What is a LASIK?
LASIK is the most common laser vision correction procedure in the world. Approximately 20-30 million people have had it done worldwide, including countless celebrities & athletes who have trusted their vision to LASIK.
LASIK stands for: “Laser-Assisted In Situ Keratomileusis”
The word “keratomileusis” is the trickiest word here, and it means “corneal re-shaping”.
The cornea is the clear window on the outside of our eyes that we look through. The cornea acts like a lens, similar to a glasses or contact lens, to focus light entering the eye onto the retina. (The retina is like the film in the back of a camera, and it relies on the cornea to focus light on it.)
The curvature of the cornea determines how strong or weak of a lens it is. People who need to wear glasses or contact lenses to see, have a mismatch in the natural strength of their cornea, relative to the length of their eye. By reshaping the cornea, light can be properly focused onto the retina so you’ll no longer need glasses or contact lenses.
What are all these different names for LASIK that I hear about?
While modern versions of LASIK are still generally called “LASIK”… LASIK today is performed very different from the way it was done 30 years ago. Thinking that Modern LASIK is the same as the LASIK of decades ago would be like calling a modern iPhone the same thing as a cell phone from 1990 without understanding the differences. Just like virtually every area of technology, the lasers and technology involved in LASIK have improved dramatically over the past 30 years – These advances have made the procedure safer, more accurate, more consistent, and able to provide better vision than ever before.
As a result, some doctors believe that modern, state-of-the-art LASIK warrants a different name to distinguish it from the original procedure. Some doctors call the version of modern LASIK they offer by different names such as: ‘HD-LASIK’, ‘SBK-LASIK’, ‘3-D LASIK’, etc. There’s no agreed upon terminology among doctors to distinguish modern LASIK with state-of-the-art technology from older versions of the procedure. This leads to confusion among patients… and is one of the main reasons we’ve started this site so that we can inform patients on what to look for — Or stated another way: To help patients distinguish marketing lingo from what’s really important.
The goal of this site is to educate patients considering laser vision correction on whats reeaaallly important… Check out our sections on “What to Look For in a Surgeon” and “Recommended Technology“…. And of course… Be sure to search our Directory of the “Best Surgeons in America” to find one near you.
How is modern LASIK performed?
There are two main parts to modern LASIK which are both performed with lasers:
- Making the flap
- Re-shaping the cornea
1.) Making the flap.
In modern LASIK, the inner layer of the cornea is sculpted with a laser to change its shape. To access these inner layers of the cornea, a thin flap less approximately 1/10th of a millimeter below the surface of your cornea is made.
Modern LASIK flaps are made by lasers… which are just a special type of light… to create a “bubble layer” at a precise depth within your cornea… and because lasers are just a fancy type of light … you don’t feel it at all!
Basically, these lasers use high resolution imaging systems to take high definition pictures and measurements of the cornea, and based on these images, the laser is focused at a precise depth under the corneal surface.
The laser energy causes a microscopic bubble to form. Over the course of a few seconds, many of these laser spots are placed next to one another, which form a connected bubble layer within the cornea that your surgeon can watch being made.
After watching and confirming that the bubble layer has been made properly, your surgeon can then easily lift the flap for the next part of the procedure.
Modern flap-making lasers have advanced tremendously from the first generation lasers developed years ago. Check out our “Recommended Lasers” section for a list of lasers that we approve of. (We have no financial interests in any laser company. Our only interest is in directing patients to quality surgeons.)
2.) Re-shaping the Cornea.
After the flap is made, your surgeon will lift it, and re-shape the inner layers of the cornea with another laser, called an “excimer laser”. Modern “excimer lasers” have also advanced tremendously over the last several decades.
The excimer laser uses pulses of light in a pattern customized to your eye that sculpts the surface of the cornea. Each laser pulse literally vaporizes a microscopic part of your cornea. By applying this laser energy in a pattern, the curvature of your cornea is changed to make it stronger or weaker based on your glasses or contact lens prescription.
Once the inner layers of the cornea are re-shaped, your surgeon will put the flap back in position and you’re all done! The entire procedure takes about 5 minutes on each eye… and the laser part take about 30 seconds (and often much less). Most of the procedure is just getting your eyelashes out of the way!
There are a lot of features of modern lasers that make LASIK more accurate and precise than ever before. For our recommendations on the technology you should look for in your LASIK procedure check out our “Recommended Technology” page.
How is modern LASIK different from older version of LASIK?
Millions of patients have LASIK every year. Simply put… Modern LASIK technology is safer and more effective at getting patients perfect vision than ever before.
Modern LASIK is performed with lasers. That means no more needles or blades of any kind like there were in the past. Lasers are simply a special type of light. So your job as a patient is to sit back and enjoy a brief light show.
