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What to Expect: Before, During & After Your LASIK Eye Surgery or PRK Procedure

Dr. Holzman will customize each treatment to the specific needs of the individual and are committed to helping you achieve your vision correction goals. We offer the most technologically advanced equipment to produce the highest-quality results while ensuring your overall comfort and safety. We have provided the following information to help patients prepare for their procedure:

LASIK Preparation

PRK Preparation

What to Expect - LASIK Eye Surgery

Pre-Operative Preparation

• Please realize that pre-operative preparation is extremely important in your healing and the ultimate success of your LASIK eye surgery. Dr. Holzman is very concerned about your success and has optimized your pre-operative regimens to help ensure outstanding results.
• All patients will receive three pre-operative medications to use. The first is an ointment to be applied to the eye, just inside of the lower eyelid, at bedtime.
• This starts one week prior to the surgery. It is called MURO 128 Ophthalmic Ointment, and your pharmacist should carry it as an over the counter medication. You will not be using this after the procedure, just prior to it.
• One day prior to your surgery you will begin two different eye drops, each to be used four times per day. They are called Zymar and Xibrom. They will assist in your healing and comfort. These two drops will also be used post operatively.
• Some patients who were found to have a significant Dry Eye Syndrome will also be prescribed an eye drop called RESTASIS pre-operatively. This is to be used twice daily once you receive the prescription, and then will continue this for at least two to three months post-op. You will be stopping this medication on the surgery day and for the first two days after the surgery, and then restarting it on post op day #3.
• PLEASE MAKE SURE YOU HAVE READ YOUR CONSENT FORMS AND ALL OTHER IMPORTANT PAPERWORK PRIOR TO YOUR ARRIVAL AT THE CENTER. Do not wear any colognes, perfumes or scented soaps on the day of your procedure. When you arrive on your procedure day, you will be given a complete post-operative kit with thorough instructions for your post care. It will contain another eye drop called PRED FORTE, which you will use along with the Xibrom and Zymar. It will also contain samples of lubricant eye drops called Refresh , which are very important to use frequently during the first few months after the procedure. These are available over the counter and you will need to purchase some once your samples have run out.
• We know that this sounds like you will be using a lot of eye drops! Don’t worry, it will all be easily spelled out for you on the forms which you will be receiving.

During The Procedure

• The procedure is very simple and easy for the patient. However it is very important to keep all the facial muscles relaxed throughout the procedure. This includes the forehead, brows, eyelids, cheeks and jaw muscles. It is also very helpful to do some deep breathing to help relax.
• This is a two step process. Step one is creating the flap with the IntraLase. The IntraLase takes approximately 40 seconds to create the flap, during which your vision will dim out and you may feel some pressure. It is very important not to talk or move around during the laser process. Just breathe gently. Once the flap is made in the first eye, the process is repeated on the second eye.
• Step two involves lifting of the flap and vision correction with the excimer laser. There will be a small piece of tape placed over one eye while the other eye has a lid speculum that will keep your eyelids open. The speculum does not hurt and it is important that you do not fight against it. It is best to keep your brow and forehead relaxed in order to make this easier for both you and Dr. Holzman.
• You will be focusing on a blinking target and will hear the ticking of the laser. It is not uncommon to notice an odor during this portion of the procedure, which lasts only a few seconds.
• The rest of the procedure will move quickly from this point on.
• Dr. Holzman will be talking to you throughout the procedure and keeping you informed each step of the way.
• The key word is relax. The more relaxed you are, especially in the facial area, the faster and easier the procedure will be.

