LASIK basics: What to know about this common vision correction procedure

This story first appeared in Healthy You - April 2025, The Gazette’s quarterly health publication.

Marion resident Jon Fitch had worn glasses and contacts for nearsightedness since he was a teenager. He hated wearing glasses, and with his astigmatism, contacts were expensive.

When he was in his early 30s, Fitch decided he wanted to get LASIK (laser-assisted in situ keratomileusis) surgery. This vision correction procedure involves reshaping the eye’s cornea — the dome-shaped clear tissue at the front of the eye — to lessen or eliminate a person’s dependence on glasses and contacts.

After being pre-screened as a good candidate for the surgery, Fitch got the procedure done at Iowa Eye Care in Robins. He kept patches on his eyes that night, but when he took them off the next morning, he realized that he now had 20/15 vision.

“I looked outside and I could see clearly forever, miles,” Fitch said.

Who can get LASIK?

Ideal candidates are people in their 20s and 30s who currently need glasses or contacts to correct their vision. They could be nearsighted, farsighted or have an astigmatism, up to certain measurements (for example, up to a -11 prescription for nearsightedness).

Waiting until your 20s is best because this is the age when most people’s prescriptions become stable. As we age, the lens inside the eye changes — in our 40s, we start needing reading vision assistance; in our 60s, cataracts grow. So the earlier the procedure is done, the more years of perfect vision a patient can enjoy.

Dr. Brian Privett, a comprehensive ophthalmologist who performs LASIK procedures at Iowa Eye Center in Cedar Rapids, said that people in their 40s and 50s can still get LASIK, even though they might still need reading glasses.

“That -4 or -5 patient who always wears glasses will still enjoy not needing glasses for distance,” Privett said. “But we make sure we’re up front with everyone that it won’t be quite as magical as if they were 25 years old.”

Pre-screening patients

Privett says that over the last 30 years of LASIK being available, doctors have been able to see who benefits the most and who might be at higher risk of complications afterward.

Before a patient is approved for LASIK surgery, they must undergo a comprehensive screening exam at their eye doctor’s office.

Since the success of the procedure hinges on the cornea being able to maintain its shape afterward, the cornea is examined for its shape, thickness, and any abnormalities or diseases. Your eye doctor will also look for any eye infections; high eye pressure; the strength of your prescription; and if you have a history of extreme dry eyes or developing keloids. Pregnant or nursing patients also cannot have LASIK done because these conditions can affect vision.

Privett says around 5 percent of people are found to be not good candidates for LASIK surgery during the screening appointment.

A computerized wavefront scan to map the patient’s eyes is also done during this appointment. This scan will help guide the laser during surgery so that the treatment exactly matches your eye.

Cost of LASIK

While some patients may receive a discount through their VSP or other vision insurance, most insurance companies consider it an elective surgery, so it is often not covered. The cost can vary from $1,500 to $5,000 per eye, depending on where you live and the strength of your prescription.

The LASIK procedure

LASIK is a quick procedure, with patients usually back in their cars within 30 minutes. Both eyes can be treated the same day, and the surgery takes place at the doctor’s office.

Patients are given medicine before the procedure to help them relax if desired. They then lie down with a neck pillow and numbing drops are placed in their eye(s). The surgeon places a small suction ring on the eye while a laser cuts a small, hinged flap on the front of the eye that allows them to reach the part of the cornea to be reshaped. This is quick, only about 30 seconds, and patients might feel a slight pressure on their eye.

A lid speculum is then placed to hold the eyelid open, although the numbing drops also alleviate the need to blink. While patients are often concerned about eye movements during surgery, the machine has tracking technology that adjusts for small eye movements and stops if your eye moves out of range. Patients also look at a target light on the machine during the procedure to help them focus.

As the laser makes corrections to the cornea, you won’t feel anything in your eye but might notice an odor like that of burning hair while this is taking place.

After reshaping the cornea, the surgeon lays the flap back into place and puts antibiotic drops in your eyes. The flap usually heals without stitches.

“The cornea is one of the fastest parts of the body as far as healing,” Privett said. “The LASIK flap does seal down very quickly. It’s almost completely healed back up within a week after the procedure.”

After LASIK

Patients will need to keep their eyes closed for four hours after surgery and wear clear shields over their eyes until morning. Eyedrops help prevent infection and dry eyes.

Fitch experienced some light sensitivity for a while but was able to drive himself to the doctor’s office the next day for a checkup. Some people might experience a halo around lights at night for a while, although Privett says that recent improvements to lasers have created less night vision glare.

The majority of patients achieve 20/20 vision or better, although some (around 5 percent, according to Privett) will need an enhancement if the surgery didn’t take care of their prescription.

For Fitch, having more than a decade of perfect vision has been well worth getting LASIK.

“Just the expense of the contacts, the worry about them falling out. It was just so much more convenient to not have these physical things you’re dealing with — glasses, contacts — and being able to just enjoy the outdoors,” he said.