Advantages of LASIK surgery
	Contra-indications to LASIK Surgery
	What you may expect after LASIK surgery
	Preparations for Surgery
	Post-operative care and restrictions
	Perspectives from our patients
	Frequently asked questions
	LASIK Post-Op Info - DOWNLOAD PDF

"LASIK" is an acronym for "Laser ASsisted Intra-stromal Keratomilieusis". This term is derived from the Greek, and implies that the corneal stroma is treated by the application of laser, thereby modifying the corneal shape, without changing the structural composition of the cornea.

This is in stark contrast to PRK. The procedure combines the advantages of lamellar corneal surgery, with the sub-micron accuracy of the excimer laser. A lamellar flap of 120 – 180 micron thickness is first created, consisting of the first three layers of the cornea. When this flap is lifted, the thick stromal layer of the cornea is exposed, into which the laser profile is shaped with the excimer laser. After completion of the laser, the flap is replaced, with the result that the corneal contour is modified without sacrificing the epithelium or Bowman’s membrane in the process.

Various laser profile treatment options are available for both LASIK as well as PRK, and are described elsewhere on this website.

Contra-indications to LASIK Surgery

Keratoconus
This implies that progressive protrusion of the cornea occurs due to corneal thinning and resultant structural weakening. In keratoconus, corneal transplantation is ultimately necessary should the patient be unable to achieve good vision with either glasses or contact lenses. When the eye has healed (about a year after corneal transplant surgery), any residual refractive error may be corrected by means of the LASIK technique, 3 - 4 months following the final removal of sutures.

Presbyopia
Patients aged 40-45 years or older, need reading glasses due to normal physiological changes that occur within the crystalline lens. Presbyopic patients that only wear reading glasses will not benefit from LASIK surgery, since only refractive errors for distance can be treated.

What you can expect after LASIK surgery

LASIK surgery usually eliminates, or at times largely reduces, one's dependence on spectacles or contact lenses. It enables one to drive, play sport, watch TV, etc. without the burden of corrective eye wear. With aging, however, one will still need reading glasses like all people over the age of 45 years (presbyopia).

During the initial period after surgery, one might experience minor fluctuations in visual acuity. This usually stabilizes by the three-month mark post surgery.

Minor light sensitivity, glare and night halos occur commonly for the first few weeks after LASIK surgery, but disappear thereafter. Occasionally, halos at night may persist for lengthy periods, up to six months after the operation.

A small percentage of patients will need enhancement surgery. The chance for this to occur is directly proportionate to the initial refractive error treated. The incidence of enhancement procedures thus varies according to the complexity of the initial refractive error.

For low and moderate refractive errors, re-treatment is rarely necessary (1% to 5%). Patients with high refractive errors may need an enhancement procedure 3 - 6 months after the initial surgery (about 10 to 20%) to correct the residual error, provided the cornea is thick enough to allow a safe correction.

Preparations for Surgery

No special preparations are necessary, as LASIK surgery is performed using local anaesthetic eye drops only.  You must, however, refrain from wearing contact lenses prior to the first consultation and before surgery.

The following information might prove useful:
	eat and drink normally on the day of the surgery
	dress warmly and comfortably (the temperature in the laser theatre is kept constant between 16 - 18°C)
	don’t wear any perfume or after-shave
	remove all eye make-up prior to your arrival
	have somebody available to accompany you to and from the laser clinic, as well as your first follow-up the next day, since your eyes will be covered after the surgery
	plan to spend approximately 2 - 3 hours at the laser center
	arrangements for payment will be made prior to surgery

The procedure

Both eyes are treated routinely during the same sitting on an outpatient basis, except if a patient prefers to have one eye treated at a time.  Patients remain awake and comfortable during the procedure, while co-operating with the surgeon.

Prior to the entry of each patient into the laser theatre, the laser is calibrated and routine safety checks are performed on the other surgical equipment.

The surgery is performed through a special operating microscope.  First, a thin lamellar corneal flap is created by using the latest state-of-the-art microkeratome, the ZyOptix XP keratome, in preparation for the laser treatment.  A new surgical separator is used and all instruments are fully re-sterilized for each and every case. This flap will cover the area to be sculpted by the laser, and allows rapid visual recovery, reduces discomfort and alleviates pain after surgery.

The flap is reflected, while the laser treatment is administered directly onto the underlying deeper stromal layer of the cornea.  Excimer laser pulses, i.e. specific wavelengths of ultraviolet light, re-shapes the cornea by gently vaporizing minute amounts of tissue from the surface of the eye, in a predetermined, computer controlled fashion.

The actual laser treatment time on average varies from 15 - 45 seconds, depending on the extent of the correction. During the laser treatment, you will be required to co-operate by looking into a red fixation light. Should you be unable to co-operate, one of the laser's advanced features, an active eye-tracking mechanism, will ensure that the treatment is administered in the correct area on the cornea.  Because Dr Potgieter checks and verifies that all the surgical equipment is in good working order and personally calibrates the laser before every treatment, the entire procedure takes a little longer at our center as opposed to most others - approximately 40 minutes for both eyes.

After completion of the laser treatment, the corneal flap is replaced onto its original position.  No sutures are needed to fixate the flap, as the normal physiology of the cornea keeps the flap in position and prevents it from moving.

Post-operative care and restrictions

Patients are requested to return to our clinic for a scheduled appointment the morning after surgery, when the plastic shields will be removed by the clinic staff.  An eye test, computerized refraction, as well as an eye examination by Dr. Potgieter will be performed to ensure that all is well.

At the first post-operative visit, most patient's uncorrected visual acuity is within the standard set by law for driving (20/40) in South Africa. Most patients are able to return to their everyday activities within the next 2 - 4 days. Two sets of drops will be provided, which will ensure speedy recovery, prevent infection and reduce discomfort.

During the first week the vision recovers rapidly and after four weeks the eyes are close to their optimal visual acuity. It may, however, take 3 months before a person’s vision stabilizes completely, depending on the initial refractive error.  Patients within the presbyopic age (40 to 45 years and older) will require reading glasses shortly after surgery, like all normal seeing individuals of that age group. These patients are advised to purchase "over the counter" reading glasses until their refractive error stabilizes, at which time they may have prescription reading glasses if necessary.

Some of the restrictions directly after LASIK include:
	no mascara or eyeliner for 2 weeks (eye shadow may however be worn within 1 week post-operation)
	extra care should be exercised when bathing and washing hair to avoid unnecessary soap and water in the eye for 2 weeks
	no swimming for 6 weeks
	no diving or water skiing for 8 weeks
	no rubbing the eyes for at least 3 to 6 months (to allow the lamellar flap to heal)

You may drive as soon as you feel comfortable to do so. Recovery to drive at night may take longer than driving during day-time, due to halo- and starburst effects of lights that may occur initially.

Do not use any eye drops or eyewashes other than those prescribed by Dr. Potgieter for at least the first month.