Most people like to schedule laser treatment in the afternoon so that they can get work done in the morning. Eat and drink according to your normal routine but do not consume any alcoholic beverages on treatment day. Plan to arrive at our center about half an hour prior to treatment, and make arrangements for a friend or relative to take you home afterwards.
We'll check you in, re-confirm measurements in certain cases, and then offer a mild sedative to help you relax (typically Valium or Xanax). Your eyes will then be prepped for surgery -- several drops of medication including antibiotic will be placed on the eyes, and the skin of the lids will be cleaned.
You will walk from our prep room to the laser room and lay down on a padded platform with your head in a special donut-like pillow. When you're comfortable and correctly positioned, the laser bed will glide so that your head comes under the treatment arm of the laser.
Most people desire to have both eyes treated on the same day and if that is the case, we will typically treat the right eye first.
Anesthetic eye drops will be used before and during treatment so there is no pain or discomfort (there are no injections or needles). When your eye is nicely numb, clear plastic tape will be placed over your eyelashes and eyelid skin, and a gentle eyelid separator will be introduced to keep your lids from blinking during the few minutes of treatment. We will ask you to look at a green blinking fixation light right in the middle of the main lens of the laser delivery system, and to keep your gaze fixated upon this target while the treatment is rendered.
Next, we will create the delicate LASIK flap, which takes just a few seconds. You may feel some momentary tightness or pressure around the eye, and vision typically goes dark for several seconds. Then the new flap is lifted, just like opening the cover of a book, and gently folded out of the way. We rotate our infra-red pupil tracker into position from over your right shoulder. Our Allegretto laser is pre-programmed with the treatment measurements and other information gathered from all your pre-op testing. We re-confirm that the info in the laser matches the chart, and you; then we'll remind you to look at the green blinking fixation light, and we'll commence laser treatment. The laser performs computer-guided, computer-controlled sculpting of the collagen layer of the cornea, under the flap. This goes very quickly, typically taking 15 - 40 seconds to complete. Treatment time varies depending on the amount of correction desired. There is absolutely no sensatin during the laser sculpting process, Each tiny spot of laser treatment can be accompanied by a low 'snap' sound which derives from the creation of the laser pulses within the laser tube. Since our laser operates at 200Hz (cycles or pulses per second) the sound seems more a continuous low buzz, like what is heard when you vibrate the tip of your tongue on your palate. When the laser energy touches the cornea, a precise shape and amount of collagen is evaporated (sculpted) and the loose molecules may create a mild, distinct aroma. Dr. Wallace will verbally explain each step in the process so nothing comes as a surprise. When the laser treatment is complete, the pupil tracker is rotated back out of position (over your right shoulder), and the flap is then returned to it's original position. Fluid is rinsed through the flap interface and over the top, then smoothed in place with special saline-soaked cellulose sponges. Healing drops are instilled and precise flap alignment is confirmed by inspection with a slit beam of light angled in from the left side. The eyelid separator and lid tape are removed.
If we are treating both eyes, we will move the bed to position the left eye under the laser lens and do exactly the same steps as were done with the right eye. When we're finished, the treatment bed is moved down toward your feet, away from the treatment end of the laser, and we're done! We remove your surgical cap and help you stand up. We'll point out a few items to make sure you can see them (like the clock on the wall, and signs across the street). The flap edge seals within minutes, and secures within hours, without need for stitches.
Following your procedure, we'll ask you to rest with your eyes closed for about 5 minutes, in one of our exam room chairs. Then we'll check you with a microscope to make sure everything looks perfect. We place protective shields and ask you to wear these just for the first evening and overnight. Your vision may be a little hazy at first, rather like mist on a windshield. We ask that you arrange for a friend or relative to drive you home, so you don't have to stress about driving yourself. Plan to relax and take it easy for the rest of the day, maybe even sleep. You may experience some mild irritation (graininess, or tearing) for 2 to 6 hours, but this usually goes away without need for any treatment other than perhaps moisture drops. The mist should clear within hours so expect your vision to be very clear by evening, and awesome by the following morning. There may some glare and/or halo noted around point sources of light (street lights, headlights, taillights) on the first evening after treatment; this should diminish incrementally day by day and be gone or 'beneath the radar of your awareness' within a week.
You will be asked to come back the next day for a quick check-up. Most people can see well enough to drive the next day, but if for any reason you don't feel comfortable driving, please don't. You should be able to resume your full, normal activities the day after LASIK. This includes showering, shampooing your hair, even putting on eye makeup; and resuming full activities including aerobics, cardio, weights, spinning, jogging, biking, yoga, or whatever other exercise regimen you typically enjoy.
Vision can fluctuate a tiny bit for several weeks, but most people can see well enough to pass a driver's license vision exam the next day following this procedure.
We routinely suggest post-op check-ups after LASIK at 1 day, 2 to 3 weeks, 3 months and thereafter as warranted or desired.
With PRK the healing process is a bit slower than with LASIK. Visual recovery can take between 4 days and three weeks to recover optimally. Medication eye drops (anti-inflammatory and antibiotic) need to be used for a significantly longer period than for LASIK.