Laser eye surgery / LASIK – FAQ
Everything you want to know about laser eye surgery/ LASIK.
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from 16-38€ month
Everything you want to know about laser eye surgery/ LASIK.
Free info kit
from 16-38€ month
How can I determine if I qualify for laser eye surgery?
Your ophthalmologist can help you decide, but here are some general guidelines:
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What happens on the day of treatment?
Laser eye surgery is an outpatient treatment, meaning you can go home afterward. You will need to be driven by someone else because your vision will be slightly blurred immediately after the surgery. You will lie on a couch. The doctor will apply anesthetic eye drops, position your head under the laser, and use a lid speculum to keep your eyes open.
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I have several questions about laser eye treatment. Who should I ask?
The best information about laser eye surgery can be obtained from a laser eye center doctor. Many offer free consultations; you just need to schedule an appointment.
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What if my vision does not improve after some time?
A small number of patients have good vision after the surgery, which then regresses. If this happens, consult your ophthalmologist to determine the cause and decide if a follow-up treatment is necessary.
How many follow-up appointments will I need after laser eye surgery?
Depending on the doctor, you will need to schedule a follow-up appointment 1 day after surgery, 2 weeks after surgery, and 3 months after surgery. Your doctor will inform you if more appointments are necessary.
When can I start wearing makeup again?
You can start wearing makeup 2 weeks after surgery. However, you should discard your old makeup to reduce the risk of infection.
What happens after the treatment?
The doctor may give you eye drops. You can rest for a moment and then go home. You may experience immediate improvement in your vision, which usually continues to improve over the next few weeks. Most laser eye patients can return to work the next day. For PRK, 5 to 7 days of rest are recommended.
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How long does a laser eye surgery take?
The actual laser treatment usually takes less than 1 minute, and the entire process takes about 10-15 minutes per eye.
Is the laser treatment painful?
You will not feel any pain during the Smile PRO, FemtoLASIK, or PRK treatments because the doctor will apply anesthetic eye drops beforehand. If necessary, they will prescribe painkillers afterward. Most Smile PRO and LASIK patients experience only mild pain that lasts at most one day after the surgery. PRK patients experience more pain because deeper layers of the cornea are exposed during treatment. Achieving good vision after PRK requires the regrowth of protective surface cells, which can take one or two weeks, sometimes longer.
Is it possible to treat both eyes in one session?
Most laser eye surgeons perform laser eye treatment on both eyes on the same day. Since it takes longer to achieve clear vision with PRK, some doctors wait 1 or 2 weeks between treating one eye and the other.
In almost all cases, laser eye surgery is performed on both eyes on the same day.
The Smile PRO or FemtoLASIK procedure is very safe and only takes about 10 minutes per eye, so there is generally no reason to schedule two different surgery days for each eye.
If you prefer to schedule a separate appointment for each eye (usually 1 or 2 weeks apart), most LASIK surgeons will accommodate your request. However, it is important to know that it can be uncomfortable between the two surgery days if one eye is corrected and the other is not. This also depends on your diopter values.
An exception is patients with moderate myopia and presbyopia. In this case, the patient and the doctor may decide to perform laser eye surgery on only one eye to achieve monovision for presbyopia, reducing the dependence on reading glasses after surgery.
Another exception is patients who need a follow-up treatment on only one eye to further improve vision in that eye after the first surgery.
Are Relex Smile / SMILE PRO and FemtoLASIK safe?
The FDA recognizes SMILE and FemtoLASIK as proven, safe, and effective. Laser eye correction uses a cool, computer-controlled laser beam. The doctor can turn the laser on and off at any time. There are several safety precautions to reduce the risk of errors. Nonetheless, every surgical procedure carries inherent risks.
Although no one knows the exact number of complications, studies show that minor issues such as dry eyes and halos at night occur in only 1 to 5% of patients, while the risk of serious incidents such as vision loss is below 1%. There are no known cases of blindness from FemtoLASIK or Smile PRO. The results are generally very good.
What is laser eye correction?
This is a surgical treatment that uses a cool (non-thermal) laser beam to gently reshape the cornea – the surface of the eyes – to improve vision. The laser removes microscopic parts of the tissue to flatten the cornea (to correct myopia), steepen it (to correct hyperopia), and/or smooth irregularities in the cornea (to correct astigmatism).
