LASIK eye surgery is a popular procedure that can correct nearsightedness, farsightedness, and astigmatism. During the procedure, a laser is used to reshape the cornea to improve vision. While LASIK is typically an outpatient procedure done under local anesthesia, some patients wonder if stronger medication can be used.
Can you be fully asleep for LASIK?
Most LASIK providers do not offer general anesthesia for the procedure. There are a few key reasons why:
- LASIK requires the patient to focus on a target light during the procedure. This ensures the laser reshapes the cornea properly. Under general anesthesia, the patient would be fully asleep and unable to focus.
- General anesthesia requires intubation and breathing support. The intubation tube can cause damage to the eyes during LASIK.
- There are greater risks with general anesthesia, including breathing problems, nausea, vomiting, and rarely, death.
For these reasons, most LASIK surgeons avoid general anesthesia and rely on local numbing medication instead. However, in rare cases, some providers may offer light sedation along with local anesthesia.
What medication is used for LASIK?
The standard numbing medication used for LASIK is topical anesthetic eye drops. These are applied directly to the surface of the eyes leading up to the procedure. Common topical anesthetics used include:
- Proparacaine
- Tetracaine
- Lidocaine
These numb the surface of the eyes so patients do not feel pain during the LASIK procedure. However, patients remain fully awake and able to follow instructions.
Can you be sedated for LASIK?
While general anesthesia is not used for LASIK, some providers may offer light sedation along with the numbing eye drops. Sedation involves giving anti-anxiety medication such as Valium and narcotic pain medication such as Demerol.
With sedation, patients remain awake but feel more relaxed and less anxious. The medications may make some patients drowsy, but not fully asleep. Patients must still be able to understand instructions and focus on the target light.
Potential advantages of sedation for LASIK include:
- Reduced anxiety during the procedure
- Less discomfort or pain
- Ability to remain still during the surgery
However, sedation also has risks such as breathing problems, low blood pressure, and nausea/vomiting after surgery. Most LASIK surgeons find the risks outweigh potential benefits.
What are alternatives to sedation for anxious patients?
For patients with high anxiety about LASIK, there are ways to reduce fear without sedation:
- Talk to your eye doctor about your concerns beforehand. Understanding the procedure can lower anxiety.
- Take calming medication like lorazepam before arriving at your appointment.
- Have a friend or family member accompany you to the surgery for moral support.
- Listen to calming music during the procedure.
- Use relaxation techniques such as mindful breathing.
These methods allow you to remain fully awake and alert during the surgery while managing anxiety and discomfort.
Are there risks of sedation for LASIK?
While light sedation for LASIK may help some anxious patients, there are risks to consider:
- Breathing problems if overly sedated
- Inability to focus properly on the target light
- Difficulty holding eyes open during the procedure
- Increased numbness and eye dryness leading to corneal damage
- Nausea and vomiting after surgery
- Drowsiness and impaired vision after surgery
- Need for extended recovery time after sedation
These side effects can lead to surgical complications. Most LASIK surgeons avoid sedation unless absolutely necessary since the procedure is relatively quick and painless with just local anesthetic drops.
Who might benefit from sedation for LASIK?
While sedation is not frequently offered, there are some instances where it may be appropriate to consider for LASIK. Examples include:
- Patients with extreme anxiety or phobias related to medical procedures.
- Patients who had a highly traumatic experience with previous eye surgery.
- Patients unable to lie flat and still for extended periods due to back pain or muscle spasms.
- Patients with disorders causing excessive eye movements that interfere with laser accuracy.
For these select cases, sedation may provide added benefits over numbing drops alone. However, risks still need to be carefully weighed.
What types of sedatives may be used?
If sedation is used for LASIK, some options may include:
- Benzodiazepines like diazepam (Valium) to induce relaxation and sedation
- Opioid pain medication like fentanyl to minimize discomfort
- Propofol to cause moderate sedation while remaining responsive
- Dexmedetomidine provides sedation without suppressing breathing
Medications are tailored to the patient’s needs and underlying health conditions. The minimum amount needed is given to avoid major side effects.
Conclusion
While it is uncommon, light sedation may be an option for highly anxious LASIK patients. However, risks need to be carefully considered against potential benefits on an individual basis. For most patients, topical anesthetic drops provide sufficient pain control during the brief LASIK procedure.
Non-medical interventions like relaxation techniques, anti-anxiety medication before surgery, and moral support are also great alternatives. In the end, you want to be as alert and cooperative as possible during LASIK to get the best visual outcome.
Frequently Asked Questions
Is LASIK surgery painful?
LASIK surgery is typically not painful. Numbing drops are applied before the procedure to anesthetize the eyes. Some pressure or discomfort may be felt during the suctioning and laser treatment, but patients do not normally feel significant pain.
Why can’t you be asleep for LASIK?
Being fully asleep under general anesthesia is too risky for LASIK. The numbing medications impair the eyes’ ability to focus and move properly, which is critical for the laser accuracy. There are also risks of eye damage and other complications with intubation.
Do you get an IV for LASIK?
An IV is not necessary for most LASIK procedures. Numbing drops provide sufficient anesthesia. Mild oral sedation may be given in some cases, but an IV is uncommon. IV fluids are more likely needed with longer eye surgeries.
How long is the LASIK surgery?
The LASIK procedure itself takes 10-20 minutes per eye. However, factoring in preparation and recovery time, patients typically spend 2-3 hours total at the surgical center.
What percent of people opt for sedation with LASIK?
Sedation for LASIK is quite rare, with some estimates of less than 1% of patients being sedated. Most people opt for numbing drops alone since sedation has added risks and downsides.
Can anti-anxiety medication be taken before LASIK?
