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About Laser Refractive Surgery

Common refractive errors of the eye, such as myopia, hyperopia, and astigmatism, can be corrected through a variety of mechanisms. Laser refractive surgery is an increasingly popular method of correcting refractive errors because it does not change your appearance (as eyeglasses do), does not require consistent maintenance (as contact lenses do), and its results are long-term and often permanent.

You may have heard of refractive surgery by its commonly-advertised version, LASIK. While LASIK is certainly the most popular version of laser refractive surgery performed today, it is one of several variations of the procedure.

Types of Laser Refractive Surgery

Laser refractive surgery is generally a painless procedure, though mild postoperative discomfort is expected for a week or two post-surgery. The use of local anesthetics ensures a pain-free experience.

There are many types of laser refractive surgery. The three most common are briefly explained  below:


  • LASIK Laser-Assisted In Situ Keratomileusis – The most common laser refractive surgery performed today. During the LASIK procedure, a small circular “flap” is cut into the corneal tissue using a microkeratome or femtosecond laser. This flap is then pulled back, exposing the underlying corneal cells (called the stroma). The laser then removes corneal tissue (on a microscopic level) in order to reshape the cornea and correct the refractive error. 
  • PRK Photorefractive Keratectomy – This surgery is similar to LASIK with the notable difference that no flap is cut in the cornea. The laser is used directly on the surface of the cornea.
  • LASEK Laser Assisted Epithelial Keratomileusis – This is a close relative of PRK. A epithelial flap is created, with epithelial cells being loosened via an alcohol solution.


What to Expect from Laser Surgery

Laser refractive surgery is relatively non-invasive in comparison to other surgical procedures. In most cases, you are in and out in just a few hours. Note that you will need a safe way to get home, such as a ride from a family member/friend or a cab. You will not be able to drive.


Before the surgery, we will perform a comprehensive eye exam5 to gauge the current state of your ocular health as well as to take detailed measurements of the eye. This consultation informs surgery and is required before any surgical referral can be provided.

If you wear contact lenses, approximately two weeks before the procedure you will need to stop wearing them and use corrective eyeglasses in their place. Contact lenses can modify the shape of your cornea, which can have adverse impacts on the surgery.

The Surgery Itself

Note that this speaks primarily to LASIK. We will provide appropriate expectations if you are receiving PRK, LASEK, or otherwise.

The surgery itself only takes a couple of hours from start to finish, with the vast majority of that time being observation and prep. The actual procedure takes approximately 10 minutes per eye, of which the laser is active for only 5 – 60 seconds.

First, numbing eye drops are applied liberally to your eye to stave off discomfort and pain. Once it has taken effect, your eye will be held open using a lid speculum. It sounds much more uncomfortable than it is.

The surgeon will mark on your cornea where the corneal flap is to be cut, and then a suction ring is applied to prevent eye movements and to ensure accuracy and quality of the flap. The flap is then created. Again, this sounds much more uncomfortable than it is.

When ready, the surgeon will ask you to focus on a singular point (usually a light or highly visible reference object). This is not the laser, but rather it is done to ensure your eyes remain steady when the laser is activated.

When the laser is activated, you will hear some clicking/whirring noises (perhaps others as well, as each operating room is different). These are normal sounds. You may also feel some pressure on your eye; this is a normal sensation.

Once the first eye is completed, the second eye is then operated on.

The entire process should take between 10 and 20 minutes for both eyes.


You will feel temporary discomfort from the procedure. This can include a gritty, itchy, burning sensation; watery eyes; blurry vision; eye fatigue. These symptoms will largely abate within 48 hours of the procedure.

You will be asked to take a few days off of work and sports (all sports, not just contact sports). This will let your eye stabilize. Your vision will continue to improve during this period.

Avoid steam rooms, hot tubs, saunas, etc. for at least a month post surgery. Avoid strenuous exercise for at least a week. These activities may dislodge the flap, requiring a revisit to the surgeon.