The goal of laser eye surgery is to change the shape of the cornea so that images can be better focused on the retina. LASIK and PRK are two types of laser eye correction.
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When should I stop wearing contact lenses before laser eye surgery?
Even clean and well-fitting contact lenses reduce the amount of oxygen that reaches the cornea. This can cause corneal swelling, which can affect the accuracy of important measurements before surgery.
Wearing contact lenses can also affect the tear film and cause dry eyes, which can affect the healing of the cornea after laser eye surgery.
For these reasons, your doctor will recommend that you stop wearing contact lenses for a certain period before the laser eye treatment.
Different doctors may have different preferences on when you should stop wearing contact lenses. But most recommend stopping wearing soft contact lenses 2 weeks before surgery.
If you use hard contact lenses, you should stop wearing them for a longer period before laser eye surgery – usually 1 month or longer.
Your doctor will give you exact instructions on when to stop wearing your contact lenses.
What happens if I blink or move during laser eye surgery?
This is a common concern, but rest assured. Blinking or moving during laser eye surgery is not a problem.
Before the surgery, you will be given anesthetic eye drops to make the treatment more comfortable and reduce the natural urge to blink. Additionally, a small instrument will keep your eyelids open during the treatment, so you cannot blink accidentally.
Movements of your head or body are also not a big problem. You will lie on a comfortable, flat, padded surface during the relatively short operation (about 20 minutes for both eyes).
Depending on the type of laser, most have a headrest to help keep your head comfortably in position during treatment. Your doctor may also gently hold your head in place.
Most lasers have an “eye tracker” that automatically monitors every position of the eyes and adjusts the laser treatment to compensate for any small, unintended eye movements during surgery.
What is done during the laser eye pre-examination?
The pre-examination before laser eye surgery
What is the duration of the effects of laser eye surgery?
Before deciding on laser eye surgery, it is important to have a thorough eye examination and consultation.
During the comprehensive pre-examination, your doctor will measure your diopter values and examine the health of your eyes to ensure that you are suitable for laser eye treatment. These examinations include dilating your pupils to thoroughly examine your eyes and suppress the focusing mechanism of the eyes to determine the exact degree of visual impairment.
During the pre-examination, additional measurements will be taken to confirm that you are suitable for the treatment. Especially since LASIK reshapes the front surface of the eyes (cornea), detailed measurements of the corneal topography will be taken to determine the shape and thickness of the cornea. Additionally, wavefront measurements will be performed to determine the type and degree of higher-order aberrations and whether a custom laser eye treatment is advisable.
The tear film will also be analyzed to detect any issues with dry eyes and treat them before LASIK surgery to prevent complications related to dry eyes.
The eyelids will be carefully examined to detect any eyelid inflammation that could increase the risk of LASIK complications.
A simple test will also be performed to determine your dominant eye. This is especially important if you have presbyopia and are considering monovision or multifocal LASIK.
During the examination, the costs of laser eye surgery will be explained to you, which also depend on the type of LASIK technology used. For example, Smile PRO is usually more expensive than a standard LASIK treatment.
When can I resume my normal activities after laser eye treatment?
Although different doctors may make different recommendations, here are some typical “waiting times” after LASIK for various activities:
Please note that these are general guidelines. Consult your ophthalmologist to get detailed guidance on when you can return to your regular activities after LASIK.
What is the minimum age requirement for laser eye surgery?
The short answer: You must be at least 18 years old for LASIK surgery. And sometimes it is better to wait even longer.
Why?
The main reason for a minimum age for LASIK is to increase the likelihood that your eyes are stable and your visual impairment – the degree of myopia, hyperopia, and/or astigmatism – is unlikely to worsen after LASIK surgery.
Most patients interested in LASIK are nearsighted, and myopia often worsens during childhood and even early adulthood. Ideally, you should have your eyes examined annually for at least 2 years before LASIK surgery, and your vision should be stable for at least 1 year before surgery (less than +/-0.50 diopters change).
If your myopia worsens after LASIK surgery, a LASIK enhancement is usually possible. But it is better to be sure that your visual impairment is stable before the initial LASIK procedure.
How long does the healing process take?
