LASIK

About LASIK Surgery

At UT Southwestern, our ophthalmology specialists offer expert diagnosis and treatment in all areas of eye care. Our physicians work closely with each patient to determine whether LASIK or another procedure is the best option for their specific vision condition. From exam to surgery to follow-up, patients receive care from the same doctor.

The Laser Center offers the latest laser eye technologies to ensure the best LASIK experience for all our patients. One of our state-of-the-art tools is the all-laser, or bladeless, LASIK device. In all LASIK procedures, doctors create a thin, hinged flap of tissue in the cornea, which is folded back to access the area of the cornea to be treated. The all-laser procedure uses a laser device to cut the corneal flap, whereas a mechanical device with a blade creates the flap in traditional LASIK.

Results with LASIK

LASIK offers benefits such as:

  • Vision improvement of 20/20 to 20/40
  • Little to no need for glasses or contact lenses until reading glasses are needed

The potential risks include:

  • Dry eyes
  • Problems with the corneal flap, such as infection or shifting
  • Undercorrections or overcorrections
  • Vision changes such as glare, halos around bright lights, double vision, or reduced night vision

What to Expect

Preparation

Our doctors begin by evaluating patients to ensure they’re good candidates for LASIK. Patients who wear contacts usually need to stop wearing them and wear only glasses for several days or weeks before the evaluation and procedure, depending on the type of lens.

In the evaluation, patients will have a complete eye exam to:

  • Check for infections, inflammation, dry eyes, or other issues that affect eye health.
  • Measure the cornea’s shape, thickness, and any irregularities.
  • Create a detailed chart of each eye to determine the areas of corneal tissue to be removed.

On the day of the procedure, patients should:

  • Arrange for someone to drive them home afterward.
  • Avoid wearing lotion, makeup, perfume, or similar substances on their face.

Procedure

The procedure usually takes about 15 to 20 minutes, with the appointment lasting about one hour, including preparation and recovery. The LASIK procedure appointment involves these steps:

  1. Patients can choose to take a medication such as Valium to help them relax.
  2. The doctor places numbing drops into the eyes and uses an instrument to hold the eyelids open.
  3. The doctor operates on one eye at a time, first placing a suction ring on the eye, then cutting and folding back a thin flap of the cornea using either a laser or a mechanical blade.
  4. The patient looks at a specific point of light to keep the eye steady, and the doctor reshapes the cornea by removing tissue using a laser programmed with the patient’s eye measurements.
  5. The doctor puts the corneal flap back into place and smooths the edges (no stitches needed). The flap adheres to the underlying tissue within minutes.

Recovery

Patients rest in the office for a short time, then a member of the care team does a brief check. Most patients recover quickly, returning to their daily activities within 24 hours.

Patients can expect:

  • Some itching, burning, or watering of the eyes for the first few hours after LASIK
  • Discomfort such as scratchiness or a feeling of something in the eye
  • Blurry or hazy vision for up to 24 hours

We typically recommend that patients:

  • Take a nap or rest with eyes closed for several hours just after the procedure.
  • Take pain medication as necessary.
  • Wear eye shields while sleeping for several nights to prevent rubbing or pressure on the eyes that could disturb the flaps.
  • Do not rub the eyes for several weeks.
  • Avoid using lotion, makeup, perfume, or similar substances for two to four weeks.
  • Avoid swimming, hot tubs, or contact sports for several weeks.
  • Contact us if they experience severe pain or other worsening symptoms.
Patients will have follow-up appointments the day after their procedure and regularly for several months. See our FAQ below for details about LASIK eye surgery and questions to ask the doctor.
Will LASIK correct all my vision problems, so I never need to wear glasses again?

No. LASIK surgery will not correct "over-40" eyes. As your eyes age, you may find you need to use reading glasses.

Can I have vision correction (laser eye surgery)?

The basic guidelines for having laser vision correction include: You must be at least 18 years old; you must have healthy eyes; you must have stable vision (your distance prescription should not have changed in the past 12 months).

The ophthalmologists at UT Southwestern's Laser Center for Vision Care also provide additional information and advice during our educational seminars. A private screening may be made during business hours if evening hours are inconvenient. After the informational seminar, you'll be able to schedule a one-on-one appointment with one of our ophthalmologists. During this appointment, a comprehensive eye exam will help us determine if you are a good candidate for laser eye surgery, and if so, which type of surgery is best suited to your visual needs.

How does laser eye surgery work?

An excimer laser delivers short pulses of a cool beam of ultraviolet light that removes a small amount of corneal tissue, usually less than the thickness of a human hair. The corneal curvature is adjusted to reduce the refractive error (how out of focus the eye is), reducing or eliminating the need for glasses or contact lenses. 

What are the benefits of laser eye surgery?

