LASIK Procedure and Post-Operative Pain Management

Introduction to LASIK

The LASIK procedure involves creating a hinged corneal flap, reflecting it, reshaping the exposed stromal bed with an excimer laser, and repositioning the flap, which preserves the central corneal epithelium and causes significantly less pain than surface ablation procedures 1

Mild to moderate discomfort can be expected during the first postoperative day after LASIK, but pain is significantly less than with PRK because the central corneal epithelium remains intact 3
Corneal nerve disruption during LASIK can lead to decreased corneal sensitivity and potential corneal neuralgia in some patients 4
Dry eye symptoms are common after LASIK due to nerve disruption affecting tear production, causing discomfort and eye strain 4
Visual aberrations such as glare, halos, and starburst effects can cause eye strain and secondary headaches through sustained accommodation effort 4

Topical antibiotics and corticosteroids are administered postoperatively for a short time to prevent infection and inflammation 3
Lubrication is typically used in the postoperative period to address dry eye symptoms 3
Protective eye shields are recommended for short-term use to protect the eye during the healing process 3
Oral analgesics may be used variably among practitioners based on surgeon preference 8
Judicious use of dilute topical anesthetics can help control postoperative pain, but prolonged use should be avoided as it delays corneal epithelialization 8

Severe pain with redness and photophobia suggests microbial keratitis rather than normal post-operative discomfort 6
Persistent or worsening pain may indicate DLK, central toxic keratopathy, or corneal neuralgia requiring specialized treatment 6