Your eyes start healing immediately after LASIK surgery. But it is normal for blurry vision and vision fluctuations to occur for a few weeks or even months after LASIK.
Your ophthalmologist will usually examine your vision the day after surgery to ensure your eyes are healthy and healing well. Most patients can drive (without glasses or contact lenses) and return to work the day after LASIK surgery.
Follow-up appointments are usually scheduled every 6 months or longer to monitor vision and eye health. In most cases, vision should be stable and clear 6 months after surgery. Even if you have experienced dry eyes, glare, halos, or other problems after LASIK, these symptoms should disappear or significantly reduce after 6 months.
If your vision is not optimal 6 months after LASIK, your doctor may recommend an enhancement. Most doctors generally wait at least 6 months before performing an enhancement to allow adequate healing time after the initial LASIK.
After LASIK surgery, you should take special care to protect your eyes from injuries. This applies even after your eyes are fully healed.
Eyes that have undergone LASIK surgery are more susceptible to traumatic injuries than eyes that have not undergone LASIK. For this reason, you should invest in safety glasses and sports goggles with polycarbonate lenses to protect your eyes from injuries when working with power tools, playing sports, or engaging in other activities that increase the risk of eye injuries.
Can my diopter values be corrected with laser eye surgery?
During an eye examination, the doctor will determine the degree of myopia (nearsightedness), hyperopia (farsightedness), and/or astigmatism and prescribe glasses with the necessary lens strengths to correct your visual impairment.
Whether laser eye surgery is possible for your lens strengths depends on several factors, including the shape and thickness of the cornea. Other factors include the brand of the laser your eye doctor uses and the laser eye technology recommended for your treatment.
In general, an FDA-approved laser can correct myopia up to about -10.00 diopters (dpt), hyperopia up to +5.00 dpt, and astigmatism up to 3.00 dpt.
During the LASIK pre-examination, your doctor will explain the best treatment for your needs and discuss with you whether your values fall within the recommended range for laser eye surgery. If your diopter values are too high for LASIK, other treatments, such as lens implantation, may be a good alternative.
Is laser eye surgery painful?
Right before laser eye surgery, you will receive eye drops to numb the cornea of your eyes during the treatment.
During the first step of laser eye surgery – cutting the protective corneal flap with a laser or a microkeratome – you will likely feel slight pressure on your eye. This is not painful, and the pressure sensation lasts less than 15 seconds.
When you are at home after laser eye surgery and the anesthesia gradually wears off, light sensitivity, tearing, and mild to moderate discomfort are common for a few hours. If you find this very bothersome, over-the-counter pain relievers can help alleviate the discomfort.
(Many patients report that if they sleep at home after surgery, they experience little or no pain afterward.)
If you experience severe eye pain after LASIK surgery – especially if pain relievers do not provide relief – consult your ophthalmologist.
Some doctors preemptively give their patients a prescription for painkillers to use if temporary pain occurs after surgery. Most patients who experience pain after LASIK report that it is relatively mild and goes away within a few hours without medication.
Do I still need follow-up eye examinations after laser eye surgery?
Yes, you still need eye examinations after laser eye surgery.
In addition to checking that your vision remains stable, you need comprehensive eye examinations to ensure the health of your eyes.
These examinations are particularly necessary to detect serious problems that could threaten your vision, such as glaucoma, macular degeneration, cataracts, or diabetic eye disease. LASIK does not increase the risk of these conditions, but it also does not reduce it. Therefore, routine eye examinations are just as important after LASIK as they were before the treatment to rule out or detect these conditions early and ensure appropriate treatment.
Since LASIK surgery changes the shape and thickness of the front surface of the eyes, follow-up checks after LASIK are also important to monitor the health of the cornea and detect early signs of keratoconus. (If keratoconus is detected early, it can be successfully managed with a treatment called cross-linking.)
If your ophthalmologist does not recommend more frequent check-ups, you should have your eyes examined annually after laser eye treatment.
You should not rub your eyes after laser eye surgery; vigorous eye rubbing can increase your risk of corneal thinning or keratoconus. (This also applies if you have not had laser eye treatment, but vigorous eye rubbing can potentially affect the stability of the corneal flap.)
If you have itchy or irritated eyes, consult your doctor for an evaluation of dry eyes or eye allergies so that appropriate treatment can be initiated.
