Common Questions About Results After Laser Eye Surgery
Select any question below to learn more or contact one of our Patient Care Coordinators at 0207 224 1005 for more information about the results you can expect to achieve.
Essentially, no. Technically there is an exceedingly small risk of blindness with laser eye surgery but it is lower than the risk of wearing monthly contact lenses for one year, so a risk that everyone seems to accept as perfectly reasonable.
The following is our recommended activity schedule for patients who have had LASIK:
- Be very careful to avoid any activity that could lead to something touching or poking your eyes.
- Rest and keep your eyes closed for the first few hours after surgery. Once things have settled, you can resume normal activity at home.
- Avoid rubbing your eyes. Instead, use lubricant drops for any itching or dryness.
24 Hours after surgery
- Take a bath instead of a shower. Avoid getting any soap or tap water in your eyes.
- You can read and watch TV as long as you do not let your eyes dry out.
- LASIK patients tend to return to work, but you should keep your eyes well lubricated with artificial tears (staring at computer screens can dry your eyes). This does not affect the outcome, but can cause temporary visual fluctuations.
- Flying is acceptable but again, but you will need to lubricate your eyes- as the air is very dry in airplanes.
48 Hours after surgery
- At this stage, your cornea will heal. This means that normal activities such as showering and wearing make up are acceptable.
Day 3 activities
- You can take exercise that does not affect your eyes such as using a treadmill, or stationary bike, but not swimming.
- You can play with small children but be careful they do not poke you in your eye!
Week 2 activities
- Racquet sports, tennis, squash, racquetball, badminton (but always wear eye protection)
- Swimming (with goggles)
- Scuba diving, snorkelling
- Motorcycling, dirt biking, mountain biking
- Skiing (with goggles)
- Avoid high-impact sports such as martial arts, boxing and water-skiing until at least one month after LASIK.
We advise you not to drive until after the 1st day aftercare appointment. Driving short distances after the 1st day appointment is acceptable if we confirm adequate vision at the evaluation.
You can apply makeup 48 hours after surgery. However, we advise you not to apply eye makeup until 7 days after your surgery. Further, you must be careful not to rub your eyes when removing your eye makeup.
LASIK patients can plan to return to work 24 hours after surgery, but you should keep your eyes well lubricated with artificial tears (staring at computer screens can dry your eyes). This does not affect the outcome, but can cause temporary visual fluctuations. LASEK patients should plan to return to work after 7 days.
Your chance of seeing 20/20 after Laser Eye Surgery at London Vision Clinic depends on your pre-operative prescription. If you would like to review our results for patients with your prescription, please click here.
In regards to distance correction, it is necessary to mention that there are no published very long-term outcomes of laser eye surgery. However, corneal flaps have been created in the cornea for approximately over 50 years (in procedures such as keratomileusis as described and performed by Barraquer since the 1950’s), the excimer laser has been used for almost 20 years in the cornea and there have been approximately 17 million procedures performed to date worldwide.
Professor Reinstein was one of the key contributors to the National Institute of Health and Clinical Excellence (NICE) Guidance Document on LASIK, which determined that the procedure was safe and effective, and that there were no serious concerns about the long-term safety of the procedure if performed with the latest technology and techniques.
Laser eye surgery is safe but no surgery is entirely without some level of risk. The fact is that an expert surgeon will have the knowledge to manage complications properly and will often be able to correct any complications that do occur. In the hands of an expert surgeon, the chance of something going noticeably wrong is around one in 1,000 procedures. The chance of a surgeon facing a situation he or she would not be able to improve, or correct satisfactorily, is about one in 30,000.
We will only perform enhancements if the patient has a real potential of seeing better than they do after the initial treatment, and if it is safe to do so. Our current enhancement rate is 5% for short-sighted patients and 8% for long-sighted patients. At London Vision Clinic, we pride ourselves in helping our patients achieve the best possible visual results. Therefore, even if a patient is 20/20 after the initial procedure, but has the potential to see better, we will offer a complimentary enhancement to help you achieve a better quality of vision. Hence, 4 out of 5 (80%) of our short-sighted patients up to -9D can see 20/16 or better after all treatments, while almost half (47%) of our longsighted patients up to +6D can see 20/16 or better after all treatments.
