Good recovery from LASIK
How long does the procedure take?
The LASIK procedure generally takes no longer than 10 minutes for both eyes. It is a routine procedure which has already been performed an estimated 50 million times around the world. Like all forms of surgery, the patient is also an active participant after the treatment has been carried out. Once the surgeon has done his part, it’s up to you to follow advice to ensure an uneventful and speedy recovery.
Although recovery is generally fast, with many people achieving sharp vision the day after the surgery, it’s important to remember that a healing process is taking place and great care is required.
What to expect after LASIK
Immediate recovery after LASIK
Laser eye surgery recovery begins as soon as the procedure is over, as the healing process begins immediately, and recovery may take up to 6 months.
The wound healing cascade is complex and gets activated during refractive surgery, be it LASIK or PRK. The refractive result, including other aspects of quality of vision, will depend on the wound healing response following a laser refractive procedure to be as close to the normal cascade as possible. It is likely that you will also notice an improvement in vision, compared to your pre-surgery vision without glasses, as soon as the surgery is over. Larger prescriptions will often experience a ‘wow’ effect, as the improvement can be dramatic.
Small prescriptions, e.g. those less than 2 dioptres, may not notice an immediate change, but vision quickly improves over the following 4-6 hours. There will be an initial slight swelling of the cornea, which you may notice as a minor degree of fogging or haziness of the vision, causing halos around lights particularly at night. Most of this swelling is settled in 24 hours, although minor haloing can be seen during the first month.
As far as discomfort is concerned, the anaesthetic drops will wear off about 20-30 minutes after the procedure, and you may notice the following side-effects:
- mild stinging
- sensitivity to light
These are all normal, temporary symptoms and should not cause you to be alarmed. You can use the supplied anaesthetic drops in your post-operative pack, which are labelled TET and contain tetracaine anaesthetic solution. Each drop of anaesthetic will numb your eyes for around 45 minutes. You may use these drops multiple times until your eyes settle after approximately 4 hours.
You will need to apply your antibiotic and steroid drops regularly according to the instructions in your post-operative information to aid recovery. These drops will be used for the first week after surgery. The antibiotic drops will protect you against infection, and the steroid eye drop will help control healing and reduce any inflammation.
Patients undergoing PRK eye surgery will continue to use steroid eye drops for two months after treatment.
The first few weeks of recovery after LASIK treatment
The healing process progresses quite rapidly, with corneal swelling usually subsiding within 24 hours. This means that the haziness will start to clear on the first day, and any blur will become progressively less over the next 2-3 days. After 1 to 7 days, vision will be quite clear. It has been reported that people with higher prescriptions may experience a slower improvement in vision during their recovery than those with lower prescriptions, due to the increased laser energy required to fully correct the prescription.
The slight feeling of dryness may remain for the first few weeks due to decreased tear production after vision correction. Lubrication of the eyes will continue to improve for 3-6 months afterwards and artificial tear drops will be used on a regular basis until the eyes feel normal.
The prescription will usually settle to its final result over 2-3 months, but may be up to 6 months depending on the individual and also on the severity and type of the prescription. Long-sighted laser eye treatments will take longer to settle down than short-sighted treatments. People with higher prescriptions, although they may notice a bigger initial improvement, may take longer to heal completely. During this time vision will continue to improve gradually.
The importance of excellent LASIK aftercare
Aftercare regimes may vary slightly from one surgeon to another but the main rules are basically the same. It is important to always follow the advice of your clinic, attend appointments as requested and always use any prescribed drops or medications. Hopefully your recovery after the procedure will be uneventful and without requiring any additional steps. It is normal, however, that you may require additional attention following treatment or a modification of the drops you are using.
If you do need additional care to address a post-operative issue, it is important that you can get quick access to your treating team and be reassured by seeing the same people at each visit. This may be facilitated by choosing a clinician-owned specialist refractive clinic rather than a large corporate chain.
Aftercare appointments following LASIK
The optometrist will see you for regular check ups following surgery. Routinely the postoperative check ups for LASIK are at one day, one week, one month, six months and one year.
Schedule of post-operative aftercare visits following LASIK and what is most important
Particularly Checking For
Flap healing, infection, inflammation, visual acuity
Visual acuity, refraction (prescription), inflammation, dry eye, flap healing, baseline post-operative scans
Visual acuity, refraction (prescription), dry eye, flap healing
Visual acuity, refraction (prescription) and assessing if enhancement is needed (1%)
Discharge appointment – visual acuity, refraction (prescription), eye health
At each check-up the optometrist will record your visual acuity and examine the recovery of your eyes to ensure the cornea is healing well.
