Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 08/22/19 6:00 PM
Most of the folks who get LASIK at Hunter Vision have at least a friend or two who’ve had LASIK. And usually the person they know was told to go home and take a nap after their LASIK procedure. Oftentimes, that friend was even given a sleeping pill to help them off to sleep once they got home. So when we tell our patients that they shouldn’t go to sleep for six hours after their LASIK procedure, they are ...curious, that may be the best word, as to why that would be.
To clear the air, going to sleep after LASIK is clearly not the end of the world. Millions of patients go to sleep after LASIK and the procedure is still very popular with an enormously high satisfaction percentage. But when we’re talking about something like your vision, the question isn’t, “What’s acceptable?” But instead it is, “What is the best possible version of this?” That’s why we ask people to stay awake for six hours instead of napping.
Why no napping?
The last step of LASIK involves replacing the top layer of cornea so perfectly that it is nearly imperceptible that anything has been done to it. We want that layer to be so well-aligned that we can barely tell where the edge is even when we look with a microscope 10 minutes after the surgery. As the guy doing the surgery, I can do that part on purpose. It just takes a little neurosis and compulsive nature and time. The part I can’t do on purpose is keep it looking that perfect. That requires lubrication. Eh? Bet you didn’t see “lubrication” coming as the next word in that sentence.
For six hours, we are waiting on a topcoat of epithelium to seal over the edge of that layer. Once that happens, it changes from being very easy to change (and any modification is bad because we left it perfect) to being very hard to change. The most common cause of microscopic, not-epic-but-still-relevant changes to that layer? Dryness. Dryness causes the surface of the eye to get just tacky enough that blinking or moving the eye under a closed eyelid will cause little microstriae (tiny, tiny wrinkles) in that layer. The dickens about sleeping is that it causes two things to happen: dryness and movement of the eye under a closed lid (known as REM sleep which was made famous by the band REM).
What do you do for those six hours?
These microstriae oftentimes don’t knock the vision down from 20/20. Sometimes it can even be 20/15. But I’ll bet my hat that the 20/15 you can see with a few micro-wrinkles on the front of your eye isn’t as perfect as a 20/15 without them. So, in order to create the most perfect and smooth surface possible, the best way to spend the next six hours after LASIK is lubricating your eyes like crazy. We ask people to use one drop of a preservative-free artificial tear every 15 minutes for 6 hours. First, they ask if we are serious. Then, when we say we very much are, they do just that. And you know what? Their eyes look amazing the next day.
“Go home and sleep and wake up with good vision” is a marketable motto. “Go home and put a preservative-free tear in each eye every 15 minutes for 6 hours” is less of a motto and more of a strategy. The deal with strategy is it involves details which are usually uninteresting and oftentimes annoying. But when you’re looking for perfection, a well-thought-out strategy can yield results that make the details worth the trouble.
Author: Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Orlando Clinic in Florida. A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.