Laser-assisted in situ keratomileusis (LASIK)

Eligibility criteria

• Aged between 18 and 45
• Refractive error:
  • Has not changed for at least 1 year.
  • Spherical power up to −8 D
  • Astigmatism up to 4 D
• You have good vision in both eyes with your glasses or contact lenses.
• No other eye abnormalities
• Cornea of sufficient thickness and with normal curvature

Are you not eligible for laser eye surgery? An implantable contact lens (ICL) may be an alternative. 

Contraindications

You are not eligible for laser treatment in the following cases:

• During pregnancy or breastfeeding
• History of herpes keratitis
• Rheumatic conditions
• Corneal disease, such as keratoconus
• You only wear reading glasses.

Specific eyesight requirements apply to some professions, including the armed forces, police and aviation. Check carefully in advance whether laser treatment is permitted.

Advantages and disadvantages

• Corrects higher refractive errors.
• The eye is less painful after treatment and heals more quickly, within a few days.
• The cornea must be of the appropriate thickness.

Screening/preliminary assessment

Several specialised examinations, including Pentacam and MS-39, are needed to determine whether you are suitable for this treatment.

These examinations are usually performed beforehand at the laser centre.

Preparation

• Do not wear contact lenses in the weeks before your treatment:
  • Hard contact lenses: 3 weeks
  • Toric soft contact lenses: 3 weeks
  • Overnight contact lenses: 3 weeks
  • Soft contact lenses: 10 days
• Do not wear eyelash extensions
• You do not need to fast.
• Do not wear make-up on the day of the procedure.
• Bring the prescribed eye drops with you.
• Arrange transport on the day of the treatment.

Procedure

Duration: 15 to 20 minutes. The laser treatment itself takes 20 seconds to 2 minutes. The treatment is painless.

• You are first given a sedative and anaesthetic eye drops.
• The area around the eye is then cleaned and disinfected.
• You lie down on the treatment table and look towards the laser.
• A sterile, transparent drape is placed around your eye.
• Your eye is held open with an eyelid speculum. You cannot blink.
• Anaesthetic eye drops are administered.
• A corneal flap is created. It is folded back so that the laser treatment can be performed.
• During the treatment, you look at a point of light in the laser system.
• The laser corrects the cornea using a series of laser pulses over a period of 20 seconds to 2 minutes.
  • You will hear a crackling sound.
  • The laser treatment produces a slight burning smell because corneal tissue is being ablated.
• The corneal flap is repositioned.
• After the laser treatment, you will be given additional eye drops.

Aftercare

• Immediately after the operation, your vision will still be somewhat blurred. This will improve quickly over the following days.
• You will attend a follow-up examination the day after the operation.

Precautions

• Wear protective eye shields while sleeping for the first 3 nights to prevent you from rubbing your eyes.
• Take care when using shampoo and soap during the first week.
• Do not use sunbeds or saunas during the first 2 weeks.
• Do not swim or take part in ball or combat sports during the first month.
• Sunlight: wear sunglasses in bright sunlight.
• Use artificial tears regularly during the first 3 months.
  • Help the cornea to heal.
  • Prevent a dry or gritty feeling.

Risks and complications

LASIK is a safe treatment. Possible adverse outcomes include:

• Under- or overcorrection.
  • Additional treatment can correct this. This additional treatment is included in the price during the first year after treatment.
• Regular or irregular astigmatism that may cause your vision to deteriorate.
  • This does not always improve with glasses.
• Inflammation: treatable.

These complications usually do not cause permanent damage to your vision.

During the stabilisation period

Symptoms that often occur temporarily during the stabilisation period include:

• Increased sensitivity to light
• Glare
• Fluctuations in visual acuity
• Starbursts or halos around light sources in the dark
• Increased vulnerability of the eye: use eye protection during activities such as tennis, squash and martial arts.

These side effects almost always decrease over time.