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Get answers to your questions and learn how the iLASIK™ treatment, along with the iDESIGN™ Refractive Studio system, can improve your vision. Learn more about before, during and after iLASIK™.
About iLASIK™ Surgery
It is an all-laser vision correction procedure that uses proprietary technology to measure the unique characteristics of your eye and provide a completely customized correction for exceptional visual clarity. LASIK with iLASIK™ technologies have been used in over 15 million procedures worldwide.
There are three steps to the iLASIK™ procedure:
Step 1: Creating Your Eye Map
A detailed map of the unique visual imperfections of your eye is created using wavefront eye-mapping technology that is 25x more precise than the measurements used to write a standard prescription for eyeglasses or contact lenses.
Step 2: Preparing Your Eye
An ultra-fast laser creates a thin flap to prepare your cornea for your personalized wavefront vision correction.
Step 3: Delivering Your Personalized Treatment
In this final step, an ultra-precise laser gently reshapes your cornea to the desired curvature, based on the digital information from your personalized eye map measurements.
The iLASIK™ procedure may help people do the things they love to do without the hassle of contacts or glasses.
It is approved to correct mild to severe nearsightedness, farsightedness, and all types of astigmatism. If you meet the following conditions, it is likely you are an excellent candidate for the iLASIK™ procedure:
- Be at least 21 years of age for the Advanced CustomVue procedure, 18 years of age for iDESIGN™ procedure, and 40 years of age for monovision procedure.
- Have healthy eyes that are free from eye disease or corneal abnormality (e.g., scar, infection, etc.).
- Have documented evidence that your refraction did not change by more than 0.50 to 1 diopters during the year before your pre-operative examination.
- Be informed of LASIK risks and benefits as compared to other available treatments for your refractive error.
- Be able to lie flat without difficulty.
- Be able to tolerate local or topical anesthesia.
- Be willing to sign an informed consent form as provided by your eye care professional.
- Be able to keep your eye accurately on the fixation light for the entire laser surgical procedure.
A certified LASIK doctor can tell you with greater certainty whether the iLASIK™ procedure is right for you.
iLASIK™ technologies have been used in more than 15 million vision correction procedures worldwide. In fact, NASA astronauts and US aviators are able to have laser vision correction surgery today because of studies validating the safety and effectiveness of the technologies.
Talk to your doctor about the risks of this procedure. Side effects include but may not limited to:
- Eye dryness
- Reduction of vision or the possible need for glasses or contact lenses after surgery
- Visual disturbances such as halos, glare, starbursts, ghost images and other visual symptoms
Complications from the iLASIK™ procedure usually can be successfully managed medically or with follow-up care. The frequency and severity of complications vary, depending on how much nearsightedness, farsightedness and/or astigmatism you have prior to the procedure and other factors.
The iLASIK™ procedure is performed on the cornea — the clear front surface of the eye located in front of the pupil and the colored iris.
The cornea provides about 65 to 75 percent of the focusing power of the eye. The rest is provided by the eye's lens, which is located behind the pupil.
The cornea is clear because it is a highly organized network of collagen (a connective tissue protein) and it contains no blood vessels.
The central region of the cornea — the portion affected by the iLASIK™ procedure — is typically 500 to 600 microns (about a half of a millimeter) thick.
Wavefront technology is an advanced, digital optical imaging technique used to detect, analyze and correct nearsightedness, farsightedness and/or astigmatism. It also corrects complex optical imperfections called higher-order aberrations (HOAs) that cannot be corrected with regular eyeglass lenses.
Eyeglass lenses correct only simple refractive errors — nearsightedness, farsightedness and/or astigmatism. But most people also have HOAs that affect the quality of their vision.
By correcting HOAs as well as common refractive errors with wavefront technology, LASIK using iLASIK™ technologies often produces noticeably sharper vision than that possible with eyeglasses and contact lenses.1
Wavefront-guided LASIK creates a personalized map of the patient's visual pathway (from the front of the cornea to the back of the retina). These measurements are obtained with an instrument called a wavefront aberrometer during your iLASIK™ technology pre-op exam and consultation.
Wavefront-guided LASIK measures and treats lower-order aberrations (LOAs) such as nearsightedness, farsightedness and astigmatism as well as higher-order aberrations (HOAs), with the goal of providing better vision than that possible with eyeglasses, contact lenses or conventional LASIK.
