Surgery of any kind can be a source of anxiety for the patient and Lasik eye surgery is no different. Having a good idea of what to expect is an important step in overcoming your fear and remaining relaxed during the procedure. As a surgeon, I am constantly telling my patients the particulars of the procedure so that they will have no surprises during their Lasik. And it has been substantially useful to me that I myself have undergone Lasik so that I can relate to them exactly what they will experience from the patients perspective rather than just from the view of the surgeon.
First of all, it is normal to feel a bit excited and even nervous as the time approaches to have the surgery. Even as an experienced Lasik surgeon, I found myself becoming nervous as I waited in the prep area before surgery. In our Lasik center, we ask patients to arrive 30 to 45 minutes early in order to receive a number of medications before the procedure. One is an antibiotic eye drop and the other is a topical anesthetic drop. I recall the anesthetic drop stinging a bit initially and causing my eyes to water up. I received a couple of sets of these drops while I waited and I was happy to see that the additional sets of eye drops did not sting at all. That's usually what our staff tells patients to expect. The initial drop stains but since it also numbs the eye, the second drop will not sting at all. That just means that the drops are doing their job properly.
Also, while in the prep area, we give patients a pill (Valium) to help them relax further. As I said earlier, it is normal to feel nervous prior to any kind of surgical procedure and I was certainly no exception. The pill helps to take the edge off your nervousness and makes you less fidgety. I've had a number of people trying to shrug it off and avoid taking the Valium, but I believe that they do. Some people see it as an option and that taking it is a sign of weakness or that they are not tough enough. Actually, the pills make the procedure go much more smoothly for the surgeon as well as the patient. They actually decrease the hypersensitive reactions and subconscious, automatic eye movements that a person has. So with the Valium, a patient's hyper tension to blink or squeeze their eyes shut in reaction to the eye lid holders or to the microscope lights is significantly reduced which makes access to the cornea easier for the surgeon and makes for a smoother procedure. Also the Valium helps to suppress the normal involuntary movements of your eye and can make for an easy treatment by helping you stay locked on target.
From the prep area, I was taken to the laser room itself. Here the surgeon usually makes a number of marks on your cornea with a sterile felt tip pen. Again, because of the eye drops, you can not really feel any of it. Then you lie down on the surgical table and are looking up into the microscope lights. In our system, you'd be looking up into a circular ring shaped white light and in the middle of the circle of light there is a blinking red lighted dot. The blinking red light is the fixation light that you will need to look at during the treatment. One of the staff will typically take this time to use a sterilizing solution to clean the area around your eyes. That's done to reduce the amount of bacteria and lower the incidence of infections.
At this point, the surgeon is ready to create the Lasik flap on your cornea. So you will feel him hold your eyelids open and place a suction ring over the front of your eye. There is a little pressure associated with the suction ring but usually no pain. The one exception is that if you have a small, tight eye socket or a constant eye brow bone, you may feel some pain if the ring is pressing up against the bone. Obviously, the surgeon will work hard to avoid any unnecessary pain but depending on your bone anatomy, it may be impossible to avoid any contact in that area.
Once the suction ring is in place, everything goes dark in that eye. I actually remember seeing just sparkles and not complete blackness. But you should not be able to see the lights or anything else clearly at all. That is actually a good sign and means that the suction ring is properly attached to your eye. I use the blade-free Intralase technology, so the next step is to attach the Laser mechanism to the suction ring and activate it. At that point, it requires about 20 seconds to create a complete Lasik flap. Afterward, the suction ring is removed and your vision returns although it usually seems somewhat fuzzy. That's normal so you should not worry about it. The Intralase creates bubbles when it does its work so your vision should seem fogged. I usually proceed to create the second Lasik flap on your other eye at that point so you will experience the exact same things on the other side. Now we usually take about a 2 minute break. That waiting time allows most of the bubbles to absorb so that the view will be clear during the treatment phase of the Lasik.