LASIK and laser vision correction

• LASIK reshapes the cornea under a thin flap. Vision often improves quickly, within a day or so.
• PRK (surface laser treatment) gently removes the thin outer layer of the cornea before reshaping it, with no flap. Healing takes longer and is more uncomfortable at first. It may be a better choice if your cornea is thin or you play contact sports.
• Small-incision lenticule extraction uses a laser to shape a thin disc of tissue inside the cornea, which is removed through a tiny opening.
• Implantable lenses are placed inside the eye, in front of your own lens. They can help people with very strong prescriptions or corneas that are too thin for laser treatment.
• Lens replacement swaps your eye’s natural lens for an artificial one, much like cataract surgery. It is usually for older adults.
• Monovision sets one eye for distance and the other for near. Some people like it, and some don’t. It is often worth trying with contact lenses first.

Glasses and contact lenses are still safe, effective choices. Surgery is optional.

Start with a consultation with your eye doctor. This is a careful exam to find out whether your eyes are healthy enough for surgery and which option would suit you. It usually includes:

• Checking your prescription and whether it has stayed steady
• Mapping the shape of your cornea and measuring its thickness
• Checking your tears for dry eye
• Measuring your pupils
• A dilated exam of the inside of your eye

If you wear contact lenses, you will need to stop wearing them for a while before these measurements, because lenses can change the shape of your cornea. Your eye doctor will tell you for how long.

The surgery itself is done by an eye surgeon (an ophthalmologist). Your eye doctor may do the consultation, refer you to a surgeon, and care for your eyes before and after. Ask plenty of questions. Good ones include: Am I a good candidate? Which procedure do you suggest and why? What are my risks? What if I need a touch-up later?

Results are not guaranteed. Many people see well without glasses afterward, but some still need them for some tasks, and a few need a second treatment. Be wary of any promise of perfect vision.

Right after surgery

• Your eyes may burn, itch or feel gritty for a few hours. Rest and keep your eyes closed as much as you can.
• Use your eye drops exactly as prescribed.
• Don’t rub your eyes. Wear the eye shields you are given, especially while you sleep.
• Avoid swimming, hot tubs, eye makeup and contact sports for as long as your eye doctor says.
• Go to every check-up visit, starting with the one soon after surgery.

Side effects and risks

Most side effects fade over weeks to months. They include dry eyes, glare, halos or starbursts around lights, harder night driving, and vision that changes from day to day. For some people, dry eye or night vision problems last longer. Less often, the eye is under- or over-corrected. Rare risks include flap problems, infection, thinning or bulging of the cornea, and loss of vision.

For years to come

Keep having regular eye exams. LASIK changes how your eye focuses, but it doesn’t protect you from glaucoma, cataracts or retina problems. People who were very nearsighted still have a higher chance of retina problems. Tell every eye doctor you see that you have had laser vision correction. It affects some eye pressure readings and the lens chosen if you ever have cataract surgery.