Co-management for LASIK & Cataract Surgery

Co-management for LASIK & Cataract Surgery

eye exam

LASIK (laser-assisted in situ keratomileusis), is the most popular refractive surgical procedure. In this procedure, a laser is used to permanently change the shape of the cornea (the clear covering on the front of the eye) to correct common vision problems such as nearsightedness, farsightedness, astigmatism, and presbyopia. This improves vision and reduces a person's need for glasses or contact lenses.

LASIK uses an excimer laser (an ultraviolet laser) to remove a thin layer of corneal tissue, giving the cornea a new shape, so that light rays are focused clearly on the retina.

In the case of a nearsighted person, the goal of LASIK is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more normal shape.

LASIK is an outpatient surgical procedure with no need to stay at the surgery center overnight as it will take 10 to 15 minutes to perform for each eye.

The procedure is done while the patient is awake, but the patient may request mild sedation. The only anesthetic used is eye drops that numb the surface of the eye. LASIK can be done on one or both eyes during the same session.


How to Prepare for LASIK Eye Surgery?

Before LASIK eye surgery, the eye surgeon will evaluate the patient’s medical history and perform a full eye examination, including measuring corneal thickness, refraction, corneal mapping, eye pressure, and pupil dilation. Afterward, the surgeon will discuss what to expect during and after the procedure.

On the day of the surgery, eat a light meal before going to the doctor and take all prescribed medications, if any. Do not wear eye makeup, creams, perfumes or lotions on the day before and the day of surgery, or have any bulky hair accessories that will interfere with positioning head under the laser.

Contact lenses shouldn't be worn for at least three days prior to the evaluation. In the case of, rigid gas permeable contact lenses, they should not be worn for at least three weeks before. Patients should arrange for a ride home from the place of surgery, as their vision might be blurry.

  • External Exam – This is an evaluation of the whites of your eyes, the iris, pupil, eyelids, and eyelashes.

  • Internal Exam – This is an evaluation of the retina and optic nerve while your eyes are dilated.

  • Visual Function and Eye Health – This includes testing depth perception, color vision, peripheral vision and response of the pupils to light, as well as an evaluation of eye focusing, eye teaming and eye movement abilities.

  • Glaucoma Testing – This is a test of fluid pressure within your eyes to check for the possibility of glaucoma.

  • Visual Acuity – Your doctor will test your vision with different lenses to determine if glasses or contact lenses can improve your vision.

Comprehensive eye exams look at your total health history.
Even though you visit a separate office for your eye health, that doesn’t mean your eyes shouldn’t be treated holistically. Your eye doctor will discuss your overall health and that of your immediate family, any medications you’re taking and whether you have high blood pressure or diabetes. They’ll also want to know if you smoke and how much sun exposure you get. All these factors help the eye doctor properly assess your eye health.

Hopefully, this article has given you the incentive to get a comprehensive eye exam -- even if you recently had a positive vision screening. The American Optometric Association recommends an eye exam every two years if you aren’t having any problems and you’re aged 18-60 and after 61, be sure to get an exam each year.

Although you’re probably not looking forward to cataract surgery, keep in mind that modern cataract surgery is one of the safest and most effective surgeries performed today. There are over three million cataract surgeries in the United States every year and the vast majority have excellent outcomes which greatly improve quality of life. Being prepared for your upcoming surgery by knowing what to ask your eye doctor and understanding your options will ease your mind and be sure you’re ready for recovery.

Once you find the right doctor, you’ll have a consultation before proceeding. You'll undergo a comprehensive eye exam and a preoperative exam to determine the level of correction needed and confirm you're healthy enough for surgery.


Your doctor will also need to take measurements of your eyes before the procedure. This will determine the curvature of your cornea and the length of your eye. They need this information to choose the right size and power of the intraocular lens (IOL). This artificial lens will replace the cloudy lens inside your eye.

There are a variety of IOLs with different features available. Before surgery, you and your eye surgeon will discuss which type might work best for you and your lifestyle but bear in mind that insurance companies may not pay for all types of lenses. Some of the types of lenses available include:

  • Fixed-focus monofocal – This has a single focus strength for distance vision. You’ll likely still need reading glasses.

  • Accommodating-focus monofocal – These are designed to provide a greater range of paragraph vision after cataract surgery than conventional monofocal IOLs.

  • Multifocal – Like glasses with bifocal or progressive lenses, they allow near, medium and far vision.

  • Astigmatism correction (toric) – If you have significant astigmatism, this type of lens can help correct your vision.

Get Ready for Surgery

Just before surgery, your eye doctor will have some instructions, including:

  • Stopping any medications that could increase your risk of bleeding during the procedure or interfere with cataract surgery

  • Using antibiotic eye drops one or two days before the surgery

Be Ready for Recovery

As you prepare for your upcoming procedure, keep the following in mind for your recovery period.

  • Get a driver – Make sure you have a reliable companion who can drive you to and from your appointment. Uncomplicated cataract surgery usually lasts 15-20 minutes.

  • However, you’ll probably be at the hospital for about 90 minutes. They need to prepare you for surgery and provide instructions about your cataract surgery recovery before you leave.

  • Have a Day-of-Surgery Caregiver – Some surgery centers require that someone be with you for at least one day if you received anesthesia, so be sure to ask and arrange coverage.

  • Ongoing Helper – You should also arrange for a friend or family member to help around the house or drive you for at least the first week. You won’t be able to do any strenuous activity and heavy lifting (nothing over 25 pounds) and you shouldn’t bend, exercise or perform any other similar activity that might stress your eye.

  • Medical Assistance – If you anticipate any difficulty giving yourself medicated eye drops, find someone who can administer them for you several times each day for a few weeks after surgery.

  • Stay Inside – Plan to stay indoors as much as possible, but you’ll receive a special pair of sunglasses for when you go outside.

  • With a better understanding of what to expect before cataract surgery, you can reduce any anxiety and form a plan for a successful procedure. Soon, you’ll be seeing your world more clearly – and be happy you decided to do it!

  • Fasting 12 hours before the procedure

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