LASIK Surgery FAQs – King LASIK

Not everyone is a good candidate for LASIK, but there are several options for those patients who do not meet the LASIK eligibility requirements. Photorefractive keratectomy, or PRK, is a viable alternative to conventional laser vision correction for individuals with very thin corneas. During PRK, the outermost layer of the cornea (the epithelium) is removed to allow access to the cornea. The surgeon then uses a laser to reshape the cornea to treat nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. PRK generally requires longer recovery time than traditional LASIK, but overall, results with LASIK and PRK are very similar.

Note: Some eye care centres advertise LASEK as an alternative to PRK. At King LASIK, we believe that PRK is a more dependable laser eye surgery solution than LASEK. To find out if you are a candidate for traditional LASIK or PRK, schedule a free consultation at King LASIK.

Following laser eye surgery, most patients will find that their vision has improved to the point where they no longer need glasses or contact lenses. Some individuals may still require a lens prescription for activities like reading or driving at night, but in those instances most prefer to simply keep a pair of glasses handy. The general rule is that if you were comfortable wearing contact lenses prior to laser vision correction, you can still wear them after surgery.

At King LASIK, we want our laser eye surgery patients to achieve the best possible results. If you still need your contacts to see well after refractive surgery at our vision correction centre, we may be able to do a second LASIK procedure to further improve your results.

There is very little risk associated with laser vision correction. Some patients may experience temporary symptoms, but only a small percentage will have long-term side effects. The most common side effects are problems with night vision, including halos and glare.

There are several possible causes for halos and glare following laser eye surgery:

If your refractive error was not completely corrected during your first laser eye surgery, you may still have low levels of nearsightedness, farsightedness, or astigmatism. This can be remedied with a revisional “touch-up” surgery to further correct the shape of your cornea.

When pupils dilate beyond the perimeter of the treatment area during laser eye surgery, this sometimes results in compromised vision in low light conditions (when the pupils are completely dilated). In order to prevent this from occurring, our LASIK surgeons measure pupil size at full dilation prior to laser eye surgery. This allows us to determine whether or not we can treat a sufficient portion of the cornea. If we cannot, the patient may not be a good candidate for LASIK.

Note – if glare and halos persist following laser eye surgery, there are several tricks that can help improve night vision. When driving, the overhead light can keep pupils from fully dilating. In some cases, medicated eye drops can also constrict the pupil to provide clearer vision.

Finally, glare and halos may result if the surgeon performed an “off-center ablation” – meaning that the laser was not focused on the proper treatment area. Choosing one of the qualified and experienced LASIK surgeons at King LASIK can help to minimize the risk of this complication. Wavefront guided LASIK also increases the likelihood that the laser will be focused on the proper treatment area.

LASIK has been performed around the world for more than a decade and is considered an extremely successful procedure. However, since laser eye surgery is relatively new, there are no studies that clearly demonstrate long-term LASIK results after this period of time. For most patients, corrected vision will remain stable following laser eye surgery. However, our vision can and will change as we age. Anyone over the age of 40 is likely to develop presbyopia, a condition that limits close-up vision for activities like reading. LASIK surgery will not prevent the development of presbyopia. For those who suffer from refractive error following LASIK, re-treatment is always a possibility.

During the laser eye surgery procedure, the surgeon creates a flap to allow access to the cornea. Once the cornea has been reshaped with the laser, the flap is placed back over the eye, where it adheres naturally without the need for stitches. The flap doesn’t require stitches because the endothelial cells along the deepest surface of the cornea create suction as they transfer fluid from the exterior of the eye – it is this suction that keeps the flap in place after laser eye surgery is complete.

When the corneal flap is created during the first stage of laser eye surgery, the surgeon always leaves a hinge. As long as this hinge remains intact, the flap cannot be lost. We advise our patients to avoid rubbing their eyes after LASIK surgery – this can displace the flap; however, flaps that have shifted following laser eye surgery can always be put back into the correct position with a secondary procedure.

Note: following LASIK surgery at King LASIK, our laser eye surgery staff will provide each patient with protective eye shields that can be worn for the first day following LASIK surgery. This shield will help prevent LASIK patients from rubbing their eyes and displacing the flap.

