LASIK is the most commonly performed method of laser eye surgery worldwide.
According to the American Academy of Ophthalmology, more than 28 million people around the world have undergone LASIK eye surgery. While the exact number of LASIK procedures performed in Australia is unknown, the Department of Health recognises LASIK as one of the two most popular laser eye procedures in Australia.
Read on to find out everything you need to know about LASIK eye surgery.
What is LASIK surgery?
LASIK, or laser-assisted in situ keratomileusis, is a laser eye surgery technique developed in the 1980s. LASIK is used to treat common vision problems including short-sightedness, long-sightedness and astigmatism. However, LASIK surgery is not a solution to presbyopia or age-related long-sightedness.
LASIK is generally considered to be one of the safest surgical procedures in Australia, though common side-effects include dry eyes and visual disturbances during the healing process.
Laser eye surgery clinics offering LASIK
Who can get LASEK?
You must have a fixable refractive error within a certain range to qualify for LASIK. Fixable refractive errors include the following:
- Myopia (short-sightedness)
- Hyperopia (long-sightedness)
- Astigmatism (an imperfection in the eye’s curvature)
To be eligible for LASIK, you must also have regularly shaped corneas and adequate corneal thickness. If your corneas are too thin or irregularly shaped, the surgeon will not be able to create a flap in the top layer of the cornea. In this case, another procedure such as PRK, LASEK, SMILE or ICL may be recommended.
You must also meet the following basic criteria:
- Be at least 18 to 20 years old
- Have relatively stable vision
- Not be pregnant or breastfeeding
- Have no active eye infections
- No history of eye scarring or severe dry eyes
- Have good general health
How does LASIK work?
LASIK is a three-step procedure involving the following:
- First, a surgeon uses a femtosecond laser or micro-scalpel (microkeratome) to create a small flap in the top layer of the cornea.
- Next, the surgeon folds back this flap and uses an excimer laser to reshape the corneal tissue below.
- Finally, once the refractory error has been corrected the surgeon will place the flap back on top of the eye. The flap will begin to heal almost immediately and no bandages or stitches are required.
How much does LASIK cost?
The cost of LASIK eye surgery in Australian generally ranges from $2,200 to $3,400 per eye or $4,400 to $6,800 for both eyes. The actual price of your surgery will depend on your refractive error and the overall condition of your eyes. Costs will also vary depending on the clinic, location, the surgeon’s experience and technology.
It is important to ask your doctor for a breakdown of all costs associated with your procedure. Some clinics will charge one flat rate that includes an initial consultation, follow-up visits and necessary medicines. Other clinics will charge separately for each step of the process. While the up-front cost of laser eye surgery is not cheap, many clinics offer payment plans.
What to expect during LASIK
Doctors usually recommend refraining from using contact lenses for a period of time prior to surgery. Your doctor may also suggest you use lubricants or artificial tears before your procedure. Follow any pre-surgery instructions given to you by your surgeon or clinic to help reduce the risk of complications.
When you arrive at your clinic you will be taken to a procedure room and given anaesthetic eye drops. Depending on the surgeon and your anxiety level, you may also be given a mild sedative.
LASIK usually takes less than 10 minutes per eye. While the procedure is generally considered painless, you may feel an intense pressure on your eye while the corneal flap is created and removed.
You’ll be taken to a recovery area when the procedure is finished and given antibiotic eye drops. Remember to arrange transportation home as you will not be allowed to drive immediately following surgery. While LASIK has a shorter recovery time than other laser eye surgery methods, you may still wish to take a day or two off work to rest.
After LASIK, many patients report light sensitivity and a gritty feeling in their eyes for several hours. You should see an improvement in your eyesight immediately after the procedure and most patients’ vision will be reasonably stable within 24 hours. Many people can go back to work the day after surgery, but if you work in an unsanitary or dusty environment your doctor will most likely recommend you take additional days off. Usually, patients are able to drive within one to two days but you should not drive until your doctor has given approval.
Your doctor will schedule a follow-up appointment within a few days to check on your progress. Even if your vision is stable, you should avoid certain activities for a few weeks after surgery to give your eyes enough time to heal. Ask your doctor about any specific sports or activities you are concerned about.
Many doctors recommend avoiding the following activities for a period of time following LASIK:
- Wearing eye makeup: one week
- Flying: one week
- Non-contact sports: one-two weeks
- Swimming: two weeks
- Rubbing your eyes: one month
- Contact sports: one month
- Scuba diving: one month
While LASIK is generally considered to be a safe procedure, every surgery has potential risks and complications. According to studies, approximately 1.2% of LASIK patients are dissatisfied with their procedure, though the chance of serious complications is low. Remember to read reviews of any laser eye surgeon or clinic you are considering.
LASIK eye surgery has the following potential risks, side-effects and complications:
- Dry eyes. Dry eyes are the most commonly reported side-effect of LASIK. According to the American Refractive Surgery Council, up to 30% of LASIK patients experience dry eyes after surgery. This side-effect typically lasts around three to six months following LASIK and can be treated with eye drops. Some patients experience persistent dry eyes and require additional treatment.
- Visual disturbances. Some patients report halos or rings of light after LASIK surgery. Other patients have reported blurred vision and glare, particularly at night time. These visual disturbances are reported less often after LASIK than other laser eye surgery types and usually disappear within a few months of the LASIK procedure.
- Over or under correction. Every laser eye surgery method has the risk of over or under correcting the refractive error. In some cases, a second procedure may be required.
- Corneal ectasia. Ectasia is a bulging of the cornea as a result of corneal thinning, leading to blurred vision. Ectasia is more common after LASIK than other types of laser eye surgery, but the risk is still very low. According to the National Institute for Healthcare and Excellence, the risk of ectasia is less than 0.2%. People with abnormal corneal shapes are most at risk of ectasia.
- Flap complications. There is a risk of complications involving the corneal flap as it could get lost or damaged during surgery. The corneal flap is also vulnerable to trauma, which is why it is so important to avoid contact sports until your doctor advises you otherwise.
Eye sensitivity. LASIK is generally considered the least painful laser eye procedure but some patients report eye sensitivity during the healing process. If you experience pain after your LASIK procedure you should contact your doctor or clinic.
Infection. There is a risk of infection with any surgical procedure. Ophthalmologists prescribe antibiotic eye drops to reduce the risk of infection.
According to a study in the Journal of Cataract and Refractive Surgery, 99.5% of LASIK patients achieve 6/12 vision after surgery and 90.8% achieve 6/6 vision or better. Your eyes should be fully healed and results stabilised within three months after LASIK.
Successful LASIK surgery eliminates the need for glasses or contact lenses. In some cases, patients still need to wear glasses or contacts if their refractive error is over or under corrected. Some patients need to continue wearing reading glasses after LASIK.
What is the difference between LASIK and PRK?
LASIK and PRK are the two most commonly performed laser eye procedures in Australia. PRK, or photorefractive keratectomy, also treats common refractive errors. Unlike LASIK, there is no flap created during PRK surgery. Instead, a thin top layer of corneal cells is removed entirely.
PRK can be a suitable alternative for those whose thin corneas or dry eyes make them ineligible for LASIK. PRK has a longer recovery time and is generally considered more painful than LASIK. Some patients may qualify for both procedures and be able to choose whichever one they prefer.