Additionally, you should wear sunglasses that protect your eyes from harmful UV rays from the sun, as these are associated with the development of cataracts, macular degeneration, and eye cancer and surrounding tissue.
Is it necessary to remain awake during laser eye surgery?
Laser eye surgery usually takes less than 10 minutes, and general anesthesia is not necessary. The laser that reshapes the cornea takes less than 1 minute per eye.
General anesthesia during any surgery carries its own risks and would significantly increase the cost of laser eye treatment without providing significant benefits.
If you think you will be very anxious during the treatment, the doctor can give you a mild sedative before surgery to help you relax.
Most patients are surprised at how quickly the laser eye treatment is over and find it much easier than they expected.
Can laser eye treatment cause blindness?
Millions of laser eye treatments have been performed worldwide with a very high level of safety and effectiveness. It would be very unusual for someone to go blind from laser eye surgery – especially if they follow the doctor’s instructions and attend all follow-up appointments as recommended.
However, it is important to remember that laser eye surgery is a surgical procedure; and as with any surgery, unexpected complications can occur.
Most risks and complications from LASIK are minor and can be successfully treated. The most common complications are dry eyes, halos, or other visual disturbances. Severe complications, including significant vision loss, are possible but very rare.
When choosing a doctor for laser eye treatment, it is important to ask many questions during the pre-examination and feel confident that the doctor you choose will do everything possible to minimize the risk of complications and effectively treat any postoperative symptoms.
During the pre-examination, the doctor will discuss your suitability for LASIK and your individual risks based on your visual impairment, corneal measurements, health, age, and other factors.
Also, ask about the clinic’s policies in case the result is not as desired and you need an enhancement to achieve better vision.
Can laser eye surgery improve my vision?
Laser eye surgery is safe and effective for correcting myopia, hyperopia, and/or astigmatism, and most patients are very satisfied with the results.
Many patients who have undergone laser eye surgery report that their night vision is significantly sharper after the surgery than with glasses or contact lenses before the surgery.
In 2014, the Food and Drug Administration (FDA), the National Eye Institute (NEI), and the Department of Defense (DoD) published the results of their joint study on quality of life after laser eye treatment. This study evaluated laser eye risks and complications based on patient reports using a standardized survey.
The questionnaire, called Patient-Reported Outcomes with LASIK (PROWL), was answered by two groups of LASIK patients: 262 military-employed LASIK patients (PROWL-1) and 312 non-military-employed LASIK patients (PROWL-2). Participants answered the questions before LASIK (while they still wore glasses or contact lenses), immediately after treatment, 1 month, and 3 months after surgery.
Night vision disturbances decreased after LASIK compared to complaints such as glare and halos before surgery.
More than 95% of surveyed patients achieved 100% vision or better without visual aids after LASIK treatment.
And although a noticeable minority reported night vision disturbances such as glare and halos around light sources after LASIK, the frequency of these problems decreased after LASIK compared to complaints before surgery when patients wore glasses or contact lenses.
For example, before LASIK surgery, 41% of patients in the PROWL-1 group and 37% of patients in the PROWL-2 group complained of glare with glasses or contact lenses. Three months after LASIK, these percentages decreased to 23% and 27%, respectively.
During the LASIK pre-examination, detailed measurements of your eyes will be taken, and your doctor will explain the risk of glare, halos, and other side effects that could affect your vision.
In many cases, a custom LASIK treatment can reduce the risk of side effects after LASIK. And if you experience persistent glare or halos after LASIK surgery, a LASIK enhancement can often help.
Can laser eye surgery also correct astigmatism?
Yes, in most cases, laser eye surgery can completely correct astigmatism, and the result is permanent.
Astigmatism is a very common visual impairment. Although the name sounds a bit scary, astigmatism is not an eye disease – it is just a visual impairment like myopia and hyperopia – and can be corrected with glasses, contact lenses, and laser eye surgery.
Astigmatism is usually caused by an asymmetrical shape of the eye’s surface (cornea).
A common comparison used to describe this is that the cornea is shaped like a football rather than a baseball. Another is that the eye with astigmatism is shaped like an egg or the back of a spoon instead of a ping-pong ball.
