Laser In Situ Keratomileusis

What you should know

Laser In Situ Keratomileusis (Precare) Care Guide

Laser in situ keratomileusis (ker-ah-toh-mi-LOO-sis) or LASIK is eye surgery that uses a special kind of laser. Surgery with this laser may help you see without contact lens or glasses. It is usually done in an outpatient center or clinic. One or both eyes may be done. You may have clear, focused vision right after the surgery. You may need to wait for a longer time before your vision is clear and focused. Your eyes may feel "itchy" or "gritty", but that should go away in a couple of days. You may have changes in your sight as your eyes heal. Normal sight without contacts or glasses should happen in about one to three months. If you are over 40 years old, you may still need to use reading glasses, even after LASIK surgery.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • If you decide to have surgery, it is important to follow your eye doctor's treatment plan after surgery. If you do not follow the treatment plan, you may not have good vision results. There are always risks with surgery. You may have eye damage, or a serious infection. You may end up with worse vision than before the surgery, even with the use of glasses. You may still need to use reading glasses as you get older. Your vision may get worse again over time.

  • You may develop problems such as dry eyes, or problems with glare (brightness), haze (foggy sight) or halos (rings around objects). Your eyes may become more sensitive to light. You may have trouble driving at night. You may get cataracts or a retinal detachment (pieces of the inside lining of the eye come off). You may develop glaucoma (glaw-KOH-mah), double vision, or ulcers (growths) in the eye. The surgery may under correct, or over-correct your vision. If this happens, you may need to have more laser surgery. Your eye doctor will watch you closely for these problems. Call your eye doctor if you are worried, or have questions about your medicine or care.

Getting Ready

One To Six Weeks Before Surgery:

  • Stop wearing hard contact lenses at least six weeks to three months before your surgery. Follow your eye doctor's instructions.

  • Stop wearing gas permeable or toric soft contact lenses at least three to four weeks before your surgery. Follow your eye doctor's instructions.

  • Stop wearing soft contact lenses at least one to two weeks before surgery. Follow your eye doctor's instructions.

  • You may need to see your eye doctor one to four days before the surgery for a final eye exam. Buy a pair of sunglasses with UV protection to wear after surgery.

  • Ask a family member or friend to be available to drive you home after your LASIK surgery. Also ask someone to be available to drive you to your first follow-up appointment (usually the day after your surgery).

  • Make plans to take one or two days off from work or school. Your vision may or may not be very clear right after surgery. If your vision is blurry or unclear, it may be safer and less stressful to recover at home.

The Day Before Surgery:

  • Do not wear eye make-up, lotions, creams, or perfumes. Remove any old make-up. This will help decrease the chance of getting an eye infection (in-FEK-shun) after surgery.

  • Drink at least six to eight (8 ounce) cups of liquid. Follow your eye doctor's advice if you must limit the amount of liquid you drink. For most people, healthy liquids to drink are water, juices, and milk. Limit the amount of caffeine in your diet. Caffeine may make you urinate too much and lose too much body fluid. Caffeine may be found in coffee, tea, soda pop, and sports drinks and foods.

  • Do not drink alcohol 24 to 48 hours before surgery. Alcohol may make you lose body fluids. This may cause your eyes and body to be too dry for surgery and healing.

The Day of Surgery:

  • Write down the correct date, time, and location of your surgery.

  • Do not wear contact lenses the day of surgery. You may wear your glasses.

  • Do not wear earrings or hearing aids. Do not bring a pager or cell phone into the laser room.

  • Do not wear eye make-up, perfume, or lotion on your face. Do not put hairspray on your hair.

  • You may eat a light meal, but do not eat heavy or greasy foods. Do not drink any alcohol.

  • Your eye doctor will talk to you before your surgery, and may give you medicine to make you relax during surgery. Just before surgery, a caregiver will cover your hair with a cap and wash around your eyes.

  • You or a close family member may be asked to sign a legal piece of paper (consent form). It gives your eye doctor permission to do LASIK surgery. Be sure all your questions have been answered before you sign this form.

Treatment

What Will Happen:

You will be given eye drops to numb your eyes so you feel no pain. You may still feel some pressure during the surgery. You may be given medicine by mouth to feel more relaxed. Before your surgery, a caregiver will wash around your eyes. You are then taken to the surgery room with the laser and computer. Caregivers help you get comfortable on the bed or in a special chair. A special pillow device is used to hold your head still during surgery.

  • A tiny, hinged device called a speculum (SPEK-u-lum) is put in your eye. The speculum will hold your lids apart so you cannot blink during surgery. Then a very small suction ring with a track guide is placed on your cornea (KOR-nee-ah). The cornea is the clear area that covers your iris and pupil. Pressure from the suction ring causes your vision to fade and become black. A special cutting tool called a microkeratome (meye-kroh-KER-ah-tohm) then moves along the track of the suction ring. It cuts a small, hinged cap or flap on your cornea. The track has an automatic stopper that keeps the microkeratome from cutting the flap off.

  • The corneal (KOR-nee-al) flap is folded over. The area under the flap is gently cleaned and examined. The laser is placed over your eye and it reshapes the uncovered layer of the cornea. You may notice an unusual smell while this is being done. The flap is then put back in its normal place. There are no stitches (threads) used. The cornea begins to heal almost as soon as the flap is moved back. The hinged device used to keep your eye open is removed.

After Surgery:

You may be taken to a recovery room. The eye doctor will watch your eyes very closely to make sure the flap does not move or wrinkle. You will be there until your eye doctor thinks your eye flaps are doing OK.

Waiting Room:

This is a room where your family can wait until you are ready for visitors after surgery. Your caregiver can then find them to let them know how the surgery went. If your family leaves the clinic, ask them to leave a phone number where they can be reached. When it is time for you to go home after your surgery, someone will need to drive you home. Do not drive home alone. An adult should stay with you for at least 24 hours after surgery.

Contact a caregiver if

  • You cannot come to your surgery appointment on time.

  • You get sick (a cold or flu), have diarrhea, an allergy flare up, a sinus infection or have a temperature. Your surgery may need to be done later when you are well.

  • You have questions or concerns about your surgery.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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