Most LASIK patients say their eyes feel fairly normal even by the first day after surgery and are happy with their vision immediately. However, your vision will usually get even better as your eyes heal.
The possibility of better vision without glasses or contacts is always exciting, but, as with every surgical procedure, there are LASIK risks. LASIK does require careful preparation and care afterwards.
Below, you’ll find some general guidelines for what happens in the first days, weeks and months after surgery, what to expect as your vision improves and what you need to know about possible LASIK risks, side effects and rare complications from LASIK.
After LASIK surgery, your doctor will want you to rest a bit. When your doctor is satisfied with your condition, you will be released to go home (you won’t be ready to drive yet, so someone should be with you). Your doctor may give you protective sunglasses or shields to wear to protect your eyes.
Most people feel fine after LASIK surgery, and others feel nothing worse than mild discomfort. You may feel mild burning or itching, your eyes may water and the whites may look red or bloodshot. These are all normal symptoms of recovery. Your doctor may prescribe a mild pain reliever, along with antibiotic drops to help with healing.
Fill and take any needed prescriptions and continue to rest as recommended for the rest of the day.
Avoid rubbing your eyes, although you may instinctively want to. While the corneal flap is healing, there is a slight risk of displacement with the friction and trauma of rubbing or itching.
The first day after LASIK surgery, your eyes may be sensitive to the touch, and they may even feel a little scratchy for a few days. Your eyes may water and the whites may look red or bloodshot. These are all normal and the prescriptions from your doctor should help. As your body adjusts, you will probably be able to resume most of your normal activities.
Call your doctor immediately if you think there may be a problem or if you have questions. Only a doctor who has examined your eyes and has your complete medical history can say if your situation is within normal limits or requires additional care.
It is essential to follow all of your eye surgeon’s instructions and keep all post-operative appointments.
Most people are able to return to work quickly, even as soon as the day after LASIK surgery. Others take a couple of days’ rest.
At your first follow-up appointment, your doctor will test your vision and examine your eyes. He or she may give update your prescriptions, and you may be advised to use artificial tears to help lubricate the eye as it heals.
If only one eye was treated initially, the second eye can usually be scheduled for surgery a week or so later.
Your doctor may advise you not to use lotions, creams or make-up near the eyes for a week or two after surgery. For several days, be careful not to get water in your eyes while bathing or washing your face. Strenuous exercise should also be avoided for up to a week, and contact sports for a few weeks, as these can affect healing. Swimming, hot tubs and whirlpools are also to be avoided for one to two months.
As your eye heals, your vision may take two to three months to reach its best focus. In some cases, vision continues to slightly improve even at six months after surgery.
Your surgery will be planned based on the average patient’s healing response. But every eye heals differently. If you are an aggressive or slow healer, you may develop an undercorrection or overcorrection of your refractive error.
What would that look like? An undercorrection improves your refractive error but doesn’t fix it entirely. An overcorrection could mean that you go from being nearsighted to slightly farsighted, or vice versa.
Rarely, a patient may first see some visual improvement and then see it diminish again over time. This is called regression. It is most likely to occur in people with high levels of refractive error.
In any of these cases, once your vision has been stable for at least three months, a touch-up treatment-also called an enhancement-may be needed to gain the best vision possible.
Whether or not to have a touch-up is largely a matter of personal preference. Your doctor will advise you about which type of touch-up would work best in your case.
Some patients, especially those with high refractive errors, may still need glasses or contact lenses under some circumstances, even after obtaining their best corrected vision from LASIK. However, the prescription level will generally be much lower than before surgery.
Patients should be aware that they will very likely need reading glasses at mid-life after LASIK, just as they would if they had been born with 20/20 vision. This is due to an age-related condition which affects all people at mid-life called presbyopia.
Following any surgical procedure, it is normal to experience some side effects as your body heals. These are generally short-term symptoms and usually do not affect your daily activities. They are treatable and tend to get better by themselves in time.
As a temporary side effect, you may see glare, halos or starbursts around lights at nighttime while driving or doing other things. Occasionally these symptoms can interfere with normal activities, but usually they are not significant and resolve within three to six months as your eyes heal.
A 10-year survey of scientific studies from around the world has shown that many people have some degree of night vision symptoms naturally and that LASIK more often reduces these symptoms than it increases them.
One way to reduce your potential for night vision symptoms after treatment is by choosing Wavefront-guided or Wavefront-optimized LASIK. Because they are more customized to your eye, these advanced technologies result in fewer night vision symptoms.
If you have bothersome night vision symptoms, a touch-up Wavefront treatment following your initial LASIK treatment may help. You may also choose to wear glasses for night vision. Treatment of dry eye symptoms with artificial tears may also help relieve night vision symptoms.
In some cases, night vision symptoms may be permanent. However, many patients say these problems are so mild that they do not significantly interfere with activities, and many prefer not to wear glasses or have a touch-up at all.
