So, How Exactly Does LASIK Work? (2021 Update)


If you’re tired of wearing eyeglasses or contact lenses, you may be wondering if LASIK surgery is right for you. Whether a friend has had the surgery with successful results or you’ve read about the procedure in magazines or online, LASIK surgery seems to have a good reputation and lasting results. Although LASIK works well for many candidates, it’s not the most suitable vision correction option for everyone. If you’re curious about the intricacies of LASIK surgery, the side effects, and risks, here’s what you need to know:

LASIK: The Procedure

During LASIK eye surgery, an instrument called a microkeratome or femtosecond laser is used to create a thin flap in the cornea. Once the flap is created, the cornea is peeled back and the underlying corneal tissue is reshaped using a laser. Once the cornea is reshaped and can properly focus light onto the retina, the cornea flap is put back in place and the surgery is complete. LASIK surgery is performed while patients are under local anesthesia, in the form of eye drops. Typically, the procedure takes about ten minutes to complete. In some cases, overly anxious patients may request a mild sedative.

Advantages and Disadvantages of LASIK Surgery

Generally, LASIK eye surgery is a safe and effective procedure. 96 percent of patients will successfully have their desired vision back after LASIK surgery, and adjustments can be made years down the line as vision continues to change with age. Due to the numbing drops and efficiency of the procedure, there is very little pain and no bandages or stitches are required. In most cases, patients have a dramatic reduction in eyeglasses and contact lens dependence. In fact, many patients will no longer need them at all.

Despite the advantages, LASIK surgery comes with its own set of risks. For one, changes to the cornea cannot be reversed. In some cases, problems can occur when the doctor creates the flap, which can permanently affect vision. Some patients experienced discomfort the first 48 hours after the surgery. Though rare, other side effects may include glare, seeing halos, difficulty driving at night, fluctuating vision, and dry eyes.

Am I a Good Candidate for LASIK?

LASIK surgery is most appropriate for those with a moderate degree of nearsightedness, farsightedness, or astigmatism. As with any other medical procedure, the outcome depends on a careful evaluation of your eyes by a professional prior to the surgery. If you suffer from severe nearsightedness, have fairly good vision, have large pupils, actively participate in contact sports, or work in a job that requires vision precision, you may want to reconsider having LASIK surgery. Additionally, many insurance plans don’t cover the costs of LASIK surgery; if cost may be an issue, you should consider other types of vision correction.

Are There Other Options Besides LASIK?

Despite being the most popular laser eyesight corrective surgery over the last decade, other contenders are available in 2021. Two other popular options are Photorefractive Keratectomy (PRK) and boasting with the latest technology is a procedure called Small Incision Lenticule Extraction (SMILE). According to a 2020 Journal of Cataract and Refractive Surgery study comparing 1-year outcomes of LASIK, PRK, and SMILE at a U.S. military refractive surgery center, all three procedures achieved excellent visual results in terms of safety, predictability, stability, and efficacy. 

Studies have shown that both SMILE and LASIK are as effective and safe in treating myopia and myopic astigmatism. SMILE is becoming increasingly popular because it has a combined advantage of both LASIK and PRK: SMILE only requires a small incision without a flap and has a quick recovery time similar to LASIK with the additional benefit of no restrictions post-operation.

Compared to LASIK, SMILE only requires one laser to create a thin contact-lens-shaped layer underneath the cornea’s surface within 30 seconds. Following that, this layer is extracted via a small 2mm or 3mm opening for the surrounding tissues to heal together. People who have gone through this procedure have remarked how comfortable and how the surgery alleviates concerns about any potential risk of flap complications. Similar to LASIK, most patients experience a sensation that they have something in their eye and tearing and burning for several hours after the procedure.

SMILE laser vision correction is a viable alternative to LASIK with some distinct advantages. 

Since SMILE does not require any postoperative restrictions, many patients can go back to wearing makeup or working the following day as visual recovery is pretty rapid. Most patients obtain 20/20 vision after only one or two days of the procedure compared to at least a week of downtime to rest with LASIK. One main reason patients do not opt for SMILE is that prescriptions such as farsightedness cannot be treated. Further, the most common risks of SMILE are over, or under-correction of the prescription, dry eye, or more rarely, visual distortions such as halos.