Moreover… modern lasers are more precise and consistent than older generations of laser technology.
Making a LASIK flap allows for access to the inner layers of the cornea, which are then sculpted with a second laser. A perfect LASIK flap is well-positioned on the patient’s visual axis, and made at a uniform, appropriate depth relative to the patient’s corneal thickness and pre-operative prescription. Modern laser flaps are thinner, more precise, consistent, and customizable than blades, and each generation of flap-making lasers is better than the last. Simply put… better flap-making lasers result in safer LASIK procedures.
The re-shaping of the cornea is performed with an “excimer laser“. These lasers have also advanced tremendously over the past several decades. There are many features of modern excimer lasers that result in safer procedures with more patients than ever getting 20/20 (and even 20/15) vision. These features include: iris registration, wavefront optimized ablation profiles, pupil tracking, and advanced nomograms.
There are a lot of details of laser technology that are beyond the scope of this “Basics” section, but for those who are interested in the technical aspects of modern lasers, feel free to send us a question on our Contact Us page.
Also, be sure to review our “Recommended Technology” section that cuts right to the chase and gives a list of the lasers that we approve.
What is the entire process of getting LASIK like?
Let’s go through the entire process of what having LASIK is like from your initial consultation, through your procedure day, to your crystal clear vision afterwards.
Step 1.) Initial Consultation / Screening Visit
The first step is having a LASIK consultation or “screening“… and choosing the right doctor & practice is already a critical part of the process.
The purpose of this “screening” exam is to determine if you’re a “candidate“ for LASIK or any other vision correction procedure. Being a “candidate“ means that your eyes have passed the preliminary tests to determine that it’s safe for you to have LASIK.
These tests for “screening” involve checking your current glasses prescription, and taking a series of measurements on your corneas. The measurements are taken with special high-tech cameras. Examples of these measurements are shown in Figures 1 and 2.
For some patients, LASIK isn’t the best option, and one of the other vision correction procedures may be a better option. There is no one-size-fits-all vision correction procedure. Based on your unique measurements, you and your surgeon should have an in-depth discussion about the risks & benefits of the various vision correction procedures that you’re a candidate for.
Choosing an expert surgeon with state-of-the-art equipment for your “screening” exam is one of the best investments you can make for your vision. Read our section on “What to look for in a surgeon” to learn what to look for.
For most patients, modern LASIK is the recommended best option & most common laser vision correction procedure in the world.
Step 2.) Comprehensive Eye Exam.
At some point you’ll need a comprehensive dilated eye exam to make sure the back part of your eye is healthy. Some doctors do this on the day of your initial consultation, while others do this afterward in a separate appointment.
When you have your dilated exam is a not critical… and amounts mostly to patient convenience. If you’re travelling a long distance to see your surgeon, you may want it done on the same day if it can save you a visit. For other patients short on time, they may prefer to keep the “screening” visit shorter, and opt for dilation only after they know they’re a candidate & get more information. Often these routine dilated exams are conducted by optometrists, and is well within their expertise & scope of practice.
If the timing of when your eyes are dilated is important to you, call your surgeon’s practice to find our their protocol in advance.
The purpose of this step is to make sure you don’t have signs of early LASIK, and the back part of your eye, which includes the retina and optic nerve, are healthy.
Next you’re ready for you procedure day.
Step 3.) Procedure Day.
On the day of your procedure you’ll typically be given a mild oral sedative, such as valium. After giving it a few minutes to kick in, you’ll be escorted to the laser suite.
You’ll be in the laser suite for about 10-15 minutes. Most of the time that you’re in the laser suite will be used to get you in position and lined up with the laser.
There are two lasers used, one to make the flap, and the second to re-shape the cornea. The actual laser portion of the procedure lasts only about 15-30 seconds. A gentle eyelid holder is used to keep your eyelashes out of the way, which most patients describe as funny tickling sensation on the eyelashes, and you typically don’t feel much more than that.
It’s helpful to remember that lasers are just a special type of light. So your doctor will typically tell you to look towards a light, and during the laser portion of the procedure you get a brief light show. And because the laser is just a fancy light… you don’t feel it at all.
Many patients ask: “What happens if I move my eye?”… Nothing to worry about! Modern lasers have a way of tracking your pupil… So if you move, the laser is able to follow your eye movements.
One of the first things most patients say after their procedure is complete is: “Wow… That was so easy! Are we really done already?”
Step 4.) Go home and take a nap.
Hooray! You did it! Your procedure’s over and it’s only a matter of time before you’ve got much improved vision.
