Definition
LASIK or Lasik is an abbreviation for laser assisted in situ keratomileusis. It is the newest type of refractory surgery which mainly treats my opia (near-sightedness), hyperopia (far-sightedness) and astigmatism (when the cornea curves or flattens unevenly, the result is astigmatism, which disrupts focus of near and distant vision). Only ophthalmologists perform this type of surgical procedure. The purpose of this surgical procedure is to provide a clearer vision.
Procedure:
In summary, the procedure involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser. The client is conscious while this operation is going on, medications such as sedative or anesthetic eye drops are given.
- Flap is created to the corneal tissue. Corneal suction is applied to the eye, holding the eye in place. Once it is immobilized, a metal blade or IntraLASIK procedure creates a series of tiny closely arranged bubbles within the cornea.
- The laser remodels the corneal stroma by vaporizing tissue in a fine manner without undue damage.
- LASIK flap is carefully repositioned over the treatment area. Routine check for proper placement and absence of bubbles indicates proper placement.
Possible Risks:
- Undercorrections – These are common in people who are nearsighted. If little tissue is taken off, little effect on the clarity of the vision will happen.
- Overcorrections – This happens when too much tissue is taken off.
- Astigmatism – This happens when there is too much eye movement during the surgery. It results to uneven tissue and requires another surgery.
- Glare, halos and double vision – There are cases that there is difficulty at seeing at night, or even halos or double visions. Eyedrops with corticosteriod are used to prevent further inflammation and better movement of the eyes after surgery.
- Dry eye – This is due to blockage or trauma on the lachrymal glands.
Nursing Considerations:
Preoperative stage:
- Encourage verbalization of feelings of the unfamiliar procedure.
- Assess the level of understanding of the client regarding the upcoming surgery, the sedation, procedure as well as the responsibility to take of the eye newly operated.
- Encourage compliance to prophylactic antibiotics to prevent risk of infection.
Intraoperative Stage:
- Assist in eye surgery.
- Observe and keep the site sterile while the operation is going on.
- Monitor the vital signs all throughout the procedure.
Postoperative Stage:
- Encourage compliance on a course of antibiotic and anti-inflammatory eye drops. These are continued in the weeks following surgery.
- Instruct the client to sleep or lie on the unoperated side to prevent increase of interocular pressure.
- Instruct the client to avoid overexertion such as straining, lifting and pushing objects.
- Frequently reorient the client to the environment and the date and time of the day to prevent sensory deprivation.
- Teach the client regarding the signs of complications such as any sharp pain or feelings of pressure in the eyes which may indicate hemorrhage, increased intraocular pressure or infection. When this happens, consult the surgeon immediately to prevent further complications.
Result depends still on the severity of the refractory errors on the eye.
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