While your eye is healing, its normal system for producing moisture is temporarily disrupted. This often causes your eyes to be dry for a time after surgery and may cause fluctuating vision. As the nerves in your eye heal, they become better able to send information to and from the tear gland again. This allows the eye to resume producing moisture as needed.
Artificial tears and other treatments can protect your eyes while they are healing. For most patients, dry eye symptoms are mild and temporary. Those who do experience difficulties generally say symptoms go away within six months after the procedure.
The best way to avoid dry eye is to be carefully screened prior to surgery. A small number of patients may be prone to long-term symptoms. Treatment of mild to moderate dry eye ahead of surgery may also reduce your experience of dry eye afterward. And an all-laser flap has also been shown to produce fewer cases of dry eye. Your doctor can advise you of your specific level of risk.
As with any surgery, certain complications from LASIK surgery can be possible. But today, such complications are rare, thanks to the latest technology and rigorous safety precautions, and almost all complications of LASIK are treatable.
Don’t forget that all of the complications mentioned below are all extremely rare-most people do not experience any of them.
During LASIK, a flap is created on the cornea. If it is made too small or too thin or if it is irregular or torn, it may be necessary to halt surgery. (It may be possible to resume laser treatment after several months.) Other flap complications can cause the cornea to become irregularly shaped, leading to symptoms like blurry vision or nighttime glare. However, these symptoms can often be reversed with a laser touch-up treatment. Still, some flap complications can lead to serious visual impairments that may require additional treatment.
As your eye heals after surgery, it is possible (though rare) for the flap to become dislocated, especially due to trauma like eyelid rubbing, squeezing or blunt trauma from flying objects. Should this happen, seek treatment immediately to minimize complications.
Occasionally, a flap may not heal evenly and smoothly. It may develop tiny wrinkles, the smallest of which (called micro striae) are so fine that they do not affect your vision or require treatment. Other wrinkles (called macro striae) are still very fine, but may need to be treated with a touch-up LASIK procedure if they are noticeable to you and visually significant.
Flap complications from LASIK may also make your eye more prone to epithelial defects (see below).
Studies show a lower incidence of flap complications with an all-laser flap.
Epithelial cells cover the surface of the eye. After surgery, they may grow beneath the flap, called an "ingrowth." This complication from LASIK is more common in patients who have had touch-up procedures compared to those who have only one procedure. Patients who have flap complications are also more prone to this condition. Epithelial ingrowth can appear one to two days after surgery and more often occurs one to three months later.
Most epithelial ingrowth is harmless-it does not affect vision or require treatment. If it occurs within the field of vision or affects a wide area, however, follow-up surgical treatment will be needed to remove the epithelial cells from the flap.
This complication from LASIK is now rare, thanks to developments in surgical techniques and Wavefront-guided technology.
Irregular astigmatism is caused by an uneven corneal surface, which can occur during surgery or if the flap heals irregularly. This condition results in symptoms like blur and double vision and can be treated with a touch-up LASIK procedure.
This condition (also called keratectasia) is rare.
Ectasia is a bulging of the cornea and may occur if a flap is too deeply cut, if too much material is removed in reshaping the cornea or if the cornea was already weak or at risk prior to LASIK (which may or may not be seen in pre-operative topographic mapping). It also occurs rarely even in the absence of risk factors.
Ectasia causes vision to be distorted. Gas permeable contact lenses or corneal implants (intacs) may be required to obtain corrected vision. Rarely, a corneal transplant may be necessary. A new technique under investigation, called collagen cross-linking, may provide a new way to stabilize the cornea, as well.
A clean surgical environment and modern broad-spectrum antibiotics make infection a rare complication from LASIK. In fact, studies suggest you may run a greater risk of infection while wearing contact lenses than after LASIK surgery.
However, as with surgery on any part of the body, there is a risk of infection as your eyes heal. Most eye surgeons prescribe daily antibiotic and/or anti-inflammatory eye drops for a short time following LASIK surgery to prevent infection. Some surgeons may also prescribe lid-cleaning routines and antibiotics preoperatively, in certain circumstances.
If you develop inflammation (swelling) under the LASIK flap, it may feel scratchy and uncomfortable. If left untreated, it can interfere with healing or even cause vision loss. Call your doctor immediately if you experience these symptoms.
Inflammation is treatable with antibiotics and topical steroids, which usually resolve the condition. If necessary, the flap can also be surgically rinsed to remove inflammatory cells and prevent tissue damage. Although rarely necessary, oral steroids may facilitate more rapid resolution of inflammation.
Transient light sensitivity
With this rare complication from LASIK, the eyes become unusually sensitive to light for two to six weeks after surgery. It is more common with an all-laser flap and is usually treatable and short-lived.
Steroid treatment should begin promptly, while the condition is mild-in the first three to four weeks of symptoms. If left untreated for six to eight weeks, sensitivity may become severe. With treatment, however, most if not all symptoms typically go away within weeks. In rare instances, symptoms may persist indefinitely.
