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Published online by Cambridge University Press: 12 January 2010
Done to reduce dependence on glasses or contact lenses, refractive surgery involves reshaping the cornea with incisions, heat, or laser to decrease myopia, astigmatism, or hyperopia. Presently, the most frequently performed refractive surgical procedure is laser-assisted in situ keratomileusis (LASIK).
LASIK can correct refractive error within a wide range. To deduce whether LASIK is a good option for a patient, a thorough preoperative eye exam is necessary. Indications may include intolerance to contact lenses, improved conditions for job-related or hobby-related activities, or a desire to lessen reliance on glasses and contact lenses.
Performed in an outpatient setting with topical anesthesia, the operation usually lasts about 15 minutes with the patient experiencing minimal discomfort. Both eyes may be operated on the same day. After it is cut, the thin corneal flap is lifted and reflected to allow the laser to reshape the cornea. The laser is programmed with the patient's refractive error; once that refractive error is corrected, the corneal flap is realigned into place.
Usual postoperative course
Expected postoperative hospital stay
Most surgeries are performed in a surgicenter on an outpatient basis.
Special monitoring required
The patient's eyes are generally not patched, though sunglasses may be necessary if there is sensitivity to light. Discomfort is minimal postoperatively.
Patient activity and positioning
Most patients will be able to see well enough on the first postoperative day to return to regular activity, though they require reading glasses for near vision if they are in the presbyopic age range.
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