Definition and Overview

A refractive surgery follow-up is a meeting between a patient and his eye surgeon following a surgical procedure that involves the eyes and any of its parts. The goal is to assess the success of the procedure and to ensure that complications did not or will not develop. In cases where complications have occurred, the follow-up ensures that they are detected and addressed immediately to keep them from getting worse.

The eyes function like a camera in a sense that they create images. These images are then converted into electrical signals that the brain can decipher.

The eyes are able to achieve this through their many different parts such as the cornea, which is the outermost layer of the eye that covers the pupil, anterior chamber, and the iris. Together with the lens, the cornea bends or refracts light, so it can pass through the pupil and the iris, where it is further narrowed before it reaches the retina. The retina is made up of several nerves that convert the light into electrical signals.

The cornea is typically round while the lens is clear. However, some people’s corneas do not have the perfect shape, and their lenses are obstructed, making images appear hazy. These problems can be corrected using different methods including the use of glasses and contact lenses as well as undergoing refractive surgical procedures.

Refractive eye surgery refers to the many different techniques of changing the shape of the cornea with the goal to eliminate or reduce the problem. Some of the most common kinds of cornea issues are hyperopia (farsightedness), myopia (nearsightedness), astigmatism, and presbyopia. Keratoconus, a degenerative eye disease characterized by the gradual thinning of the cornea that it becomes more conical, is also common with 1 in every 500 people affected by it. The surgery may also refer to cataract surgery, which is the replacement of the eye’s natural lens with an artificial intraocular lens (IOL).

Who Should Undergo and Expected Results

A refractive surgery follow-up is for:

  • Those who have undergone refractive surgery – Meeting with the refractive eye surgeon following the surgical procedure is a must. This presents a perfect opportunity for both the surgeon and the patient to gauge the success of the procedure and to determine whether or not complications or side effects have occurred.

  • People who are showing signs of complications – Surgeries will always have risks, and refractive surgeries are no different. Statistics show that complications occur at least 5% of the time for those who have gone through LASIK, which is one of the most popular types of refractive surgeries these days. Follow-up care is necessary not only to prevent the complications but also to manage them, should they ever happen.

  • High-risk patients – Factors such as age, certain genetic predispositions, underlying conditions, and environment can affect the eyes in the long-term. The follow-up care is essential to ensure that these factors that increase the risk of patients developing symptoms and complications after they have undergone refractive surgery are mitigated on time.

With a refractive surgery follow-up:

  • Patients can recover quickly as the risk of developing complications are minimized.
  • Complications that arise post opt are controlled and eliminated promptly.
  • Possible risks that increase the chances of eye problems developing in the future despite the surgery are mitigated.
  • Patients will know how to take care of their eyes through counseling or education during these follow-up visits.

How Does the Procedure Work?

Post-operative or follow-up care must be discussed with the patient even during the pre-operative evaluation. Since this requires time, it is something that should be seriously considered and properly decided by the patient.

The follow-up schedule can vary based on the general condition of the patient. However, patients can normally expect the following:

  • The first follow-up session is scheduled a day after the surgery. At this time, the surgeon will assess the success of the procedure. In the process, an eye test known as biomicroscopy may be conducted. This involves examining the cornea, retina, lens, and vitreous humor using a slit lamp equipped with a binocular microscope. Other tests that may be conducted include tonometry and dilated fundus test.
  • The patient is then asked to follow-up after a week.
  • The patient then returns to the surgeon a month after.
  • If everything goes well with the last follow-up, the patient may go back after three months.


Depending on the result of the refractive surgical procedure and the patient’s risk of developing complications, follow-up care may have to be performed consistently for many years. In some cases, this is carried out for the rest of the patient life. However, the interval may be much longer like between 9 months and a year, depending on the surgeon’s assessment.

Possible Risks and Complications

A follow-up care can be frustrating for some patients who may think that their refractive errors can be completely corrected by the procedure or when they develop symptoms and other complications. But this can actually be avoided during the pre-operative evaluation in which the patient and the doctor discuss the possible risks and complications associated with different surgical options.

Eye surgeries can also be scary or [depressing] (http://www.docdoc.com/info/condition/depression) for the patient especially when the results are not what they expected or the eye problems only get worse. For this reason, the doctor should focus not only on the condition of the eyes but also on the overall well-being of the patient, including one’s mental health. If necessary, he must provide counseling or refer the patient and the patient’s family to a therapist to help them cope with the emotional issues that may arise due to the surgery.

References:

  • Mimura T, Azar DT. Current concepts, classification, and history of refractive surgery. In: Yanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 3rd ed. St. Louis, MO: Elsevier Mosby; 2008:chap 3.1.

  • Questions to ask when considering LASIK. San Francisco, CA. American Academy of Ophthalmology. Available at: http://www.geteyesmart.org/eyesmart/glasses-contacts-lasik/lasik-questions-to-ask.cfm. Accessed August 30, 2014.

  • Young JA, Kornmehl EW. Preoperative evaluation for refractive surgery. In: Yanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 3rd ed. St. Louis, MO: Elsevier Mosby; 2008:chap 3.2.

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