What you can expect with your recovery after vision correction surgery. A 3 part series.
Recovery time after vision correction surgery varies based on the procedure, but in general, return of full vision is very quick. With LASIK surgery your vision will be improved almost immediately after surgery, but is still hazy for the first four to six hours, as the swelling of the flap and the dryness of the surface cells dissipate. After this, vision is typically quite good, and most patients are able to drive themselves back to the doctor’s office for the post-operative visit and return to work the next day. In terms of discomfort, the eye may feel a little irritated; a feeling like something is in the eye for the first four to six hours after the procedure.
Healing is fairly quick, but there are many precautions that must be followed.
In terms of healing of the cornea, the flap sticks back onto the cornea within sixty seconds. Thus, blinking will not move the flap. This occurs because of the negative stromal swelling pressure of the cornea, which means that the cells on the inside of the cornea (endothelium) pump water from the outside of the cornea to the inside of the eye, which is the mechanism by which the cornea remains clear. This pump sticks the flap back on the underlying corneal stroma much like putting your hand over the opening of a vacuum cleaner hose while it is turned on. The epithelial incision at the edge of the flap heals within the first three to four hours. Attachments between the cornea and flap (stromal healing) start within the first few weeks and are maximized within six to twelve months. During this period of healing, we advise patients not to rub or put direct pressure on their eyes for the first six months after surgery, with the first two to four weeks being the most critical time period. If pressure is put on the flap that dislocates or wrinkles it, irrigating under the flap and smoothing it easily fixes this.
Enhancements are always an option for the future.
While quite strong, the interface between the flap and the underlying cornea technically never fully heals after LASIK, which allows us to dissect and relift the flap even years later in order to do an enhancement. Because of this healing pattern, we recommend PRK (flapless LASIK) instead of LASIK for patients who are likely to receive direct blows to the eye (such as professional martial artists or boxers). I performed PRK instead of LASIK on Sebastian “Bas” Rutten, the 2000 Ultimate Fighting Champion (UFC) a few years back for this reason.
Many precautions are recommended to ensure a safe recovery.
Based on healing patterns, the following precautions are recommended for patients after LASIK: No dusty environments nor sweat in the eye for forty-eight hours, and no swimming, hot tubs, nor opening of eyes in the shower for one week after surgery—to prevent infection. No makeup for three days after surgery, and plastic shields must be worn while sleeping for one week after surgery (four weeks if a stomach or side-sleeper) to prevent dislocation of the flap. When removing makeup, the upper and lower lid must be raised away from the eye and pressure put on the underlying orbital bone rather than the eyeball. (As a side note, many people ask me if jumping, running, or flying on an airplane will dislocate the flap. They will not, and are okay immediately after LASIK, providing that no perspiration gets in the eye for forty-eight hours.)
In Part 2 of Recovery After Vision Surgery, we discuss PRK surgery recovery.