Everything You Wanted to Know About LASIK Surgery

Vision correction procedures have come a long way since eyeglasses were invented in the 13th century. People with poor eyesight can now opt for bifocals, trifocals, progressive lenses or contacts — and more recently, even corrective optical surgeries such as LASIK.

But LASIK surgery isn’t as new as you think. Patented in 1989, the LASIK technique has been refined over the last few decades, making surgery a safer, more accessible option. Yet some people still have questions and concerns about this “new” procedure, and those questions are preventing them from seeing the clear truths about LASIK.

“Basically, LASIK is a generic term for a few different types of surgeries to correct nearsightedness, farsightedness or astigmatism,” says James Khodabakhsh, M.D., an ophthalmologist and medical director at the Beverly Hills Vision Institute. What makes this optical surgery such a popular procedure, he explains, is the fact that it’s proven, painless and effective.

And while most of us are aware that LASIK surgery involves a laser of some kind (LASIK stands for Laser-Assisted in Situ Keratomileusis), the rest of the details (especially the “in Situ Keratomileusis” part) can be kind of blurry.

“It’s basically a two-part procedure,” continues Khodabakhsh, explaining that the first part of LASIK surgery involves making a small “flap” in the surface of the cornea. This incision can be made with either an oscillating microkeratome blade or a femtosecond laser, the latter of which is Khodabakhsh’s preferred method. “The laser flaps are much more precise and much more safe,” he says.

The second part of the surgery utilizes another laser, this time to reshape the cornea. This laser, which is known as an “excimer” laser, is focused underneath the corneal flap created earlier. As explained by Ilan Cohen, M.D., a LASIK and cataract specialist at the 5th Avenue Eye Center in New York, the excimer is then used to “remodel the surface of the cornea to change its curvature,” which modifies its lens power. “By modifying its power,” he adds, “we can eliminate the need for glasses.”

Once the procedure is finished (a process that both Khodabakhsh and Cohen say takes about 10 minutes per eye), the flap is put back in place and the recovery process begins.

“Most people — not everyone — get most of their vision back within the first 24 hours,” claims Khodabakhsh, adding that eyesight is often be blurry right after surgery. “For patients with very high astigmatism, it may take longer.”

Cohen agrees. “Recovery is usually next day,” he says, but adds that there can be some minor discomfort from anywhere between “a few days to a few weeks, depending on the individual.”

But afterwards, patients can expect fantastic results. While some might experience mild regression down the road, Cohen and Khodabakhsh say that most patients achieve perfect vision after the procedure, a result that Khodabakhsh describes as “life-changing” for many of his patients.

LASIK surgery, however, may not be an option for everyone, as Khodabakhsh was quick to point out. “You have to be the right candidate,” he says. “The eye has to be stable. The prescription of your eye shouldn’t be changing constantly.” Other factors such as eye diseases, thin corneas and age can also prevent a patient from undergoing surgery, he says. A thorough screening by a well-trained professional is needed to determine if LASIK is the right option for you.

These screenings can also drastically reduce any complications, which Cohen estimates to happen at a frequency of about 1 in 1,000 for minor complications (like dry eyes, over-correction or under-correction) and 1 in 10,000 or 100,000 for more severe complications. “Generally, the more experienced the surgeons, the lower the complication rates, but there are other factors as well,” he states.

But as Khodabakhsh explains, that’s no reason to be wary of LASIK. “There is no surgery in the world that is without risk,” he says. “The good news is, since the advent of the blade-free flap creation, the incidence of major complications has decreased,” adds the doctor, calling today’s high-tech LASIK procedure “probably one of the safest surgeries in the world.”

The next thing to consider is the price. According to Cohen, LASIK procedures can run anywhere from $900 per eye up to $3,500 per eye, depending on the surgeon’s experience. Khodabakhsh says that some surgeons might charge even less, but advises against choosing a surgeon based on price alone.

“I think the most important thing is for a patient to trust their doctor,” Khodabakhsh advises. “You need to do your research, because LASIK might not be right for you.”