LASIK Eye Surgery

LASIK (Laser-Assisted In Situ Keratomileusis) is a surgical procedure that can reduce a person's dependency on glasses or contact lenses. It is ideal for patients with astigmatism. The procedure permanently changes the shape of the cornea, which is the delicate clear covering on the front of the eye.

To have clear vision, the eye's cornea and lens must properly bend (refract) light rays so images focus on the retina. The changes in the corneal shape help patients achieve this focus.

Surgeons perform LASIK eye surgery on people who have nearsightedness (myopia). LASIK is an outpatient surgical procedure that usually takes 10 to 15 minutes for each eye.

Here, we'll discuss the basics of LASIK eye surgery. We'll also describe the side effects and possible risks.

Is LASIK Safe?

LASIK isn't appropriate for everyone, but the U.S. Food & Drug Administration (FDA) has approved LASIK as a safe and effective procedure. It's essential to have a complete evaluation before undergoing LASIK. People who aren't good candidates but undergo the surgery anyway may experience poor results.

LASIK Precautions

There are specific precautions you must take to have a successful surgery. Your laser eye surgery provider should screen for the following conditions or indicators of risk before undergoing LASIK eye surgery:

• Blepharitis (inflammation of the eyelids with crusting of the eyelashes)
• Large pupils
• Thin corneas
• Previous refractive surgery, such as LASIK, RK, or PRK
• Dry eyes

Of course, your ophthalmologist will conduct other tests during your LASIK consultation. For instance, they'll do a preliminary eye exam to determine if you have farsightedness or have issues with distance vision.

Your LASIK surgeon will also need to know if you use reading glasses or other devices while reading, driving, or performing daily tasks. If you use eye drops regularly, let your surgeon know. While vision correction surgery is common, there are still risks.

Does LASIK Hurt?

LASIK generally doesn't hurt. You'll receive anesthetic drops to numb your eye, making the procedure painless. According to the Flaum Eye Institute's LASIK FAQ, some people feel pressure around the eye during surgery.

After your procedure, you may feel like something is in your eye for a few hours. You can ask your doctor for a pain reliever if needed. By the next day, you should feel fine. Most people rest and take their preferred non-prescription pain reliever.

What To Tell Your Healthcare Provider

Before undergoing LASIK eye surgery, tell your healthcare professional if you have a history of any of the following:

• Herpes simplex or zoster (shingles) in or near the eyes
• Glaucoma, glaucoma suspect, or ocular hypertension
• Eye diseases, such as uveitis or iritis (inflammations of the eye)
• Eye injuries or previous eye surgeries
• Eye dryness
• Keratoconus (a thinning disorder of the cornea that causes visual distortion)

Your doctor needs to know these things to perform your procedure safely. This information also helps determine if you're a good candidate for LASIK surgery.

Certain Patients Should Not Use LASIK

As with any other procedure, such as cataract surgery, certain patients are not good candidates for LASIK eye surgery.

According to the Food and Drug Administration (FDA), if you meet the following conditions, you should reconsider vision correction procedures, including LASIK. These conditions include the following:

• You don't want to take a risk: Some eye surgery risks are unavoidable. There's no long-term data available for current LASIK procedures.
• It could harm your career: Some jobs prohibit specific refractive procedures. Be sure to check with your employer or an expert in your field before undergoing any medical procedures. You can also consult with a local eye center to see what they say about the impact surgery will have on your career.
• The cost is a concern: Although prices have decreased, they are still significant. Most insurance carriers won't pay for LASIK surgery. Of course, most eye surgeons offer financing options. You'll have to decide after meeting with an eye care specialist.
• Your contact lens or glasses prescription changed in the past year: Patients who are more likely to have this refractive instability include patients who—
  • Are in their early 20s or younger
  • Have fluctuating hormones due to diabetes or another condition
  • Are pregnant or breastfeeding
  • Take medications that may cause fluctuations in vision
• You have a disease or are on drugs that may affect wound healing: These conditions include autoimmune diseases, immunodeficiency states, and diabetes.
• You play contact sports: If you participate in sports where blows to the face and eyes are normal, LASIK may not be appropriate.
• You are a minor: Currently, the FDA has not approved LASIK lasers for people under 18.

LASIK Health Risks

While most patients like the results of LASIK or other refractive surgery, there are risks. You should consider these risks before moving forward with surgery. You should also be familiar with these risks during the healing process. If something isn't right, contact the doctor who performed your laser treatment.

Beware of the following risks before moving forward with LASIK:

• Losing lines of vision
• Developing debilitating visual symptoms, such as glare, haloes, and double vision, that can seriously affect nighttime vision
• Being under-treated or over-treated, meaning you may still need glasses or contact lenses after surgery

Developing severe dry eye syndrome. This occurs when the eye can't produce enough tears to keep the eye moist. It may cause discomfort and reduce visual quality.

LASIK results are generally not as good in patients with substantial refractive errors. For some farsighted patients, results may diminish with age. Long-term data isn't available since LASIK is a relatively new technology. The long-term safety and effectiveness of LASIK surgery are still unknown.

The FDA Regulates LASIK

In the U.S., the Food and Drug Administration (FDA) regulates the sale of medical devices, including the excimer lasers used for LASIK. Companies must receive FDA approval before legally selling a medical device in the U.S.

To gain this approval, an applicant must present evidence that the device is reasonably safe and effective for a particular use. Doctors can decide to use a medical device for other uses if it's in the patient's best interest. But the FDA doesn't regulate this use or the doctor's practice of medicine.

So, the FDA doesn't have the authority to:

• Regulate an eye doctor's practice
• Tell doctors what to do or what they can tell their LASIK patients
• Set the amount a doctor can charge for LASIK eye surgery
• Insist doctors give a potential client the patient information booklet from the laser manufacturer
• Make recommendations for eye doctors or clinics
• Maintain or have access to a list of doctors who perform LASIK eye surgery
• Conduct or provide a rating system on medical devices

It may seem like the FDA doesn't do enough to protect patients. But their power only extends so far. The FDA does perform follow-up evaluations to ensure the safety of medical devices.

Bad Experiences With an Eye Doctor

Most people who have LASIK surgery report a positive experience. If your experience is unpleasant, you can file a voluntary report with the U.S. Food & Drug Administration's MedWatch program at 1-800-FDA-1088. You can also file a complaint online.

You can also contact the state optometry or medical licensing board to file a complaint. Your state may also have a consumer complaint organization, such as the Better Business Bureau or a state consumer protection agency, where you can file a complaint.

Contact an Attorney if Your LASIK Surgery Causes an Injury

If LASIK surgery harms you or a loved one, consult an experienced attorney to protect your legal rights.

To learn more about an attorney's role in these cases, see the Get Legal Help With a Defective Product Injury and Get Legal Help With a Medical Malpractice Issue articles.