The highly precise laser used in laser eye surgery can be programmed to reshape the cornea to make it more symmetrical, thus eliminating the visual impairment caused by astigmatism.
If astigmatism is present, it is usually no stronger than 3.0 diopters and can be completely corrected with a single laser eye treatment.
Even stronger astigmatism can be corrected with laser eye surgery, but the likelihood of needing an enhancement is higher.
If you have strong astigmatism, this may affect the cost of laser eye surgery, depending on the specific laser eye clinic. This will be discussed with you during the pre-examination.
Can laser eye treatment correct amblyopia (lazy eye)?
Amblyopia (also known as lazy eye) is reduced vision in one eye because the eye and brain do not work together properly. The affected eye often looks normal but is not used normally – the brain favors the other eye.
There are two main causes of amblyopia: 1) a misalignment of the eyes (called strabismus) and 2) the eyes have significantly different visual impairments. The result is the same: the brain starts to favor one eye, leading to vision loss in the other eye.
Usually, laser eye surgery cannot correct amblyopia. But there is an exception…
If one eye is much more nearsighted or farsighted than the other or if one eye has a stronger astigmatism than the other, it is possible that the brain ignores the eye with the greater visual impairment, leading to amblyopia.
Because the strength of the glasses affects the size of the images projected onto the back of the eye, it can be very uncomfortable for patients in this situation to wear glasses – the unequal magnification caused by the different strengths of the glasses can cause dizziness.
Because contact lenses sit directly on the surface of the eye, very different strengths of contact lenses for both eyes do not cause the magnification problems associated with unequal glasses lenses. Therefore, contact lenses are better suited for people with different visual impairments that could cause amblyopia than glasses lenses.
If a patient with this condition (called anisometropia) cannot wear contact lenses safely or successfully, LASIK surgery may be the best option to correct the different visual impairments and thus prevent amblyopia.
If you are at risk of amblyopia if you do not wear your glasses or contact lenses regularly, ask your ophthalmologist if laser eye surgery is a good option for you.
Can I wear contact lenses after laser eye surgery?
Although the goal of LASIK is to completely correct myopia, hyperopia, and/or astigmatism and eliminate the dependence on glasses and contact lenses, there are certain cases where contact lenses may be needed or desired after LASIK surgery.
One example is a patient with very high diopter values that could not be fully corrected by laser eye treatment but for whom an enhancement with laser eye treatment is not possible or recommended. This patient may still want to wear contact lenses after laser eye surgery.
Another example is a patient whose vision was fully corrected by laser eye surgery but who now experiences presbyopia due to age. This patient may want to wear a contact lens on one eye to achieve monovision instead of being dependent on reading glasses. Yet another example is a patient who has achieved very good vision after LASIK but wants to wear colored contact lenses to enhance or change their eye color, either daily or for special occasions.
Whatever the reason, in most cases, it is safe and effective to wear contact lenses after laser eye surgery. If lenses are worn on both eyes to correct vision, many patients find that gas-permeable hard contact lenses (including scleral lenses) or hybrid contact lenses provide sharper vision than soft contact lenses. Fitting contact lenses can be more challenging after laser eye surgery because the curvature of the front surface of the eyes has been changed by the laser treatment. For this reason, it is advisable to see an ophthalmologist who specializes in the challenging fitting of contact lenses in special cases.
Most doctors recommend waiting 2 to 3 months after LASIK before getting contact lenses fitted. Ask your ophthalmologist for their specific recommendation if you want to wear contact lenses after laser eye surgery.
Can laser eye surgery be performed during pregnancy?
The hormonal changes during and after pregnancy can also affect the eyes, making the results of laser eye surgery less predictable. These changes can also affect the healing of the eyes after laser eye treatment.
Additionally, several prescription and over-the-counter medications must be used by patients during and after laser eye surgery, some of which may harm the unborn child.
For example, patients are often given mild sedative tablets (such as Valium) on the day of surgery. And for several days after surgery, patients must use antibiotic and steroid eye drops several times a day to prevent infections and reduce inflammation.
The effects of these medications on pregnant women are not yet fully known, and they could potentially harm the unborn child if they enter the mother’s bloodstream.
For this reason, most doctors recommend not undergoing laser eye surgery during pregnancy and waiting several months after weaning to correct vision.