Almost all LASIK patients at day one will notice their vision is great and the majority of patients are able to read the 20/20 line. Some patients can report slight hazy or cloudy vision even though they can see well. The optometrist will explain this is normal as your eyes will still be healing and the eye drops can cause some blur to your vision. The optometrist will advise you on the precautions to take at each stage and measure any dry eye after one week. This can help to tailor and manage dry eye treatment if required. It is normal for the vision to fluctuate in the early few months of treatment due to dryness affecting the surface of your cornea (the clear window at the front of the eye).
At each visit after the first day, your optometrist will measure your vision and prescription. If the optometrist finds your level of vision to be reduced at any point post-operatively, you may be asked to attend an additional appointment to see if this will improve spontaneously or whether an enhancement (re-treatment) may be needed. For most prescriptions at Focus Clinics, this only occurs in only 1% of cases. (Published studies generally show a more frequent rate of needing a second procedure, at between 3% and 9%.) This is usually performed after six months to ensure the prescription is stable. Re-treatment is easily performed at this time with the procedure taking around 4 minutes to complete.
At your one-year check up you are usually discharged to the care of your local optometrist. It is recommended to have a routine eye examination every one to two years to continue monitoring the general health of your eyes.
Laser eye surgery aftercare
Immediate recovery after your LASIK procedure
Although you may be feeling perfectly normal directly after the procedure, a few steps of caution must be taken:
- Eye drops – Your surgeon will prescribe you an antibiotic eye drop to prevent infection, a steroid eye drop to prevent inflammation and also a lubricating eye drop to help dryness. These may cause slight stinging or blurring initially.
- No Driving – You must arrange transportation home before the procedure as there is strictly no driving on the LASIK treatment day. Most patients are able to recommence driving after their first day post-operative check-up appointment.
- No rubbing – Rubbing the eyes can displace the corneal flap and lead to complications. This risk is mainly on the treatment day itself, but one should always be careful during first 7 days after surgery.
- Sleep – This is the best remedy, as it is when most of the healing takes place. Two to three hours of sleep help the corneal epithelium begin its healing and help the stinging subside.
- Eye Shields – Your surgeon will give you protective eye shields to wear while sleeping. These will be applied over both eyes (or only one eye if you had unilateral treatment) and held in place with medical sticky tape.
- Pain Relief – This may not be necessary but can be given to relieve any discomfort.
Your first post-operative appointment will be 24 hours after the LASIK procedure, at which time a clinician will check the condition of your corneas and ensure there is no infection or adverse effects. He or she will also give you advice for the following few weeks, and see you again at regular intervals during the first 6 months. The next appointment is most commonly a week after surgery.
However, if you experience any pain redness, discharge or a sudden decrease in vision before your next appointment, contact your doctor immediately. Specialist clinics will provide you with your surgeon’s mobile telephone number.
The first few weeks of recovery after LASIK
The following precautions must be taken to avoid injury and infection, and will be stressed by your surgeon or optometrist at your first post-operative appointment.
- Eye drops – the lubricant must be continued for 3 months but the antibiotic and steroid can be discontinued after 1 week, unless you are advised to the contrary.
- Eye shields – continue wearing these for the first week.
- Driving – driving may be resumed on the second day once your vision is confirmed to be above the driving standard without glasses.
- No rubbing – this should be avoided for the first month during the healing process.
- No dust and dirt – avoid dusty environments and gardening for 1 week.
- No sports – avoid sports and exercise for a week after the procedure, and avoid contact sports for at least a month. It may be advisable to wear eye protection for contact sports for the first 3 to 6 months, such as playing squash.
- No tap-water – keep tap water out of the eyes for a week after surgery, so wash hair with caution.
- No swimming – Avoid swimming pools, saunas and hot tubs for at least 4 weeks.
- Sunglasses – wear sunglasses at all times for the first week, as your eyes may be more sensitive to light.
- No make–up – eye makeup should not be worn during the first week, and all eye make-up should be renewed.
- Smoking – smoke may irritate the eyes during the first week.
Complete laser eye surgery recovery can be expected to take up to 6 months for most prescriptions. You should however be able to resume all your usual activities by one month after treatment, with the exception of some contact sports, such as martial arts. Keep your eyes well lubricated during the first few months, especially when using a computer screen. Your laser eye procedure should continue to give you clear vision for many years into the future, so enjoy your new vision and freedom from glasses or contact lenses.
During the first few weeks following PRK or LASEK
PRK differs slightly as the healing time takes longer the first check up is on day three when the bandage contact lens is removed from your eye. The optometrist will then review you again at two weeks, six weeks, three months, six months and one year.
PRK patients will find their vision improves after the bandage contact lens is removed on day three and notice a greater improvement by one week. These patients tend to find more fluctuations in their vision day to day with eyesight fully stabilising at three to six months after treatment.