Most patients have questions about laser eye surgery. Here we will provide answers to our most commonly asked questions.
Whether or not you are a candidate for laser eye surgery will be determined during your evaluation with your optometrist, as well as during the consultation appointment and preoperative testing that we, at the Horizon Laser Vision Center, administer. During these tests, your optometrist and surgeon will determine if laser eye surgery is the right choice for you. However, there are some basic requirements which include having a stable prescription, healthy corneas, and being at least 18 years old.
Laser eye surgery is a surgical procedure that uses a laser beam to gently reshape the front surface of your eye. The laser is used to either flatten your central cornea (to correct nearsightedness), steepen your cornea (to correct farsightedness), and/or smooth out corneal irregularities (to correct astigmatism). Your reshaped cornea will be able to focus images on your retina and give you sharper vision. iLASIK and PRK are two types of laser eye surgery.
iLASIK involves creating a thin flap in your corneal tissue, which is gently folded back so that the laser can reshape your cornea. In PRK your surgeon removes the outer epithelial layer of of your cornea instead of creating a flap and applies the laser to the front surface, directly.
The first laser eye surgery, radial keratotomy, was performed in 1963. PRK was first performed in 1987 and LASIK was developed in 1991. Horizon Laser Vision Center has been performing surgical procedures since 1996.
There is no real “maximum” age for laser vision correction. However, to be a candidate your eyes need to be healthy and free of eye disease.
Depending on your age you may require reading glasses even after you have undergone laser eye surgery. Almost everyone requires reading glasses by their mid-forties due to a common condition known as presbyopia. Presbyopia causes the lenses inside our eyes to be less flexible. If you already wear bifocals or reading glasses you will still need them after you undergo laser eye surgery.
However, presbyopia can be treated using monovision iLASIK. During this procedure, your dominant eye will be corrected for distance, while your non-dominant eye will be left slightly nearsighted so it can see up close. Since your eyes work together as a team, monovision allows you to clearly see objects up close and far away. Some people may still require reading glasses even after getting monovision.
Another possible treatment for presbyopia is the Kamra Corneal Inlay. This treatment involves placing a small inlay directly into the cornea of your non-dominant eye. The inlay focuses light and improves your near vision in that eye and binocularly.
Both iLASIK and PRK are approved by Health Canada and considered effective and safe procedures. iLASIK is approved by NASA for their astronauts and military pilots! However, laser eye surgery is not an appropriate choice for everyone. To find out if you might be a candidate for laser eye surgery please request a consultation.
Before your surgery begins you will be given anesthetic eye drops to completely numb the front surface of your eye. During the procedure, you may feel a small amount of pressure around your eye, especially if you are undergoing iLASIK where your surgeon needs to create a flap in your cornea.
After your procedure, your eyes may feel gritty for a few hours for iLASIK or a few days for PRK, so you will be supplied with pain medication to take after your procedure. Most people however, experience very little pain.
Laser eye surgery can correct astigmatism by reshaping your cornea so that when light enters your eye it is focused properly onto your retina, giving you clear vision.
Most surgeons perform the surgery on both eyes during the same appointment.
The actual surgical procedure takes about ten minutes per eye. Depending on how strong your prescription is, and how much your vision needs to be corrected, the laser only takes between twenty and fifty seconds per eye to correct your vision.
During the surgery, your eye will be held open to prevent you from blinking. The instrument used to keep your eye open, called an eyelid speculum, will be placed immediately before the treatment and removed immediately afterwards.
A focusing mechanism makes sure the laser is centerd. During the procedure, you will be asked to focus your gaze on a blinking target light. The laser’s computer will use a tracking system to monitor the position of your eye and adjust the laser to follow the tiny movements your eye makes.
Before your surgery begins we will potentially offer you anti-anxiety medication, which will be taken orally and will help you feel less apprehensive. Your surgeon will also talk you through the surgery so there won’t be any surprises.
Immediately after the surgery is complete, your vision will be blurry – like looking through a fog. This blurriness should dissipate overnight. The vast majority of iLASIK patients are able to see well enough to legally drive as soon as the next day. However, visual recovery rates vary. You should be able to resume normal activities within one or two days, but it may take as long as two months for your vision to fully stabilize.
Your vision may not be crisp and clear right away and may fluctuate slightly. This is perfectly normal.
On the day of your surgery, it is important that you have a trusted friend or family member available to drive you home. You should also arrange for someone to drive you to and from your first postoperative appointment. We also strongly recommend that you avoid driving or operating heavy machinery until you have been advised that are you are seeing well enough and feel comfortable enough to do so safely.
Most people who undergo iLASIK can return to work within days after their surgery. However, PRK patients recover more slowly and may need to take approximately a week off work following their surgery.
You may begin wearing eye makeup about ten days after your surgery. However, you should throw away your old mascara, eye liner and eye shadow, and purchase a new ones in order to decrease your risk of developing an infection.