In rare situations (<1 in 6,000 cases), the flap can become completely detached during laser eye surgery. This is not necessarily a problem. In fact, LASIK was originally performed using a “free-flap” method. Our LASIK surgeons can simply replace the flap in the correct position. Though the free flap heals quickly, it can be lost if the patient rubs their eyes too soon after the laser eye surgery is complete. If the corneal flap is separated from the hinge, the staff at King LASIK will advise the patient concerning any extra precautions that need to be taken to prevent the loss of the flap.

The decision whether or not to have both eyes corrected at the same time is a personal choice that is usually left up to the patient. The majority of patients who visit King LASIK choose to have LASIK surgery performed on both eyes at the same time. Certain individuals may wish to have each eye corrected separately in order to minimize the risk of complications affecting both eyes; however, the risk of complications from laser eye surgery is so low that this precaution makes little difference. Actually, there are benefits to having both eyes corrected at the same time, including the fact that medication will only have to be taken one time around instead of twice. This reduces the risk of side effects associated with the medication that must be taken following laser eye surgery.

Regardless of whether you choose to have both eyes treated at once or during separate procedures, the risk of post-op infection and other complications is extremely low. For those patients who would prefer to have their eyes treated separately, we are happy to accommodate their needs.

LASIK surgery is widely regarded as a safe and effective treatment. Like any type of surgery, there are possible side effects and complications; however, the risk is very low.

Possible complications:

Free flaps – In very rare instances, the corneal flap can become detached during laser eye surgery. This occurs in less than one in 6,000 cases. If the flap is detached the LASIK surgeon will simply place the freed flap in the correct position after the cornea has been reshaped.

Imperfect flap – During surgery, there is always a small risk (1 in ~1,000) that the corneal flap will be too short, too thin, or uneven. If this occurs, the surgery will be cut short and the flap will be placed back over the eye and allowed to heal. In a few months the surgery can be resumed and a new flap can be created.

Striations (flap wrinkles) – Wrinkles in the corneal flap can occur if the surgeon fails to properly line up the flap after surgery or if the patient rubs their eyes and displaces the flap before it has properly healed. If the wrinkles are affecting vision, the corneal flap can be re-lifted and smoothed out during a secondary procedure.

Dry Eye – Many patients experience mild, temporary dryness in their eyes following laser eye surgery; however, for approximately five percent of LASIK patients dry eye persists for an extended period of time. Eye drops can provide relief.

Astigmatism – Post-surgical astigmatism can occur even after a “textbook” surgery. The odds are very low (1 in 3,000), but if the LASIK surgeon is inexperienced or the equipment is not up to par, the odds are increased. Patients who have high levels of refractive error prior to laser eye surgery are at a slightly higher risk for post-surgical astigmatism.

Glare and Halos – Glare and halos will affect night vision for approximately five to ten percent of LASIK patients. Symptoms generally fade within a few weeks to several months, but some patients may experience glare and halos for an extended period of time. Most patients report that post-surgical glare and halos are not a significant problem.

To find out more about the side effects associated with LASIK eye surgery, contact King LASIK today.

Every LASIK eye surgery begins with creation of a corneal flap. During the first stage of LASIK, a thin corneal flap is created and then lifted to allow access to the cornea. To create this flap, our LASIK surgeons will utilize either the IntraLase® laser or Zyoptix® XP microkeratome. The IntraLase® is a long wavelength laser that can be used to create the corneal flap during LASIK. Both the IntraLase® and the microkeratome involve a brief period of applied suction during creation of the corneal flap. There is no pain associated with either technique and the same anesthetic is used for both.

At King LASIK, we have invested in the latest lasers and equipment for our centre. We offer IntraLase® flap creation as well as Zyoptix® XP microkeratomes. At your preoperative exam, our staff will explain the differences in flap creation technology and provide a recommendation based on your individual eyes.

The majority of patients achieve 20/20 vision just one to two days after laser eye surgery. Many can drive and return to work the day after LASIK.