Wavefront-guided LASIK produces a higher level of personalization compared with wavefront-optimized LASIK (see the next question below), which is based only on the eye's refractive error and corneal curvature.
Wavefront-optimized LASIK produces computerized laser treatment plans based on typical lower-order aberrations associated with specific refractive errors. In particular, wavefront-optimized LASIK attempts to minimize the effect of spherical aberration.
The goal of wavefront-optimized LASIK is to provide better visual outcomes than conventional LASIK — primarily by reducing the amount of spherical aberration caused by the laser reshaping process during LASIK.
The iLASIK™ procedure uses two sophisticated state-of-the-art medical lasers: an ultra-fast laser (femtosecond laser) that creates a thin flap to prepare the cornea for treatment, and an ultra-precise laser (excimer laser) that gently reshapes the cornea based on the digital information from a 100% personalized eye map.
A femtosecond laser is an ultra-fast medical laser that creates the thin flap to prepare the cornea for treatment. The femtosecond laser creates a pattern of pulses of laser energy at a specific depth within the cornea. At this point, corneal tissue is separated by a process called photodisruption. The creation of the iLASIK™ system flap with a femtosecond laser takes less than 20 seconds.
Most people with healthy eyes and mild to moderate refractive errors are excellent candidates for the iLASIK™ procedure. You may not qualify for the iLASIK™ procedure for a few reasons including – but not limited to:
- Autoimmune diseases (e.g., rheumatoid arthritis; lupus; multiple sclerosis)
- Diabetes
- If you are taking Accutane® (a prescription medication for acne)
- If you are taking Cordarone® (a prescription medication for irregular heartbeat)
- A history of Herpes simplex or Herpes zoster eye infections
- Signs of keratoconus or abnormal corneal topography
- Significant dry eye that is unresponsive to treatment
- Severe allergies
- If you are pregnant or nursing
- If you have thin corneas
Your eye doctor will discuss these and other possible contraindications at your pre-operative exam and consultation.
You should not have the iLASIK™ procedure if you are pregnant or nursing because these conditions may cause temporary and unpredictable changes in your cornea.
Dry eyes can affect the accuracy of pre-operative measurements that are crucial to achieving good vision after the iLASIK™ procedure. Also, dry eyes can affect how well and how quickly your eyes heal.
It depends on how thin your corneas are, how much refractive error you have, and other factors.
iLASIK™ procedure like all types of LASIK surgery, corrects vision by reshaping the cornea. In this process, a very small amount of tissue is removed from the central cornea.
During your iLASIK™ technology pre-operative exam and consultation, your eye doctor will take detailed measurements of the thickness and shape of your cornea and calculate how much laser treatment is required to fully and safely correct your vision.
If your corneas are too thin, you still might be a candidate for other types of vision correction surgery.
Most people are glasses-free after the iLASIK™ procedure. Still, some people who have minor refractive errors remaining after find that wearing eyeglasses part-time for tasks such as driving at night provides added clarity and comfort.
For glasses needed for near vision, please see the question about reading glasses.
No, the iLASIK™ procedure may not eliminate the need for reading glasses even if you have never worn them before. LASIK surgery will not prevent the normal aging change in the lens of the eye that causes blurry reading vision sometime after age 40 (presbyopia).
When most people start experiencing presbyopia, they simply purchase reading glasses and use them when needed to see small print. But there are options available if you have presbyopia and want to reduce or eliminate your need for reading glasses after the iLASIK™ procedure.
Ask your eye doctor about options for reducing your need for reading glasses during your iLASIK™ technology pre-operative exam and consultation.
Complications from the iLASIK™ procedure usually can be successfully managed medically or with follow-up care. The expected frequency and severity of complications vary, depending on how much nearsightedness, farsightedness and/or astigmatism you have prior to the procedure and other factors.1
LASIK has been proven safe and effective.2 The iLASIK™ procedure has the added advantages of being a blade-free, "100 percent laser" procedure that includes the latest wavefront-guided technology to help you achieve your personal best vision. However, there are risks and complications.*
*Detailed information can be found in the following text.
Before Your iLASIK™ Procedure
If you wear contact lenses, it is very important to stop wearing them 2–4 weeks before examination and treatment for the doctor to obtain an accurate eye measurement. Failure to do this might produce suboptimal surgical results.
