Robert Cykiert, M.D. - New York City's Premier Ophthalmologist, LASIK and Eye Surgeon
What is LASIK?
LASIK is an abbreviation for "laser-assisted in-situ keratomileusis," a procedure where laser light of a specific wavelength and frequency is used to change the shape or curvature of the cornea. This eliminates or greatly reduces nearsightedness, farsightedness and astigmatism and in most cases eliminates the need for glasses and contact lenses.
What is the CORNEA?
The cornea is the very front part of the eye. It is a transparent membrane made out of living tissue and cells, appproximately 0.5 - 0.6 mm. thick. (In contact lens wearers, the contact lens sits directly on the surface of the cornea). The cornea, because it has a specific curvature, acts as a lens and focuses the light or images that enter the eye. In eyes that are nearsighted, or farsighted, or have astigmatism, the curvature of the cornea is not optimally matched for the size and shape of the entire eyeball. LASIK, uses a laser to reshape the curvature of the cornea to match it more precisely to the size and shape of the eye, thereby eliminating or greatly reducing the need for glasses or contact lenses to see clearly, or close to 20/20 vision at distance.
What is a LASER?
A laser is a beam of light of a specific wavelength and frequency. During the LASIK procedure, the laser light, knows as an "excimer" laser, actually breaks microscopic chemical bonds within the cornea, and reshapes the corneal curvature thereby changing the lens power of the cornea. This is done in a very precise and exact way by programming the LASIK laser with data about the optics of the eye. This data is obtained by the LASIK eye surgeon before the procedure is done.
How long does the LASIK procedure take?
LASIK takes approximately 5-10 minutes per eye, and there is about a 5 minute interval between each eye. Therefore the entire procedure, for both eyes, may take 15-25 minutes in most cases.
Does LASIK use one or two lasers?
LASIK actually involves 2 steps. In the first step, a very thin flap is created on the surface of the cornea. When LASIK was first done in the late 1990s, the flap was created using a precise oscillating razor blade known as a microkeratome. In the last 15 years or so, the microkeratome razor has been largely replaced with a more precise, lower risk "femtosecond" laser that creates the flap. If you have LASIK done, make sure your surgeon is using a femtosecond laser, rather than a metal, razor microkeratome to create the corneal flap. The second step of LASIK always uses an "excimer" laser to change or reshape the curvature of the cornea.
Does LASIK hurt?
There is a mild-moderate pressure type of discomfort during the first part of the procedure, when the flap is created by the femtosecond laser. However, that takes only 1-2 minutes. The second part of LASIK, using the excimer laser to reshape the corneal curvature, causes no pain at all. During LASIK, your eye surgeon will apply anesthetic or numbing drops to the eye to minimize discomfort. In some cases, your surgeon may give you some oral medication prior to the procedure to make you more comfortable or less nervous and anxious.
How long does it take for vision to recover after LASIK?
In the vast majority of patients, vision recovers to an excellent level the day after LASIK, however it sometimes takes weeks or a few months for vision to fully recover. In most cases, patients will be able to do their normal work or activities the day after LASIK. During the postoperative period, you will need to take special eye drops prescribed by your surgeon to make sure the cornea heals properly and to maximize the vision result. You will also need to see your surgeon for postoperative visits from time to time. In a small percentage of cases, patients may need an enhancement laser procedure to maximize their vision.
Are there any risks to LASIK?
Every surgical and laser procedure, including LASIK, has some risks, and there are no guarantees that you will have perfect vision and will be able to completely eliminate all need for glasses and/or contact lenses. However, if you are a good candidate for LASIK, and your surgeon has expertise and experience, and you are having LASIK done with state-of -the-art equipment in the appropriate facility, the risks of LASIK are very low. Make sure your surgeon reviews all of the risks of LASIK with you prior to the procedure. Watch the FDA video below for more information about the risks of LASIK.
Will you need reading and/or computer glasses after LASIK?
LASIK is generally used to correct distance vision. If your distance vision is fully corrected by LASIK in both eyes, then starting from the age of approximately 40-45 and older, you will need to wear glasses for all near vision tasks such as reading books, magazines, newspapers, and using smartphones or computers. This reduction or blur of near vision in this age group is not the result of having LASIK. It occurs to everyone in this age group because of an aging process of the eye called "presbyopia." There is a variation of LASIK called "monovision correction" which may delay or sometimes eliminate the need for near or reading glasses. Your surgeon can determine if you are a candidate for monovision.
Are there alternatives to LASIK?
You don't have to have LASIK. It is a completely elective procedure. You can continue to wear glasses and/or contact lenses instead of having LASIK. There is an alternative excimer laser procedure called "PRK" (Photorefractive Keratectomy) which is similar to LASIK and has some pros and cons as compared to LASIK. Your surgeon can discuss that with you. There is a relatively new procedure called the "SMILE" laser technique which also has some pros and cons as compared to LASIK.
For more information about LASIK, watch the video below made by Johnson & Johnson, a major LASIK excimer and femtosecond laser manufacturer. (Dr. Robert Cykiert uses Johnson & Johnson excimer and femtosecond lasers to perform LASIK and PRK. However, the specific lasers, techniques, and equipment he uses may vary from the video below).
Video by Johnson & Johnson: A major manufacturer of excimer and femtosecond lasers used for LASIK.
Watch this important informational video about LASIK Laser Vision Correction from the FDA.
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