Laser vision correction reduces or eliminates your dependence on contact lenses and glasses, so there is a cost savings and some people find wearing glasses or contacts uncomfortable or inconvenient, particularly while participating in some sports. Some patients just want to be able to see the clock when they wake up.

Is it safe?

More than 17 million laser vision correction procedures have been performed worldwide since 1990. Data obtained during exhaustive clinical trials show that all patients experience a significant improvement in uncorrected vision (vision without glasses or contact lenses) after laser vision correction. Infection is a rare but treatable complication.

How does wavefront LASIK compare to conventional LASIK?

Wavefront adds an automatic measurement of more subtle distortions (called higher order aberrations) than just nearsightedness, farsightedness, and astigmatism corrected by conventional LASIK. However, these higher order aberrations account for only a small amount (probably no more than 10 percent) of the total refractive error of the average person's eye.

Conventional LASIK increases higher order aberrations. Although wavefront-guided treatments attempt to eliminate higher order aberrations, results from the clinical studies have shown that the average aberrations still increase, but less than they do after conventional LASIK.

In a few studies comparing wavefront-guided LASIK to conventional LASIK, a slightly larger percentage of subjects treated with wavefront LASIK achieved 20/20 vision without glasses or contact lenses compared to subjects treated with conventional LASIK. Patient selection and the experience and competence of the surgeon are still the most important considerations. [Source: FDA Medical Devices]

What is "All-Laser LASIK," and how does it compare to traditional LASIK surgery?

The difference between traditional LASIK and All-Laser LASIK (also known as bladeless LASIK) is the method by which the LASIK flap is created. In all-laser LASIK, a device called a laser keratome is used to cut a corneal flap for LASIK surgery. This is a newer method to create a corneal flap than the traditional method of using a microkeratome, a mechanical device with a blade. There is no definitive opinion among eye surgeons on the better choice for flap creation.

Some factors a surgeon considers when choosing a preferred method of flap creation during LASIK:

  • Quality of vision
  • Pain during and after surgery
  • Precision of flap size and thickness
  • Rate of complications
  • Time to recovery of vision
  • Expense

Discuss with your doctor any questions and concerns you have about how they chose their preferred method of flap creation. [Source: FDA Medical Devices]

What will my vision be like after surgery?

This depends largely on the amount of correction required. Most people require a low to moderate degree of laser vision correction, which should result in vision similar to that with glasses or contact lenses. Vision is usually blurry in the first day or two after procedure. It is expected that most patients should be able to legally drive without corrective lenses within one week.

What follow-up is needed after surgery?

Post-surgery visits are required at the following intervals: 24 hours, one week, one month, three months, six months, and 12 months.

Your eyes will be light sensitive for up to a week after surgery. The eye heals during this period, so we recommend you take a day or two off work and avoid light exercise. You should not drive for 24 hours after the surgery and be careful not to get soap or shampoo in your eyes while bathing.

For one to eight weeks, you should avoid any activities that might cause you to get dirt or dust in your eyes, such as rubbing the eyes, gardening, strenuous exercise, heavy duty house cleaning, or contact sports. You should not swim or use a hot tub during this time. Your doctor can give you a specific length of time to avoid these activities and tips for protecting your eyes while they heal.

Preparing for Surgery

Before LASIK, do I need to get an eye exam?

Yes. Before treatment you will have a thorough eye examination to determine whether your eyes are healthy and suitable for laser vision correction. If you have been wearing contact lenses, it is important that the lenses be removed prior to the examination.

The rule of thumb is to remove the lenses two weeks before the exam if they are soft lenses, three weeks if they are gas permeable, and four weeks if they are hard lenses.

A detailed video and computer image are taken of your eye to detail the curvature, shape, and overall smoothness and regularity of the cornea. Corneal thickness measurements are taken, and refractive stability is verified.

How long do I need to go without makeup?

You should not wear eye makeup to your initial eye exam or on the day of surgery, and you should not wear eye makeup for two weeks after surgery. Base, powder, and blush are OK if you take care not to get anything in your eyes.

How long do I have to be out of my contacts?

Because contact lenses reshape the cornea slightly, you should remove your soft contacts two weeks before the initial eye exam. If you wear gas permeable lenses, you should remove the lenses three weeks ahead of time, and four weeks for hard lenses.

What other preparations are there before LASIK?

The day before surgery, you should stop using:

  • Creams
  • Lotions
  • Makeup
  • Perfumes

These products as well as debris along the eyelashes may increase the risk of infection during and after surgery. Your doctor may ask you to scrub your eyelashes before surgery to get rid of residues and debris along the lashes.

Before surgery, be sure to arrange for transportation to and from your surgery and your first follow-up visit. On the day of surgery, your doctor may give you some medicine to make you relax. Because this medicine impairs your ability to drive and because your vision may be blurry, make sure someone can take you home after surgery.