What to Expect Before and After LASIK Eye Surgery?

LASIK surgery is a widely performed refractive procedure that successfully treats vision problems such as myopia, hypermetropia, and astigmatism by reshaping the cornea. It has benefited millions by freeing them from their daily dependence on spectacles or contact lenses. However, it requires sophisticated medical intervention, a careful approach in preparation, and diligent aftercare to achieve the best possible outcomes. 

Understanding LASIK Eye Surgery

LASIK surgery utilises an excimer laser to reshape the cornea, the clear front part of the eye. This eliminates refractive errors and improves vision. The process typically takes 10-20 minutes. The retina, located at the inner back side of the eyeball, has no direct involvement in the LASIK procedure. However, it is evaluated preoperatively to check for any presence of retinal pathology, such as thinning or tears that may require treatment before LASIK.

Before LASIK Surgery

You will be subjected to a wide array of evaluations and preparations, all designed to ensure the health and readiness of each eye for the LASIK procedure. Here’s what you can expect at each step:

1. Pre-LASIK Evaluation

Pre-LASIK evaluation is a critical phase that determines overall suitability for undergoing the procedure. Ideally, this comprehensive assessment would include:

• An elaborate medical and ocular history
• Specific measurement of vision and refractive error
• Corneal evaluation using topography and pachymetry (corneal thickness)
• Optic nerve and retina assessment to exclude other eye diseases
• Dry eye evaluation, pupil size, and corneal diameter

Through this evaluation, the surgeon selects the most appropriate LASIK technique and confirms that your cornea is healthy enough for a safe reshaping process.

2. Initial Consultation

Your LASIK surgeon will discuss with you during your initial consultation:

• The risks, benefits, and alternatives to LASIK surgery,
• Expected results and limitations of the procedure,
• The specific type of LASIK procedure proposed to you according to your tests,
• Your responsibilities before, during, and after surgery.

This is the best time to get your questions answered and any doubts clarified. Consent is sought before proceeding.

3. Preparing for the Surgery

It is important to prepare well so that risks are minimised and the chances of surgical success are maximised: 

• Cessation of contact lenses: Soft contact lenses should be stopped at least 1-2 weeks before evaluation and surgery. Rigid gas permeable (RGP) lenses may require discontinuation for 2-3 weeks. Contact lenses can temporarily alter the shape of the cornea and influence preoperative measurements.
• Cease use of eye makeup and creams: Stop all eye cosmetics and creams at least 24 to 72 hours before surgery to reduce the possibility of infection and inflammation. All traces of makeup must be removed on the day of surgery.
• Arrange transportation: You will not be allowed to drive after the procedure. You will need to arrange for a driver to take you home.
• Additional preparations: Avoid perfumes or colognes on the day of surgery, eat a light meal, and wear loose, comfortable clothing. You will sign an informed consent form right before the procedure.

During LASIK Surgery

The LASIK procedure is performed under a topical anaesthesia using numbing eye drops. You will remain awake but comfortable throughout:

• The surrounding area of the eye is cleaned.
• Your eyelid will be kept open, and the suction cone is gently applied to stabilise the eye.
• The flap on your cornea is created using either a microkeratome (blade) or a femtosecond laser. At Nethradhama, advanced techniques using the femtosecond laser (bladeless LASIK) is performed. 
• Your refractive error measurements and corneal topography guide the excimer laser to reshape the underlying corneal tissue.
• The flap is then moved back to its original position, and either a protective shield or glasses are used to prevent inadvertent rubbing or trauma.

The total time is about 15-30 minutes. During tissue ablation, you may hear sounds from the laser and notice a mild smell; both are normal.

After LASIK Surgery

The postoperative period of any procedure lies at the core of healing and optimal visual outcome, and is all you can expect after LASIK. 

First 24–48 Hours After LASIK Surgery

After surgery, the most commonly felt symptoms, on the day of surgery, among patients are:

• Mild discomfort, mild pricking sensation in the eyes
• Tears or watery eyes
• Blurry or hazy vision on the day of surgery 
• Light sensitivity

These symptoms typically improve within the first few days. The drops used are prescribed to alleviate the discomfort and prevent infection. Protective shields should be worn at night while sleeping to prevent accidental rubbing of the eyes.

Dos and Don’ts After LASIK Surgery

Do’s:

• Use prescribed antibiotic drops as well as lubricating eye drops as indicated.
• Attend all scheduled follow-up appointments.
• When outdoors, wear sunglasses to protect your eyes from UV exposure.
• Rest and avoid any strenuous activity for a few days.

Don’ts:

• Rub your eyes for at least 2-3 weeks after the operation. 
• Avoid hot tubs and saunas for at least 4 weeks. Avoid using make-up or cream products near the eyes for at least one week, or until cleared by your surgeon. 
• Avoid exposure to dust, smoke, or dirty water. 
• Avoid contact sports or heavy exercise until your surgeon gives clearance. 

Visual disturbance or seeing halos and glare, especially at night, may take several weeks to months to resolve fully as the vision stabilises. 

Precautions Before and After LASIK Eye Surgery

Precautions are crucial before and after LASIK surgery for a safe procedure and smooth recovery. 

Before LASIK:

• Strictly follow guidelines for discontinuing contact lenses to allow accurate corneal measurement. 
• Avoid any makeup, lotions, or creams around your eyes for at least 1 to 3 days before the surgery. 
• Find someone to bring you home and help you right after the surgery. 
• Tell your surgeon about any illness or medication taken recently. 

After LASIK:

• Ensure the eyes are protected from trauma, dust, and water exposure. 
• Do not rub or touch the eyes. 
• Use all prescribed medications exactly as directed
• Report any persistent pain, loss of vision, or unusual redness to your surgeon immediately
• Attend follow-up appointments to monitor corneal healing and, if needed, retinal health

Conclusion

LASIK is a procedure that allows a person to enjoy clearer vision by reshaping the cornea. More importantly, the success of this procedure largely depends on thorough preoperative evaluation and adherence to all instructions before, during, and after surgery. Before the operation, one must follow essential steps such as discontinuing contact lenses, avoiding cosmetics, and arranging transportation. After surgery, emphasis is placed on protecting the eyes and maintaining hygiene. With a clear understanding of expectations and careful follow-up, you can experience the benefits of LASIK and enjoy spectacle-free vision.