Some people experience dry eye, which disappears over time and can typically be relieved using eye drops. Other patients may experience starbursts or halos around lights, especially at night. This effect usually lessens or dissipates over time.
Some people may experience dry eyes after surgery, though this generally dissipates over time. If your dry eyes are persistent, you may require eye drops or other forms of treatment.
Laser eye surgery is incredibly safe. The excimer laser used during your surgery is computer controlled, pre-programmed with your treatment data, and activated by your surgeon.
There is a very remote possibility that you may experience vision loss due to infection or inflammation. To minimize your risk of infection we only use sterile techniques in the surgery suite. We will show you how to use antibiotic and anti-inflammatory eyedrops after your procedure to help minimize the risks.
Laser eye surgery does carry risks, which will be further explained in the informed consent document that you will review and sign prior to your surgery. Possible risks include:
- Over or under correction
- Corneal flap-related healing problems
- Pain or discomfort
- Dry eyes
- Hazy vision
- Sensitivity to light
- Glare at night
- Loss of best corrected visual acuity
The majority of patients have a trouble-free experience with laser eye surgery. Your surgeon will be happy to discuss any concerns you may have about the procedure.
Some patients may experience problems with their nighttime driving, such as starbursts or halos around lights in the months after their surgery. The advanced technology we use today is able to minimize these issues, which will subside over time as your eyes heal. It is rare for night vision problems to become permanent.
Laser vision correction is permanent in most cases, especially if your eyeglass prescription was stable before your surgery. Should changes in your prescription occur, you may be able to undergo a retreatment or enhancement to correct the problem. Normal age-related changes will still occur after refractive eye surgery.
Before you undergo your surgery you should schedule your follow up appointments. These will include an appointment:
- One day after your surgery (which will be with either your surgeon or the Horizon Laser Vision Clinic optometrist)
The remaining postoperative appointments will be with your optometrist:
- One week after your surgery
- One month after your surgery
- Three months after your surgery
- Six months after your surgery
- One year after your surgery
- Yearly thereafter, with your optometrist
You may also require more appointments if either your surgeon or your optometrist feels your recovery should be followed more closely.
Since contact lenses can alter the shape of your cornea you will need to remove your contacts prior to your preoperative assessment at the Horizon Laser Vision Center. If you wear soft contact lenses you should stop wearing them at least one week before your testing. If you wear rigid gas permeable lenses you should stop wearing them at least four to six weeks prior to your assessment.
Removing your contact lenses will allow your cornea to return to its natural shape before your measurements are taken. After your preoperative assessment, you may be able to occasionally wear your contact lenses before your surgery – however you will need to discontinue them for 1 week prior to surgery for soft lenses, 4-6 weeks prior to surgery for rigid lenses. You should talk to your surgeon and your optometrist before wearing your contacts prior to surgery.
Only about 5% of laser eye surgery patients require an enhancement treatment. This procedure is performed at no charge up to 24 months after your initial surgery. The chance that you will need an enhancement depends on your eyes degree of refractive error and your body’s healing response. Individuals with highly myopic, hyperopic, or astigmatic prescriptions are more likely to require a second treatment in order to achieve crystal clear vision.
You should avoid flying for up to one week after your surgery.
Following your surgery, you should rest for the remainder of the day. Your eyes will be sensitive to light and you may require pain medication. You can return to your normal daily activities as soon as you feel comfortable doing so.
Cross-linking is a medical procedure that uses UV light and riboflavin eye drops to increase your cornea’s biomechanical strength. Xtra is a cross-linking procedure that is performed in conjunction with iLASIK or PRK.
The UVA light that you will be exposed to during your Xtra procedure is comparable to one full day’s worth of sunlight exposure. Riboflavin, also called Vitamin B2, is a photosynthesizer that occurs naturally in the body. It has been safely used in corneal cross-linking procedures for more than a decade and is non-toxic. It is a commonly used food and pharmaceutical additive.
Once your refractive procedure is complete a few drops of riboflavin will be applied to your eye. Once the riboflavin has been allowed to soak in, your eye will be exposed to UVA light. This light activates the riboflavin, which encourages a chemical bond to form between the collagen molecules in your eye, strengthening your cornea.
There are no age limits for Xtra, and patients that are good candidates for laser eye surgery are also generally eligible for Xtra. Your team at the Horizon Laser Vision Center will help you determine if your eyes require Xtra.
Your recovery timeline and visual outcomes should not be affected by adding Xtra to your procedure.
Both treatments follow the same procedure. However, when cross-linking is used to treat conditions like keratoconus it requires a longer soak time and more UVA light exposure.
Undergoing Xtra will not require you to adhere to any additional limitations beyond those recommended by your surgeon and your optometrist following laser eye surgery.
Eyes that have been treated with Xtra will not look any different than eyes that have been treated with iLASIK or PRK only.