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After Your Procedure

• Immediately post-operative, your vision will be watery and blurry, and will remain that way for most of the first day.
• There will be tearing and burning for a few hours after the procedure, and it is highly recommended that you go home, place your first set of eye drops in, and then take a two to three hour nap. Do NOT sleep for more than three or four hours.
• Visual acuity should improve rapidly over the first 12 to 24 hours, but will fluctuate greatly over the first few days.
• Your vision on day one in no way represents your final result. There is usually significant swelling of the cornea which needs to diminish.
• Visual acuity reaches maximal level expected within three to four weeks following the procedure, with full stabilization reached within three months in most patients.
• The healing process is very much individualized and therefore, results will vary greatly from patient to patient.
• At night, there will be a "halo" or "starburst" affect around lights especially in the early healing process. These usually diminish over time, from weeks to months. You should expect glare/haloes and a "filmy" sensation to your vision during the first month, with resolution of these symptoms over time.
• Most patients will find it difficult to read in the first few days following LASIK eye surgery.
• Most patients will experience dryness after the procedure, varying from several weeks to months. Artificial tears can be very helpful and should be used frequently after the procedure.
• Occasionally, you may see blood-red spots in the white of the eyes following LASIK eye surgery. These are due to fine, fragile blood vessels that have been disrupted. DO NOT worry about these blood spots as they mean nothing to your outcome. They will disappear within a week.
• A very small number of patients may experience under-response, over-response, or regression after the procedure. This can occur if your healing process falls outside the "normal" range. In most cases, an enhancement procedure may help improve visual acuity. The enhancement procedure is usually not performed until vision has completely stabilized, typically about three months after the original procedure. There is no guarantee that an enhancement will be successful in improving the outcome, although it usually does. No guarantees of visual outcomes can be made. Rarely, patients may need glasses/contacts to improve vision post op.

What to Expect - PRK

During The Procedure

• The procedure is very simple and easy for the patient. However it is very important to keep all the facial muscles relaxed throughout the procedure. This includes the forehead, brows, eyelids, cheeks and jaw muscles. It is also very helpful to do some deep breathing to help relax.
• There will be a small piece of tape placed over one eye while the other eye has a lid speculum that will keep your eyelids open. The speculum does not hurt and it is important that you do not fight against it. It is best to keep your brow and forehead relaxed in order to make this easier for both you and Dr. Holzman.
• During the procedure, Dr. Holzman will be asking you to look at a red light for fixation. At times, he will also block the red light with instruments. It is best to keep looking straight up in the direction of the light, even if you don't see it.
• The procedure is very fast and will frequently be done wi thin a few minutes. A contact lens will be placed over the eye to help it heal during the first several days.
• Dr. Holzman will be talking to you throughout the procedure and keeping you informed of each step of the way.
• The key word is relax. The more relaxed you are, especially in the facial area, the faster and easier the procedure will be.

After Your Procedure

• Immediately post-operative, your vision will be watery and blurry, and will remain that way for most of the first few days.
• There will be tearing and burning for a few hours after the procedure, and it is highly recommended that you go home, place your first set of eye drops in, and then nap if possible. About 15 percent of patients complain of significant irritation and light sensitivity. This is usually during the first 48 hours. Use as many artificial tears as possible, keep all your drops chilled, and follow instructions carefully. Your irritation will resolve. Get as much rest as possible.
• It is normal for the vision to be better on day one and day two, with a bit more blurring on days three and four. This is because the corneal surface heals across the center of the vision on days three and four. The contact lens which is helping you heal will typically be removed on day four or five.
• Your vision in the first week in no way represents your final result. There is usually a great deal of fluctuation and visual improvement over the coming weeks.
• Visual acuity usually reaches maximal level expected within six to eight weeks following the procedure, with full stabilization usually reached within three months in most patients. You should be functional during the healing period, even during the first weeks.
• The healing process is very much individualized and therefore, results will vary greatly from patient to patient.
• At night, there will be a "halo" or "starburst" affect around lights especially in the early healing process. These usually diminish over time, from weeks to months. You should expect glare/haloes and a "filmy" sensation to your vision during the first month, with resolution of these symptoms over time.
• Most patients will find it difficult to read in the first few days following PRK.
• Most patients will experience dryness after the procedure, varying from several weeks to months. Artificial tears can be very helpful and should be used frequently immediately after the procedure.
• Patients may experience under-response, over-response, or regression after the procedure. This can occur if your healing process falls outside the "normal" range. In some, but not all cases, an enhancement procedure may help improve visual acuity. Re-treatment is usually not performed until vision has completely stabilized, typically about three months after the original procedure. There is no guarantee that re-treatment will be successful in improving the outcome.
• No guarantees of visual outcomes can be made. Rarely, patients may need glasses/contacts to improve vision post op.

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