Many women also experience dry eyes during pregnancy, making wearing contact lenses uncomfortable or even dangerous. If you are pregnant or trying to become pregnant, you should have well-fitted glasses that you can wear if dry eyes occur.
An eye examination of visual impairment before pregnancy can serve as a reference for your laser eye doctor to determine if your values are stable before surgery.
Can LASIK be performed with cataracts?
Laser eye surgery cannot correct the vision loss caused by cataracts. Since cataracts gradually worsen over time, cataract surgery is usually necessary. For this reason, laser eye treatment is generally not recommended for patients with cataracts.
But there are a few exceptions. If you have congenital cataracts that are stable and do not significantly affect your vision, laser eye treatment may still be possible. This depends on the size and stability of this unusual congenital form of cataracts and your best possible corrected vision. Your ophthalmologist can advise you on whether you are suitable for laser eye treatment if you have congenital or mild, stable cataracts.
If you have typical age-related cataracts that worsen over time, your doctor can correct the visual impairment, including presbyopia, at the same time with premium intraocular lenses (IOL) during cataract surgery.
Although this type of refractive cataract surgery incurs additional costs not covered by health insurance, you benefit from reduced dependence on glasses after cataract surgery.
Ask your doctor about this option during the pre-examination.
Can laser eye treatment be performed after cataract surgery?
Yes, laser eye treatment can be performed after cataract surgery, but it may not be necessary.
Modern cataract surgeries can also correct myopia, hyperopia, and/or astigmatism by inserting premium intraocular lenses (IOL). These lenses are specifically designed to correct your visual impairment and reduce or eliminate the need for glasses after surgery.
This advanced type of cataract surgery is sometimes called “refractive cataract surgery.”
There are even multifocal lenses that can correct presbyopia, further reducing dependence on reading glasses.
Sometimes, a small visual impairment remains even after refractive cataract surgery. In this case, a laser eye treatment is often performed a few weeks or months later to further improve vision without glasses.
Refractive cataract surgery usually incurs additional costs not covered by health insurance. Ask your ophthalmologist for more details.
Can laser eye treatment be performed on thin corneas?
Laser eye surgery corrects vision by reshaping the front surface of the eyes (cornea) with a very precise laser. During this process, corneal tissue is removed.
Millions of laser eye treatments have been performed worldwide, and many studies have been conducted on the safety of removing corneal tissue.
During the laser eye pre-examination, detailed measurements of your cornea will be taken to ensure your cornea is healthy and thick enough for a safe operation.
If you have an unusually thin or irregularly shaped cornea or very high diopter values that require the removal of a larger amount of corneal tissue, you may not be a suitable candidate for laser eye surgery.
Frequent eye rubbing can also cause thin corneas and thus be a contraindication for laser eye surgery. Eye rubbing is also associated with keratoconus and can lead to significant thinning of the cornea, potentially requiring a corneal transplant.
Chronically itchy eyes can also indicate dry eyes or allergies. If you frequently rub your eyes or have been told that you have thin corneas, discuss this with your ophthalmologist – especially if you are considering Smile PRO, FemtoLASIK, PRK, or another refractive surgery method.
If you are not suitable for LASIK surgery because your cornea is too thin, other treatments, such as lens implantation, may still be suitable for you.
Can I drive myself home after laser eye surgery?
No, you will require a driver to take you home following the surgery.
Although your vision may seem very good shortly after surgery, blurry vision is common for a few hours after the surgery. As the effect of the anesthetic eye drops wears off after treatment, your eyes may be sensitive to light for a few hours. This can cause your eyes to water, affecting your vision.
Additionally, you may be given a mild sedative before surgery, which can cause drowsiness and affect your reaction time after laser eye surgery.
It is best to have a friend or family member drive you home so you can relax or sleep.
After surgery, you will be given protective glasses to prevent you from accidentally touching, rubbing, or bumping your eyes, especially in the first few hours after surgery.
At the follow-up appointment the next day, the doctor will check your vision to determine if you are allowed to drive without visual aids. Later, you will also receive a certificate for the motor vehicle department to remove the requirement for wearing glasses from your driver’s license.
Once your ophthalmologist confirms that your vision meets the requirements for driving, you can safely drive again after laser eye surgery.