Oral anti-anxiety medication like lorazepam may be used before LASIK to manage nervousness. This is an alternative option to help relaxed and calm patients without sedation drugs during the actual surgery.
What happens if I move during LASIK?
It is critical to lie still throughout the LASIK procedure. Movement can throw off the laser positioning and alignment and reduce the accuracy of the vision correction. This is one reason local anesthesia is preferred over sedation.
Table Comparing Sedation Options for LASIK
| Sedation Method | Benefits | Risks & Downsides |
|---|---|---|
| No Sedation, only numbing drops | – Lower risks – Patient remains alert – Able to follow instructions |
– Potential anxiety or discomfort |
| Oral sedative like Valium | – Reduced anxiety – Mild relaxation |
-Some drowsiness – Potential next-day drowsiness |
| IV sedation medications | – Lessened anxiety – Reduced pain/discomfort – Still somewhat alert |
– Breathing suppression – Nausea – Disorientation – Extended recovery |
| General anesthesia | – Completely asleep – No consciousness of procedure |
– Respiratory distress – Corneal damage – Nausea and vomiting – Severely impaired function – Higher risks |
As seen in the table, the risks and downsides tend to increase with heavier levels of sedation. Most LASIK surgeons aim to use minimal medications to keep patients comfortable yet alert.
What to Expect With LASIK Eye Surgery
Understanding the step-by-step process of LASIK can help ease anxiety leading up to the procedure.
Before surgery
To prepare for LASIK, you will:
- Undergo a thorough evaluation to determine if you are a good LASIK candidate
- Have your eyes measured with advanced devices to plan treatment
- Discuss the risks, benefits, alternatives
- Review instructions for before and after surgery
- Arrange transportation, since you cannot drive immediately after
Be sure to discuss any anxiety with your eye doctor beforehand.
Day of surgery
On the day of your LASIK procedure:
- Arrive at the surgical center on time
- Drop anesthetic eye drops in your eyes to numb them
- Lie down on the treatment bed below the laser
- Have your eye stabilized with an instrument to hold the lids open
- Focus on a blinking light throughout the treatment
- The laser will steadily reshape the cornea as you lie still
- The process takes 10-20 minutes per eye
Let your surgeon know if you feel any significant pain or discomfort during the procedure.
After surgery
Following LASIK surgery:
- Your eyes will be irritated and blurry
- Eye drops help soothe discomfort as your vision stabilizes
- Wear the protective eye shields as directed
- Use prescribed medication to help the eyes heal
- Attend all follow-up appointments as scheduled
- Most patients see well within 24-72 hours after LASIK
Be sure to take care of your eyes properly in the weeks after LASIK to ensure proper healing.
Finding the Right LASIK Surgeon
Choosing an experienced LASIK surgeon is key to minimizing risks and achieving the best visual outcome from your procedure. Here are some tips when researching doctors:
- Look for a board-certified ophthalmologist who specializes in LASIK and has years of experience performing it
- Ask about the number of procedures the surgeon has done and their rate of complications
- Select a high-volume LASIK center that has the latest laser technologies and tracking systems
- Consider reviews from previous patients
- Schedule consultations to meet potential surgeons in person before deciding
The right surgeon will make you feel comfortable explaining the whole process and addressing all your concerns. Do not rush your choice – you want an exceptional doctor to perform this permanent, vision-changing procedure.
What Questions Should You Ask Your LASIK Surgeon?
When meeting with potential LASIK doctors, make sure to ask these important questions:
- How long have you been performing LASIK surgery?
- How many total LASIK procedures have you completed?
- How many cases of complications or enhancement surgeries have you had?
- Do you use the latest laser technologies and eye trackers?
- What medications and anesthesia will be used before/during surgery?
- What should I do to prepare for surgery and my recovery?
- What surgical risks and side effects should I be aware of?
- How accessible will you be if I have post-surgery concerns?
The surgeon should be able to explain the entire LASIK process clearly. Make sure all your questions and anxieties are addressed before moving forward.
Alternatives to LASIK Surgery
While LASIK is a popular choice to correct refractive error like nearsightedness, farsightedness, and astigmatism, it is not for everyone. Some other refractive surgery options include:
Photorefractive Keratectomy (PRK)
In PRK, the corneal surface is reshaped after the thin outer epithelial layer has been removed. This avoids the corneal flap made in LASIK. Vision recovery is slower with PRK but complications like flap issues are reduced.
Refractive Lens Exchange (RLE)
RLE involves removing the eye’s natural lens and replacing it with an artificial intraocular lens to change refractive power. This is an option for people with extreme nearsightedness or farsightedness not treatable by LASIK or PRK.
Implantable Collamer Lens (ICL)
ICL surgery places a thin, foldable lens inside the eye in front of the natural lens to correct vision. No corneal tissue is removed. ICL may be an option for those unable to get LASIK.
Conductive Keratoplasty (CK)
In CK, radiofrequency energy is applied to the cornea through a fine probe to reshape specific spots. It is used to treat mild farsightedness or presbyopia in older adults.
Discuss all lens and refractive surgery options with your eye doctor to determine what is right for your eyes and vision needs.
Conclusion
While LASIK is not typically performed under general anesthesia, light sedation may be an option for highly anxious patients. However, most LASIK surgeons rely on numbing eye drops alone due to the risks and downsides of sedation. Non-medical approaches are often preferred to keep patients comfortable yet alert during the procedure.
When choosing an ophthalmologist, select one with extensive LASIK experience to minimize complications. Ask plenty of questions upfront so you know what to expect before, during and after surgery. Understanding the process can greatly ease anxiety.
While LASIK is very common, make sure you explore all refractive surgery alternatives as well with your doctor. Finding the optimal vision correction method tailored for your eyes is the ultimate goal.