Refractive surgery step-by-step

You may find it helpful to know more about the "typical" routine our patients experience when they have refractive surgery. Of course, you will see some variation depending on the type of surgery, but these guidelines should give you a good picture of the process and what to expect.

Screening appointment
This preoperative evaluation is extremely important, and at the Kellogg Eye Center it will take approximately two hours. Because we feel strongly about continuity of care, the physician you meet during this examination will also perform the surgery and see you at all follow-up visits. As you complete your screening appointment, your physician will review the test results, explain the surgery in detail, and finally, discuss results and risks associated with the procedure. Findings from these tests will determine whether you are a good candidate for refractive surgery and may indicate that one procedure is more appropriate than another.

We ask that you do not wear soft contact lenses for one week and hard or rigid gas permeable lenses for three weeks prior to evaluation. We encourage you to bring a list of questions to this appointment.

Screening tests include the following:

• A dilated eye examination
• Visual acuity (best-corrected as well as uncorrected)
• Corneal topography (to map the shape of your cornea)
• Orbscan II (to detect corneal irregularity early)
• Intraocular pressure (to check for glaucoma)
• Slit-lamp examination (to examine the front of your eye for disease)
• Pachymetry (to measure corneal thickness)
• Pupillometry (to measure the size of your pupil)
• Schirmer test (to measure dryness of the eyes)
• Fundus examination (to examine the optic nerve, retina, and back of the eye for disease)
• Ocular motility (to evaluate the eye muscles and their alignment)
• Aberrometry (to create a map of optical abnormalities)

Preparing for surgery

• Do not wear soft contacts for one week before surgery and hard or rigid gas permeable lenses for three weeks before surgery.
• Do not wear make-up, including mascara, for one week prior to surgery.
• Fill the prescriptions for eye drops that you were given at your screening examination and bring the bottles with you on the day of surgery.
• Plan to spend approximately one hour at the Refractive Surgery Clinic.
• Bring someone with you to drive you home.
• Wash your face with soap and water before you arrive.
• You may eat a light snack prior to surgery.
• Avoid alcohol and medications that produce drowsiness.

Day of surgery
First you will meet with your surgeon, who will review everything that is going to happen during your surgery. You will be fully awake during the procedure, but you will be given a mild sedative to help you relax. Next the surgeon or assistant will administer antibiotic eye drops as well as anesthetic drops to numb your eyes. When you are ready, the procedure will begin. Typically, refractive surgery takes 10 to 15 minutes per eye. Most people say they feel a slight amount of pressure during the procedure, but no pain. When your surgeon feels that the flaps (if any) are adhering properly, you will leave the treatment room and walk back to the clinic for a brief examination. Your surgeon will place an eye shield over each eye.

Evening after surgery
Many patients feel as if there is something in their eye, although most do not feel much discomfort. If your ophthalmologist anticipates that you will be in pain, s/he will have prescribed pain medication. We recommend that patients spend a quiet evening at home.

Day after surgery
You will have an appointment with your surgeon to check your vision and the healing process. When your eye shields come off you will be able to see how your vision is beginning to improve. Most patients notice an immediate and significant difference. Typically, people return to their normal activities within one to three days.

Follow-up care
You will see your doctor one week after surgery, and again in one month, three months, six months, and one year. Should you have questions or concerns during this time, please call the Refractive Surgery Clinic at 734.615.6914 or email us at lasik@umich.edu.