Your eye doctor or iLASIK™ technology surgeon will give you specific advice about when to stop wearing your contact lenses at your iLASIK™ technology pre-operative eye exam and consultation.
Bring a list of all medications you take (including supplements and other non-prescription, "over-the-counter" products) to your iLASIK™ technology pre-op exam and discuss all allergies. Your eye doctor will advise you if you should discontinue any of these products prior to the iLASIK™ procedure.
During your iLASIK™ procedure pre-operative ("pre-op") exam, your doctor will perform a comprehensive eye exam to evaluate whether you are a good candidate for the iLASIK™ procedure.
An important component of this exam is a thorough review of your medical history. Bring a list of all medications (including supplements and over-the-counter products) to your exam so your eye doctor can advise you whether any of these products could pose a problem.
Additional testing called a wavefront eye map is performed during an iLASIK™ pre-op exam. This is a sophisticated evaluation of the optics of your eye that determines the type and amount of LOAs/HOAs present. HOAs are subtle, irregular optical imperfections that can affect the quality of your vision and cannot be corrected with eyeglasses but can be minimized with the iLASIK™ procedure to give you sharper vision.
Also, care will be taken to determine the exact amount of nearsightedness, farsightedness and astigmatism you have and to make sure your eyeglass prescription has not changed significantly within previous year.
Your cornea (the clear front surface of your eye) will be thoroughly examined to ensure it is healthy, has a normal shape and is thick enough for the iLASIK™ procedure.
Additional testing will be done to make sure you have a healthy tear layer on the surface of your eyes and that there are no signs of a dry eye condition that could affect your visual outcome and the healing of your eyes after the procedure.
The comprehensive eye exam includes dilation of your pupil to thoroughly evaluate the health of your eyes.
Perhaps the most important discussion to have with your eye doctor or LASIK surgeon during your pre-op exam and consultation concerns your expectations for your vision after the iLASIK™ procedure.
A recent review of LASIK satisfaction worldwide found more than 95 percent of LASIK patients are satisfied with the results of their procedure2. But it's important to have realistic expectations.
For example, iLASIK™ may not eliminate the need for reading glasses even if you have never worn them before. LASIK cannot stop your eyes from aging or eliminate your need for reading glasses if you are already over age 40 and are experiencing the normal age-related loss of near vision called presbyopia. Also, it's possible you might experience problems such as dry eyes or glare after any type of corneal refractive surgery, including the iLASIK™ procedure.
Your pupils will be dilated during your pre-operative exam. As a result, your vision will be blurry and you will be sensitive to light. It is important you bring a pair of sunglasses to this exam. You may also want to bring someone along to drive you home. Discuss this with your doctor.
Day of Your iLASIK™ Procedure
Bring a list of your medications with you to your pre-op exam, and your eye doctor can advise you about this at that time. If you have any concerns about this between your pre-op exam and the day of your procedure, call your iLASIK™ technology surgeon for advice.
Numbing eye drops will be applied to your eyes to keep them comfortable throughout the iLASIK™ procedure.
You will feel some pressure on your eye when the flap is created to prepare your cornea for treatment and the sensation usually lasts less than a minute.
When you return home, you may experience moderate pain and discomfort that could last up to 3 days. Your surgeon will advise you which medications to use if you are uncomfortable.
If you experience significant discomfort after your iLASIK™ procedure, call your surgeon for further instructions.
Please discuss this with your surgeon during the pre-op visit. If you feel nervous when you arrive for your iLASIK™ procedure, your surgeon may provide some medication to help you relax.
Yes, you will be awake during the iLASIK™ procedure.
Your eyelids will be gently held open with a small device (lid holder) during the procedure, and eye drops used during the procedure will reduce any urge you might have to blink.
You will be lying on a chair during the brief iLASIK™ procedure, and your head will rest on a contoured cushion. Your surgeon will be close by and may gently hold your head to help you stay perfectly steady when the laser is active, which lasts less than a minute.
The iLASIK™ procedure also includes an automated "eye tracker" feature that monitors the position of your eye and compensates for any small involuntary eye movements during the laser treatment delivering the treatment right where it is intended.
The entire iLASIK™ procedure (both eyes) usually takes about 20 minutes.
After Your iLASIK™ Procedure
It's normal for you to feel some moderate pain and discomfort for up to 3 days after your iLASIK™ procedure. In particular, some people report their eyes feel like an eyelash or something is "in" the eye.
