After Lasik

Within minutes after LASIK, most patients will have a scratchy sensation as if something were in their eye. This is not painful, and lubricating drops cause the feeling to subside. Vision is often somewhat hazy for several hours. Without glasses, your vision may still be better than it had been before LASIK, but you should not be concerned if it is not. Bandaging the eye is not necessary.

It is best to return home, eat if you are hungry, and go to sleep. While sleeping, protective eyewear should be worn for a few weeks. By the next day, most patients are able to see clearly enough, without glasses, to actually drive a car and return to work. Using eyedrops, especially lubricants, is very important and aids proper flap healing.

The good news is that, in properly selected patients who have undergone the type of pre-LASIK evaluation described earlier, serious problems are extremely unusual after LASIK. Nonetheless, there is no such thing as a medical procedure that never causes problems; this section discusses the most common situations that could occur after the procedure.

 

After LASIK, the cornea of virtually every patient will easily become dry for a period of time that can vary from a few weeks to several months; this requires all patients to use lubricating drops. This occurs because the nerves to the corneal flap are severed as the flap is created and the flap will be relatively insensitive or “numb” until the nerves regrow. The eye will therefore not sense dryness very well, and this results in infrequent blinking. Whenever the brain senses the development of the

slightest dryness on the surface of the eye, blinking automatically occurs. This reflex is temporarily disrupted after LASIK. Therefore, if a patient’s eye feels dry after LASIK, the eye is usually very dry. This can cause blurred vision unless lubricating drops are frequently applied. Because temporary dryness is expected in every patient, it is not considered to be a complication or a problem.

This is by far the most common problem after LASIK. The surface of the cornea is composed of cells (the epithelium) that are actually replaced by the body every 7 days. Some of these rapidly growing cells may become loose during the LASIK procedure, causing the equivalent of a corneal abrasion. This situation is normally treated by wearing a “bandage” contact lens. This is a special therapeutic lens that is extremely thin and is placed on the eye by the LASIK surgeon. It promotes both patient comfort and healing, and is usually left in place for a few days until the epithelium is healed. More frequent examinations may be necessary, and recovery of good vision may be delayed for days or even few weeks if this unforeseeable problem occurs.

In less than 1% of LASIK patients, a generally mild inflammation develops within the cornea. Rarely, this problem can be severe enough to cause temporary or even permanently blurred vision. The medial term for this problem is “Diffuse Lamellar Keratitis” (DLK), and the cause is unknown. 

Because antibiotics are placed on the eye both before and after LASIK, this potentially serious problem is quite rare. Symptoms include blurred vision, pain and sensitivity to light; should any of those develop after your LASIK procedure, you should contact your LASIK surgeon immediately.

After LASIK, you should use protective eyewear while sleeping and avoid eye-rubbing. Doing this will help the flap to heal normally and prevent accidental flap dislocation. Occasionally, however, the flap may slip out of position and/or develop undesirable wrinkling within it.  The LASIK surgeon must then reposition and smooth the flap. This is a routine procedure, following which normal flap position is restored. Rarely, it may be necessary to place 1 or more sutures to hold the flap in position during the early healing period.

Proper healing of the corneal flap is extremely important after LASIK. Rarely, because of inflammation, infection or other healing problems, the flap may develop an irregular surface. In approximately one out of a thousand patients, this irregularity can seriously compromise vision and require the patient to wear a hard contact lens to see well. However, there is a new treatment on the horizon for this problem; lasers are now being developed that can be programmed to smooth these irregular corneas and thereby restore excellent vision.