LASIK surgery allows an individual to have corrected vision without using contact lenses and eyeglasses. It reshapes the cornea to fix refractive errors that causes blurry or distorted vision. Unlike most surgeries, LASIK surgery is an outpatient surgery that only takes less than an hour to complete.
LASIK surgery does not necessarily require anesthesia. Unlike other surgical procedures, surgeons may choose to use local or topical anesthesia rather than general anesthesia when performing LASIK surgery. Local anesthesia allows the patient to be fully conscious but not feel any pain during the operation.
Local vs General Anesthesia
Laser-Assisted In Situ Keratomileusis or LASIK surgery is a surgical procedure performed to treat refractive errors in the eyes such as astigmatism, nearsightedness, and farsightedness. This procedure takes only around 30 minutes with only slight discomfort. Each eye will only take a maximum of 15 minutes to create an opening on the corneal flap and reshape the cornea to address refractive errors.
While general anesthesia is often used for surgical procedures, Surgeons do not require general anesthesia for patients undergoing outpatient and minimally-invasive procedures such as LASIK. General anesthesia will induce sleep in the patient to allow the surgeons to focus on the meticulous details of the operation. Usually, operations that require general anesthesia last for several hours.
LASIK, however, requires patients to be fully awake during the operation. Surgeons only use low-dose sedatives like Valium to keep the patient calm throughout the operation. Local anesthesia like numbing eye drops is also put in the patient’s eyes to numb any discomfort and reduce the urge to blink during the procedure.
Local anesthesia is a safer and more practical choice of anesthesia for LASIK surgery because it has a lesser risk for complication and also does not incur unnecessary costs for the patient. The use of general anesthesia requires the presence of an anesthesiologist to ensure the proper dosage of anesthesia for a particular surgical procedure and to monitor the patient’s vital signs during the operation.
The use of general anesthesia also has a longer preparation time and recovery period alongside a greater number of risks on the body; One of the associated risks of general anesthesia is greater toxicity levels for the lungs, brain, and heart. Leading to symptoms like vomiting, agitation, nausea, and confusion. Higher levels of toxins in the body can also cause respiratory depression and other genetically linked complications.
Thus, general anesthesia does not provide a great number of benefits when compared with local anesthesia. It also increases the cost of the operation beyond what is required and necessary.
Are You Awake During LASIK?
There is a common misconception about the LASIK surgical procedure. Many patients have fears of undergoing LASIK since it involves slicing through the cornea surface using a laser or blade. However, the patient is only required to look at and focus at a red light during the entire procedure.
LASIK surgery involves three main steps. First, the surgeon will create a flap on the corneal surface using a femtosecond laser to expose the cornea for readjustment. Second, the excimer laser will reshape the cornea to correct the refractive errors and fix vision. Lastly, the corneal flap will be folded in place and allowed to heal without stitches.
This procedure has less than a 1% chance of complication and is considered to have a high success rate. It has minimal risks of complication and a low chance of exhibiting side effects.
Given the simplicity of this procedure, surgeons choose not to administer general anesthesia to their patients. It is also painless and only induces slight discomfort.
Another reason why surgeons only apply local anesthesia during LASIK rather than general anesthesia is that they need patients to be fully awake and conscious during the operation. Patients should be able to follow directives from the surgeon through constant communication. This will help the surgeon achieve an optimal outcome.
Keeping the Eyes Steady During LASIK
Another common fear about not having general anesthesia and thus being awake during LASIK surgery is the potential inability to keep the eyes open during the entire procedure; Keeping the eyes steady is crucial to avoid complications during LASIK surgery.
Painkillers and nerve stabilizers ensure that the patient remains calm and will not experience any pain, except for a slight discomfort, as well as reduce the urge to blink during the operation. A lid speculum also keeps the eyes open and prevents the patient from blinking.
Surgeons also have specialized equipment to monitor eye movement throughout the procedure. The surgeon performs the LASIK surgery in an examination room with a specialized reclining chair and a laser system. A large machine with a microscope attached to a computer provides an accurate visualization of the eye for the surgeon. Afterward, a mechanical microkeratome or a blade device is used to cut a flap on the cornea and the laser device will reshape the cornea.
The laser used in LASIK surgery is capable of monitoring eye movement up to 4000 times per second. An inability for the patient to focus on the reference point will immediately stop the laser. It will only resume the operation once the patient’s eye is in the proper place.
LASIK surgery requires the patient’s participation and cooperation with the surgeon during the operation. By following instructions and directives, the patient helps the surgeon make the most accurate adjustments on the cornea. Local anesthesia helps in this interaction between the patient and the surgeon while also numbing any pain or discomfort they might experience.