As the cornea heals, you may experience some blurriness, tears may form and you will be sensitive to bright lights.
If you experience significant discomfort after your iLASIK™ procedure — particularly if it worsens over time — call your eye doctor for further instructions.
You must have someone drive you home after your iLASIK™ procedure because your vision will be blurry. Also, if you were given a mild sedative to help you relax, it's likely you will be a little drowsy.
You may resume driving only after receiving permission from your doctor.
The best thing to do when you return home from your iLASIK™ procedure is to take a nap or simply relax and let your eyes rest a while. Be sure to use eye drops as recommended by your doctor to keep your eyes moist, healthy and comfortable.
Be sure to check with your surgeon and follow your surgeon's directions.
Do not rub or bump your eyes. Wear sunglasses to shield your eyes from the sun's UV rays, reduce glare, and protect your eyes from trauma or drying out. Protective shields will be placed over your eyes to help you avoid rubbing, touching or bumping your eyes in the hours following your procedure.
Ask your LASIK surgeon about precautions.
You will be given clear plastic shields to tape to your brow and cheek to protect your eyes during sleep after the iLASIK™ procedure. You can see through these shields and they have ventilation holes, so they are not hot or uncomfortable.
Your doctor will advise you how long you should wear the shields before you leave the laser center on the day of your procedure and/or during your follow-up visits.
Some blurriness and fluctuation of vision is common during recovery. This should continue to diminish with time. It's not unusual for vision to take 2 months or longer to continue to improve and become more stable after the iLASIK™ procedure.
It's common for full healing to take three months or longer. Ask your LASIK surgeon about recovery time.
Generally, your first follow-up visit will be approximately 21 hours after your iLASIK™ procedure. Even if your vision seems clear, have someone drive you to this visit.
Your eye doctor or LASIK surgeon will examine your eyes and make sure they are healing properly. Your surgeon will let you know when it is safe for you to drive at your first follow-up visit.
Ask your LASIK surgeon when it is safe for you to resume swimming.
Ask your LASIK surgeon when it is safe for you to exercise.
Absolutely. Routine comprehensive eye exams are still needed after your iLASIK™ procedure to safeguard the health of your eyes.
General Questions About LASIK
When considering LASIK or other elective surgery, it's wise to learn as much as you can about the procedure and surgeons in your area.
The Internet is a great place to begin your research and locate LASIK doctors near you.
But when choosing a LASIK surgeon, online reviews should be only one factor among many that you consider.
Online reviews are available for virtually any product or service, and the variation in reviews is as varied as the personalities and experiences of the people who write them. Many LASIK surgery reviews posted online often don't provide an accurate representation of the overall satisfaction most patients have with their LASIK doctors.
When choosing a LASIK surgeon, there is no substitute for a face-to-face consultation and dialog. Many LASIK doctors offer free, no-obligation consultations so you can get to know them and decide if LASIK is right for you. Others offer free information meetings for groups of potential LASIK candidates.
Recommendations from friends you trust also can be very helpful.
Occasionally, complications occur even when your procedure is performed by a highly skilled and experienced LASIK surgeon using the latest technology.
Thankfully, most LASIK complications can be successfully managed by your LASIK surgeon or eye doctor. The first step if you are unsatisfied with your LASIK outcome or are experiencing bothersome symptoms is to return to your LASIK surgeon for a thorough evaluation and consultation. If your surgeon cannot resolve your problems to your satisfaction, seek a second opinion from another eye doctor who has experience managing LASIK complications.
Keep in mind that complications from LASIK usually can be successfully managed medically or with follow-up care. The expected frequency and severity of complications vary, depending on how much nearsightedness, farsightedness and/or astigmatism you have prior to the procedure and other factors.
Astigmatism, like nearsightedness and farsightedness, is a common vision problem (called a refractive error) that usually can be fully corrected with LASIK surgery.
Astigmatism causes the rays of light entering through different parts of the eye to focus unequally so that they do not ever form a single spot. Some rays may focus on the retina, but other rays focus in front of or behind the retina. Things look blurry because images are not ever focused clearly on the retina.
Lasers approved by the Food and Drug Administration (FDA) for LASIK performed in the United States can correct astigmatism.
The maximum amount of astigmatism LASIK can correct depends on many factors, including the type and magnitude of your astigmatism and the health and thickness of your cornea.
