--------------------------------------------------------------Before Surgery
 
If you wear contact lenses, it is a good idea to stop wearing them before your baseline  evaluation and  switch to wearing  your  glasses  full-time.

Soft contact lenses:      you should stop wearing them for 2 weeks before your initial evaluation.   Toric soft lenses or rigid gas permeable (RGP) lenses:      you should stop wearing them for at least 3 weeks before your initial evaluation.   Hard lenses:      you should stop wearing them for at least 4 weeks before your initial evaluation. We will ask you about:   your past and present medical and eye conditions   medications you are taking, including over-the-counter medications      and any medications you may be allergic to We will perform a thorough eye exam and discuss:   whether you are a good candidate   what the risks, benefits, and alternatives of the surgery are   what you should expect before, during, and after surgery   what your responsibilities will be before, during, and after surgery The day before surgery, you should stop using:   creams   lotions   makeup   perfumes

These products as well as debris along the eyelashes may increase the risk of infection during and after surgery. On the day of surgery,  you may  be given  medicine to help you relax.  Because this medicine impairs your ability to drive and because your vision may be blurry,  make  sure someone can bring you home after surgery.

 

--------------------------------------------------------------During Surgery
The surgery should take less than 30 minutes. You will be positioned on a bed in the operating suite containing the laser system.  The  laser  system  includes a large  machine with a microscope attached to it and a computer screen.

A numbing  drop will  be placed in your eye,  the area  around your  eye  will  be cleaned,  and an instrument called a  lid speculum will be use to hold your eyelids open.  A  ring will be placed  on your eye and very  high  pressures will be applied to create suction to the cornea.  Your vision will dim while the suction ring is on and you may  feel  the pressure and  experience some discomfort during  this  part of the procedure. The  microkeratome,  the instrument which creates the flap in your cornea,  is attached  to the suction ring.

The  microkeratome  and the suction ring are  then removed.  You will  be able to see,  but you will experience fluctuating degrees of blurred vision during the rest of the procedure. We will then lift the flap & fold it back on its hinge, and dry the exposed tissue

The laser will be positioned over  your eye and you will be asked to stare at a light. This is not the laser used to remove tissue from the cornea.  This light is to help  you keep your eye fixed on one spot once the laser comes on.

When  your  eye is  in the  correct  position,  we  will  start the  laser.  At  this  point in the surgery, you may become aware of new sounds and smells. The pulse of the laser  makes a ticking sound. A computer controls the  amount of  laser  delivered to  your eye. After the pulses of  laser energy vaporize the corneal tissue, the flap is put back into position.

A shield will  be placed over your  eye at  the end of the procedure as protection, since no stitches are used to hold  the flap in place.  It is  important  for you to wear this  shield to prevent  you from rubbing your eye and putting pressure on your eye while you sleep,  and  to protect  your eye from accidentally being hit or poked until the flap has healed.

--------------------------------------------------------------After Surgery
Immediately  after the procedure,  your eye may  burn,  itch, or feel like there is something in it. You  may experience some discomfort, and you may be instructed to take a mild pain reliever.  Both of your  eyes  may  tear or  water.  Your vision  may be  temporarily hazy  or blurry. You  will  instinctively  want to rub  your eye, but don't!   Rubbing  your  eye could dislodge the flap, requiring  further  treatment. In addition, you may experience a temporary mild sensitivity to light.

These symptoms will improve considerably within the first few days after surgery.

At  the  first  postoperative  visit,  (typically the next day)  the eye  shield  will  be  removed , your vision tested, and  your eyes examined. You may be given one or more types of eye drops to take at home to help prevent infection or inflammation. You may also  be advised to use artificial tears to help  lubricate the eye. Do not resume wearing a contact lens in the operated eye, even if your vision is blurry.

You should wait one to three days following surgery before beginning any non-contact sports, depending on the amount of  activity required, how you feel, and your instructions, based upon our evaluation of your surgery and your lifestyle.

To help prevent infection, you may need to wait for up to two weeks after surgery or until advised otherwise  before  using  lotions, creams, or  make-up  around  the  eye. You  should  also avoid swimming and using hot tubs or whirlpools for 1-2 months

Strenuous contact sports such as boxing, football, karate, etc. should not be attempted for at least four weeks after surgery. It is important to protect your eyes from anything  that might get in them and from being hit or bumped.

During the first few months after surgery, your vision may fluctuate slightly. It may take three to six months for your vision to stabilize after surgery. Other visual symptoms may also persist during this stabilization period.