There are steps you can take to keep your LASIK risks of side effects and complications as low as possible:
A thorough screening, regular follow-up appointments and realistic expectations are the most reliable predictors of success. Learn how to choose your doctor for optimal outcomes.
LASIK has the highest patient satisfaction rate of any elective surgery: 95.4%, according to a 10-year survey of scientific studies from around the world. And advances in technology now deliver better outcomes than ever, so that you can enjoy excellent vision-often without any glasses or contacts lenses.
Not sure what a particular term means? Click on words in bold to pull up the glossary tab.
No. Patients may experience some discomfort and/or blurred vision for a few hours after surgery. And most patients receive a sedative prior to surgery. Therefore, you cannot drive home after undergoing the procedure, and you should plan not to drive for at least twenty-four hours.
You can resume most normal activities immediately after surgery. However, for at least two weeks you should avoid activities that would cause perspiration to run into the eyes. You should also avoid contact sports or swimming for several weeks. Your surgeon may recommend wearing safety glasses during contact sports for at least one month after LASIK (you should wear safety glasses during contact sports anyway).
If you participate in boxing, wrestling, martial arts or other activities in which blows to the face and eyes are a normal occurrence, LASIK may not be for you-talk with your eye doctor about other surgeries that might be more appropriate.
It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days after surgery. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery.
Clear, curved surface at the front of the eye through which light enters the eye. Along with the sclera (the white part of the eye), provides external protection for the eye. Often called the window of the eye. During many types of vision correction surgery, such as LASIK, the cornea is reshaped to reduce or eliminate the main types of refractive error - nearsightedness, farsightedness and astigmatism.
Thin slice of tissue on the surface of the cornea made at the beginning of LASIK surgery. Made with either a microkeratome or a femtosecond laser. The flap is folded back before the LASIK procedure can shape the inner layers of the cornea.
A syndrome characterized by corneal dryness due to deficient tear production. Often related to hormonal changes, local atmospheric conditions and many other causes. Approximately 42 million Americans experience this condition.
Epithelium or epithelial layer
Cellular tissue that covers the outside of body surfaces, including the outside of the cornea (the clear outer covering of the eye).
Defects in the epithelium (protective layer of cells on the cornea) can allow invasion by bacteria, fungi, viruses or Acanthamoeba. Can be initiated by mechanical trauma or nutritional deficiencies. Symptoms are progressive redness, foreign body sensation, ache, sensitivity to light and tearing.
Farsighted, farsightedness (or hyperopia)
Common vision problem and type of refractive error. Caused by too little curvature of the cornea or too little distance between the front of the eye and the retina at the back. Both structural defects cause light entering the eye to focus incorrectly on the retina, resulting in blurred close-up vision. Treated with corrective lenses, laser vision correction or multifocal or accommodative IOLs.
Appearance of additional luster around lights that can interfere with vision, especially night vision. Sometimes occurs as a side effect of LASIK surgery and often decreases with time. May also be caused by cataracts or other eye conditions.
Appearance of rings around lights at night. Sometimes occur as a side effect of LASIK surgery and often decreases with time. May also be caused by cataracts or other eye conditions.
LASIK (laser in-situ keratomileusis) surgery
Type of laser surgery in which the cornea is reshaped to improve vision. Either a microkeratome or a femtosecond laser is used to surgically create a thin, hinged flap of corneal tissue. The flap is folded back, and an excimer laser is directed to the corneal surface exposed beneath the flap to reshape the cornea for corrected vision. Then the flap is brought back into place.
Nearsighted, nearsightedness (or myopia)
Common vision problem and type of refractive error. Caused by either too much curvature of the cornea or too much distance between the front of the eye and the retina at the back. Both structural defects cause light entering the eye to focus incorrectly on the retina, resulting in blurred distance vision. Treated with corrective lenses, laser vision correction or multifocal or accommodative IOLs.
When the change to refractive error after refractive surgery exceeds the attempted correction.
Irregularities in the cornea, lens or shape of the eye that prevent correct focus at any distance.
Appearance of rays or fine filaments of light coming off a light source, such as a headlight of a car. Can become longer and denser at night. Severity of starbursts varies-they may be experienced differently in terms of size, shape, length of rays, the density of rays and transparency (whether the light source is visible through the starburst). Sometimes occur as a side effect of LASIK surgery and often decreases with time. May also be caused by cataracts or other eye conditions
Also called lacrimal glands. Paired almond-shaped glands, one for each eye, that secrete the aqueous layer of the tear film. They are situated in the upper, outer portion of each eye cavity.
When the desired change to refractive error is not fully achieved after refractive surgery.
Also called custom LASIK. Creates a personalized map of existing higher order aberrations to correct refractive error and these more subtle vision problems. In some cases, existing higher order aberrations are severe enough to require this special treatment.
Newer LASIK technology that corrects refractive errors while accounting for both the natural curvature of the eye and the unique characteristics of each individual's eye. Has less risk of inducing higher order aberrations than conventional LASIK