Laser eye treatment candidates often go from poor eye sight to 20/20 or better. The best part of this procedure may be that for most patients, it causes very little discomfort, can be done in a matter of minutes, and is an outpatient procedure. Once the procedure is over, most patients will be seeing better within days, if not hours. Not everyone goes to 20/20 or better vision, but reports indicate that 90-98% achieve significant vision improvements.
Prior to Laser Eye Surgery
The first step is to undergo a complete eye exam and obtain a map of the eye with computer assisted wavefront technology. The exact shape of the eye and any anomalies or irregularities are determined. This will include analysis of astigmatism, hyperopia and myopia among other things.
Contact lenses can reduce the amount of oxygen the cornea can absorb. This can cause neovascularisation (growth of blood vessels into the cornea) which in turn can create inflammation. Inflammation will have an adverse affect on post-operative healing. For this reason, it is usually advised to stop wearing the contact lenses for awhile prior to laser eye treatment.
Finally, a course of antibiotics is prescribed prior to treatment. This pre-medicating will help prevent infection during the post-operative healing period.
The Laser Eye Surgery Procedure
Patients are not put to sleep during Laser eye treatment, but may be given a sedative to help calm them. Eye drops containing topical anaesthetic will be used to numb the eyes.
With the patient lying down, a special retainer that has a suction ring is placed over the eye to make sure the eyelid stays open. Few people ever report any discomfort with this.
Aided by computer to track the exact eye position, the surgeon uses a blade or femtosecond laser to cut a flap in the cornea. The flap is left attached on one end. The flap is retracted to expose the stroma (middle part of the cornea). The surgeon then vaporizes the part of the cornea to be removed with an excimer laser. Cool ultraviolet light rays are used to excise tiny pieces of tissue without causing damage to the stroma. The amount of tissue to be removed will depend on the severity of corneal defects. The cornea is then reshaped also using the laser.
The laser has a clicking sound while running. You will probably hear that. You will also smell a mild acrid scent associated with the tissue being removed. The removal of tissue and reshaping of the cornea, aided by precise computer measurements, allows the cornea to focus better.
Finally, the flap is replaced and allowed to heal. The procedure will vary in the amount of time it takes with the severity of abnormalities being corrected.
Post-Operative Considerations
Following post-op advice is very important to a good outcome of any surgery and it is especially important with laser eye treatment. Here are some things to consider.
No Driving
Immediately after surgery you will be instructed by your surgeon not to drive. The amount of time will vary, but be sure to follow the surgeons recommendations and when in doubt about when to start driving always check with the surgeon first. In many instances, 48 hours after surgery you may be able to start driving for short distances.
Depending on your work, you will also probably need to take some time off work. Discuss this possibility with your surgeon before the procedure and make necessary arrangements.
Post-Op Visits
Follow up visits are normally scheduled for one week, one month, three months and sometimes six months post-operatively. It is very important to keep these appointments to make sure that healing is proceeding normally and to avoid complications.
Eye Make-Up
You will usually be asked by your surgeon to stop wearing make-up three days prior to surgery and for three days after the surgery. You will also usually be asked not to use any facial lotions for 48 hours post surgery. Eye make-up can usually be worn again about one week after surgery, but this will ultimately be up to your surgeon. You also will not want to use soap or facial washes for a few days after surgery when you are showering or washing up.
Post Surgical Expectations
The corneal flap must heal and conform to the reshaped inner corneal surface. This can take up to six months for normal healing and vision problems to disappear. Full corneal flap healing can take up to 2 years, but vision problems should be gone well before that.
You will usually be given eye drops to use for about 4 weeks and these will help to alleviate any discomfort during this time. Your first post-op visit will normally be in 24 hours from the surgery with 4-5 more after that. Again, be sure to keep all appointments.
It is normal during this initial healing period to experience certain discomforts. Among these are: watery eyes and runny nose, sensitivity to light, redness and/or swelling of the eye, dry eyes and slightly blurred vision.
For those who get tired of being dependent upon contacts or glasses whenever they want to see something, Laser eye treatment may be worthy of consideration. You should consider carefully your current situation and your potential situation. Ask your eye doctor what the risks are for you.