For most patients, the sedative used during the procedure is still in your system for a few hours after the procedure. Many doctors encourage their patients to go home and relax or take a nap. Taking a nap allows you to sleep through a few hours of the early normal scratchiness of the eyes, and kick starts the healing process.
After virtually every medical procedure, whether it’s on your knee, hip, or eyes… there is some swelling and inflammation. It’s this swelling and inflammation that causes your vision to be blurry for the first few hours after LASIK. Over the first 24 hours most of the swelling and inflammation resolve, and you’ll notice your vision gradually sharpen.
What will my vision be like after LASIK?
1.) Immediately after the procedure
The day of the procedure expect your vision to be blurry, and your eyes are likely to feel a little scratchy. Most patients (who have previously worn contacts) describe the sensation as similar to waking up after falling asleep with your contact lenses in. Most people still have valium in their system after the procedure, and they go home and take a nice long nap. If your procedure was in the morning, by the evening, your vision may already be good enough to watch television or use a computer… but expect it to be pretty fuzzy for the entire day of the procedure.
The following morning is when most patients notice the biggest difference. Most patients feel comfortable driving without glasses or contact lenses to their follow-up appointment the next day. The vision usually measures very sharp this next day, but is normal to be fuzzy on the edges or with some glare and blurriness in certain lighting situations. It can be said that by the next day your vision is typically 90-95% recovered, but the last 5-10% gradually improves over the next several days and weeks.
2.) One month after LASIK
By 1 month after your procedure the vast majority of patients have outstanding vision. For good candidates with otherwise healthy eyes who are near-sighted prior to LASIK, this may be as high as 99%.
LASIK surgeons are always trying to hit the bulls-eye perfectly to get you the best vision possible. LASIK lasers are most accurate for near-sighted prescriptions with low astigmatism. As prescriptions become more extreme, it becomes harder to hit the target on the first try. For example, it’s much easier to hit the bulls-eye on a routine -5.00 patient, than on a patient with a prescription that’s -10.00 with high astigmatism.
Fortunately, if there’s a little bit of prescription left over… a simple touch-up can be performed. Typically, your surgeon would wait a few months for things to stabilize, and then bring you back to the laser quite for a touch-up. Ask your surgeon how likely it is that you’ll need a touch-up for your prescription… since for most patients… but not all… they are very uncommon.
Touch-ups are almost always for a much smaller amount of prescription than the original procedure, and are typically extremely accurate in hitting the bulls-eye and getting you to your vision goals.
3.) Long term / Years after LASIK.
After your doctor hits the bulls-eye for your vision, you want it to stay that way for as long as possible. LASIK in near-sighted patients is extremely stable and can last for decades… and most patients who have LASIK are near-sighted.
The changes made to the cornea during LASIK are permanent; however, the rest of our eyes continue to change as we age.
(Note: The expectations for LASIK in far-sighted patients are different compared to near-sighted patients. Be sure to ask your surgeon how the accuracy & long-term stability of LASIK in far-sighted patients differs from near-sighted patients.)
We all have a natural lens inside our eye which changes as we age. Specifically, this natural lens stiffens and changes shape. As patients get to their mid-to-late-40’s, and certainly by 50, changes to the natural lens can result in the need for reading glasses, and then, on average, people develop LASIKs in their 60’s and 70’s. For this reason, most people find that the younger they have LASIK the more years they get out of it.
If you’re interested in LASIK and are already having problems with reading vision, then there are several options available to make you less dependent on reading glasses. (Ask your surgeon about whether “blended vision” and “lens replacement” options are right for you.)
In summary… There’s no one-size-fits-all solution to vision correction… and there’s a reason that doctors who perform LASIK are required to have such long educations & training.
Choosing an experienced surgeon with access to state-of-the-art technology is the best decision you can make to ensure an outstanding outcome from your vision correction procedure.
What celebrities have had LASIK?
We get asked this question soooooo frequently that we thought it deserved a place on this page!
Whenever we’re considering something new, it common to look to those who have gone through it before us.
Modern LASIK is trusted by many of the top A-List celebrities and All-Star athletes in the world. These are high performing individuals whose careers… and millions of dollars… depends on them having the best vision… and for athletes… gives them a tremendous advantage over the competition.
Many celebrities like to keep whether they’ve had medical procedures like laser vision correction a secret… so no one knows the complete list of celebrities who have had it done… But to give you an idea of just a few of the A-List stars who have had it done in the prime of their careers… just take a look at this group:
Lebron… Tiger… D-Wade…
Kim Kardashian… Brad Pitt… Taylor Swift…
They don’t get more famous than that!
The number of celebrities & athletes who have trusted their eyes to LASIK and other laser vision correction procedures is countless!
