24 hours after the procedure, you should rest your eyes as your surgeon orders to ensure your eyes heal.

You should be able to safely drive yourself the day after the procedure. If you have trouble seeing, report this to your eye doctor immediately.

References

1. LASIK. (March 2018). United States Food and Drug Administration (FDA).

2. Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK. (March 2017). American Family Physician.
   

3. LASIK Quality of Life Collaboration Project: Initial Study/PROWL-2. (June 2021). United States Food and Drug Administration (FDA).

4. What Should I Expect Before, During, and After Surgery? (July 2018). United States Food and Drug Administration (FDA).

5. LASIK – Laser Eye Surgery. (October 2020). American Academy of Ophthalmology (AAO).