If some astigmatism remains after a LASIK procedure, it often can be fully corrected with a follow-up care. Your eye doctor can provide more details about this at your LASIK consultation.
Your LASIK surgeon will discuss astigmatism and how it may affect your LASIK surgery during your LASIK consultation.
Blurry vision is common immediately after LASIK and should be expected during the early stages of your LASIK recovery.
You will have a number of follow-up visits after your LASIK surgery. Your eye doctor will examine your eyes and monitor your vision at these visits. Some blurriness and fluctuation of vision is not unusual as your eyes recover after LASIK and it may take up to a few months for this to resolve completely.
If you feel your vision is too blurry for safe driving or other activities during your LASIK recovery, ask your eye doctor if a temporary pair of prescription eyeglasses is a good idea.
Ask your LASIK surgeon about his or her experience dealing with issues related to blurriness.
During the early stages of your LASIK recovery, it's important to avoid swimming and other water-related activities that could increase the risk of contaminated water getting in your eyes and causing an infection.
Different LASIK surgeons may have different recommendations about when you can resume swimming and other water activities during your LASIK recovery.
Ask your LASIK surgeon when it is safe for you to resume swimming and other activities during your post-op exams.
The most important thing you can do to facilitate the LASIK recovery is to closely follow the post-op instructions given to you by your LASIK surgeon. Use all medications as directed for the time specified, even if you have no vision problems or discomfort symptoms.
Your eyes may feel dry after LASIK. Your surgeon may recommend sterile, non-preserved artificial tears very frequently in the early stages of your LASIK recovery to keep your eyes moist and comfortable and help the healing process.
Avoid rubbing your eyes or exposing your eyes to dust, wind and cigarette smoke. Wear comfortable wrap-style sunglasses outdoors to shield your eyes from dust, wind and UV rays. Also, wear protective safety glasses or sports goggles when performing any activities that could increase your risk of eye injuries.
Finally, if you have any unusual eye or vision symptoms during your LASIK recovery, call your eye doctor immediately for advice.
The benefits of LASIK surgery are clear, functional vision that may eliminate or reduce dependence on eyeglasses or contact lenses.
But like any medical or surgical procedure, LASIK has associated risks and potential complications. Here are some LASIK complications cited by the U.S. Food and Drug Administration1, which oversees the safety of LASIK in the United States:
Some patients experience reduced visual acuity. Some LASIK patients lose the ability to see some of the small letters near the bottom of an eye chart after LASIK surgery, even with the help of glasses or contact lenses.
- Some patients develop debilitating visual symptoms. Some LASIK patients experience glare, halos, and/or ghost images that can seriously affect vision.
- Some patients do not see as well in situations of low contrast, such as at night or in fog, after LASIK, compared with their vision with glasses or contact lenses before LASIK.
- Some people are under-treated or over-treated. Most LASIK patients can see 20/20 without glasses or contacts after surgery, but some may require an additional care due to an under-correction or over-correction of their vision.
- Some people develop severe dry eye syndrome. Some LASIK patients are unable to produce enough tears to keep their eyes moist and comfortable after surgery. Dry eyes are uncomfortable, can cause redness, and can cause intermittent blurry vision and other symptoms. These symptoms can be permanent, even with frequent use of artificial tears and other dry eye treatments.
- For some farsighted patients, results may diminish with age. The level of improved vision after LASIK surgery may decrease with age.
- Long-term data are not available. The safety and effectiveness of LASIK surgery over the long-term is not known.
Before deciding whether to have vision correction surgery, you should carefully weigh the risks and benefits of LASIK to decide if the procedure is right for you. Your LASIK surgeon can give you more specific information about your particular risks during your LASIK consultation.
As with any medical procedure, risks and potential complications may occur. Please consult your eye care specialist for detailed information and to discuss these possible risks and complications with you prior to the procedure.
References:
- U.S. Food and Drug Administration (FDA). What are the risks and how can I find the right doctor for me? FDA website: https://www.fda.gov/medical-devices/lasik/what-are-risks-and-how-can-i-find-right-doctor-me. Last updated June 9, 2014. Accessed August 6, 2015. RED2021OTH4551
- Sandoval HP, et al. Modern Laser in Situ Keratomileusis Outcomes. J Refract Surg. 2016;42:1224-1234. REF2016RF0112.
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