Read this before making that laser eye surgery decision

What to anticipate before, during, and after laser eye surgery varies according to doctor and patient. This area contains patient education materials provided by manufacturers and healthcare experts, but it is not a substitute for the discourse you should have with your physician. Take the time to thoroughly read this material and, using the checklist, discuss your expectations with your doctor.

• Prior to Surgery 
• During Surgery 
• Following Surgery

Prior to Surgery

If you decide to proceed with laser eye surgery, your eye doctor will conduct an initial or baseline examination to establish if you are a suitable candidate. What you need to know to prepare for the test and what to anticipate are the following:

If you use contact lenses, it is a good idea to discontinue use before to your baseline test and replace them with glasses. Contact lenses may alter the curvature of your cornea for up to several weeks after you stop using them. Not removing your contact lenses long enough before laser eye surgery to allow your cornea to revert to its normal shape might have detrimental implications. These effects include inaccuracies in measurements and an inadequate surgical design, which results in impaired eyesight after laser eye surgery. 

These measures, which are used to calculate the amount of corneal tissue to remove, may need to be revisited at least a week after your first examination and before laser eye surgery to ensure they have not altered, particularly if you wear RGP or hard lenses. For soft contact lenses, you should refrain from using them for two weeks prior to your first examination.

• if you are using toric soft lenses or rigid gas permeable (RGP) lenses, you should discontinue use at least three weeks before to your first assessment.
• if you are using hard lenses, you should refrain from wearing them for at least four weeks prior to your first assessment.

You should inform your doctor about the following: 

• your history and current medical and ocular problems
• any drugs you are taking, including OTC medications and any medications to which you may be allergic.

Your doctor should do a comprehensive eye examination and explain the following: 

• if you are a good candidate for laser eye surgery
• the risks, advantages, and alternatives to laser eye surgery
• what to anticipate before, during, and after laser eye surgery
• your duties prior to, during, and after laser eye surgery.

During this session, you should have the option to ask your doctor questions. Allow enough time to consider the risk/benefit conversation, to research any educational material supplied by your doctor, and to have any further questions addressed by your doctor prior to choosing to proceed with laser eye surgery and completing the informed consent form.

You should not feel compelled to get laser eye surgery by your doctor, family, friends, or anyone else. Consider the advantages and disadvantages thoroughly.

The day before the laser eye surgery, you should discontinue the use of the following: 

• creams 
• lotions 
• cosmetics 
• scents

These products, as well as debris along the eyelashes, may contribute to an increased risk of infection both before and after laser eye surgery. Before surgery, your doctor may ask you to clean your eyelashes for a length of time to remove residue and dirt from the lashes.

Additionally, make arrangements for transportation to and from your operation and your first follow-up appointment prior to surgery. On the day of operation, your doctor may provide medication to induce relaxation. Because this medication inhibits your ability to drive and may cause blurred vision, even if you do not drive, ensure that someone can transport you home after laser eye surgery.

During the Operation

The procedure should be completed in less than 30 minutes. You will recline on a reclining chair in an exam room equipped with a laser system. The laser system consists of a big machine equipped with a microscope and a computer screen.

A numbing drop will be injected into your eye, the region surrounding your eye will be cleansed, and your eyelids will be held open using a tool called a lid speculum.

Your doctor may carve a flap in the cornea using a mechanical microkeratome (a blade instrument).

If a mechanical microkeratome is utilized, a ring is put around your eye and very high pressures are applied to the cornea to generate suction. While the suction ring is in place, your vision may darken and you may feel some pressure and pain during this portion of the laser eye surgery. The suction ring is coupled to the microkeratome, a cutting device. Your doctor will carve a flap in your cornea using the blade of the microkeratome. Microkeratome blades are intended to be used once and then discarded. After that, the microkeratome and suction ring are removed.

Your doctor may choose to cut a flap on the cornea using a laser keratome (a laser instrument) rather than a mechanical microkeratome.

The cornea is flattened using a transparent acrylic plate if a laser keratome is employed. During this portion of the operation, your vision may darken and you may feel pressure and pain. The laser light is targeted into the cornea tissue, causing millions of microscopic gas and water bubbles to expand and join, separating the tissue under the cornea surface and generating a flap. After that, the plate is removed.

You will be able to see, although your vision will be obscured to varying degrees during the remainder of the treatment. The doctor will next pull and fold back the flap on its hinge, allowing the exposed tissue to dry.

You will be asked to gaze at a light while the laser is placed over your eye. This is not the laser that is used to remove corneal tissue. This light is intended to assist you in focusing your gaze on a single point once the laser is turned on. NOTE: If you are unable to focus for at least 60 seconds on a fixed object, you may not be a suitable candidate for this procedure.

When your doctor determines that your eye is in the proper position, he or she will activate the laser. You may become aware of new noises and odors at this point in the procedure. The laser pulse produces a ticking sound. As the laser eliminates corneal tissue, some patients have experienced a burning hair-like odor. The quantity of laser energy given to your eye is controlled by a computer. Your doctor will have programmed the computer before to the commencement of laser eye surgery to vaporize a certain quantity of tissue depending on the measurements collected during your first examination. After the laser energy pulses evaporate the corneal tissue, the flap is repositioned.

At the conclusion of the treatment, a shield should be put over your eye for safety, since no sutures are required to secure the flap in place. It is critical that you wear this shield to avoid scratching your eye and applying pressure to it while you sleep, as well as to protect your eye from being accidently struck or poked until the flap has healed.