You will be relieved to know you will not need any stitches. Initially, a vacuum effect keeps the corneal flap in position. The cells lining the inner surface of your cornea, known as endothelial cells, pump water out to the inner part of the eye. This suction holds the corneal flap in place. During the first day or two after surgery, the outer surface of the cornea, known as the epithelium, seals the edges of the corneal flap. Over the next few weeks, natural substances inside your cornea bond the corneal flap to the underlying tissue.
The corneal flapattaches to the rest of the cornea by a hinge. So there is no chance of losing it. However, if you rub your eye shortly after surgery, you may dislodge the corneal flap. Your surgeon would then have to reposition the corneal flap in the operating room. Very rarely, the microkeratome instrument will cut a free cap, without a hinge. This affects about one in 1,500 cases. If this happens, the surgeon will replace the cap after the laser part of the procedure. We will tell you this has happened and warned to take extra care not to rub your eye soon after surgery, to reduce the risk of losing the free cap. Even in the days when surgeons did surgery without a hinge, it was extremely rare for anyone to lose the part of the cornea that a surgeon had cut and replaced.
If your cap was lost, your cornea would become thinner, and there would be a chance of scarring. Overall, your vision would still probably be quite good, although surgeons consider this a serious complication. There is a very remote possibility that you would need a corneal transplant.
Few people develop side effects from Laser Eye Surgery. Of those who do, problems such as glare and halos, affecting night vision, are among the most common. There are several reasons.
If the laser did not shape of your eye has not been changed enough during your first procedure, you may still be slightly short or long-sighted, and/or still have a minor astigmatism. A follow-up procedure or wearing glasses at night can help.
The size of your pupils can be another cause of glare and halos. If a patient’s pupils dilate (open) beyond the area of the cornea that the laser has treated during laser eye surgery, this can cause glare and halos in low light conditions. A surgeon can prevent this by measuring your dilated pupil size before surgery. The surgeon can determine whether they can effectively treat a large enough area of your cornea with the laser. If this were not possible, then they would disqualify you from surgery.
If you do have glare and halos at night following surgery because of your pupil size, a few techniques can help. Some patients find that, when driving, keeping the overhead light on inside their car stops their pupils dilating so much that it affects their vision. Some people find medicated eye drops that stop their pupil from dilating fully helpful.
Finally, the treatment can cause glare and halos if the area of your cornea treated by the laser is off to one side (off-centred ablation). Choosing a properly qualified and experienced surgeon can help to minimise the risk of these complications. This is especially important, since to date, there is no entirely satisfactory solution available. Using Wavefront technology may significantly reduce the risk of glare, haloes and night vision difficulties.
LASIKand PRK decrease the normal amount of lubrication of the eye. The corneal nerves supply information to the lacrimal gland to supply a continual amount of lubrication. LASIK and PRK surgery severs the corneal nerves so that they can no longer supply the appropriate information, leading to dry eyes. Over the course of weeks to months to years, the nerves heal, and the lubrication level of the eye can return to normal. However some patients with pre-existing dry eyes are at risk for prolonged dry eyes that can cause significant symptoms, and some patients even years after surgery have dryer eyes than before surgery.
In general, the use of artificial tears is important following LASIK and PRK. Careful discussion with our nurse both before and after surgery is important in determining the amount of lubrication required. In severe dry eye cases, patients can use a punctal plug. A punctal plug is a plastic plug that prevents the outflow of tears from your eye to the nose. This devise can raise the amount of lubrication in the eye, just like plugging the drain of a sink. A surgeon can place and remove the plastic plugs can be months later, if required.
Some patients experience a regression of effect following surgery, but not to the preoperative level. A surgeon can fine-tune or enhance the surgery to further improve the vision if necessary.
When you break down a surgeon’s overall results into specific results for each type of prescription range, the difference between patient groups is clear. Generally, the lower your prescription before surgery the higher the likelihood of a better outcome after surgery. When looking at results tables, you must be sure to compare like with like. If your prescription is minus five (-5.00d) and the results tables are showing data from a patient group with prescriptions up to minus three (-3.00d), then this data does not tell you about your chance of a successful outcome.
In fact, results including patients with lower starting prescriptions (-3.00 and below for example) will skew the overall results so this can be misleading for a patient with a higher (-5.00) starting prescription. This also applies in the opposite direction. If you have a low prescription but the results tables show a wide range of patients, including those with very high prescriptions, the overall data would suggest poorer results than you are likely to experience. The closer the data is to your own situation, the more accurate they will be about your individual chance of successful result.
Contact us with your laser eye questions today.