Who can have LASIK eye surgery? Consideration and procedure

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LASIK eye surgery is a common laser surgery procedure to correct vision issues, removing or reducing the need to wear glasses or contact lenses. Suitable candidates for the procedure include people who have a refractive eye error, are aged 21 years or older, and have a prescription that has not changed significantly in the last 12 months.

This article explores what the procedure involves, the risks and side effects, and how people can choose the right doctor to carry out this type of eye surgery.

According to the American Academy of Ophthalmology (AAO), LASIK surgery treats vision problems due to refractive errors.

Refractive errors occur when light rays cannot travel through the cornea and lens well enough to send signals from the retina to the brain. This causes the image formed on the retina to be out of focus, causing blurred vision. LASIK surgery can permanently change the shape of the cornea so that light rays can focus on the retina.

The LASIK procedure treats:

It is important to note that LASIK may not be able to treat presbyopia, a refraction error due to older age that causes many to wear reading glasses to correct.

Before going ahead with LASIK surgery, a doctor will evaluate a person’s eye health and measure the cornea, pupils, and refractive errors. People who wear contact lenses may need to switch to glasses for up to several weeks before the doctor takes these measurements. This allows the cornea to return to its natural shape and reduces measurement inaccuracies.

During the procedure, a surgeon will cut a flap into the cornea, exposing the stroma, the middle section of the cornea. They will then use a pulsing laser to vaporize parts of the stroma before replacing the flap.

Surgeons adopt one of two techniques for creating the flap in the cornea. Traditional LASIK uses a mechanical blade, while all-laser LASIK procedures use a device called a laser keratome. A 2015 study found no statistically significant difference in the outcome of either technique, and both are safe and effective.

The procedure takes no longer than 30 minutes, and people are awake throughout the surgery. Before the procedure, a healthcare professional will numb a person’s eyes and hold their eyelids open with a speculum.

At the end of the procedure, a doctor will place a shield over the eye to protect it from irritation and pressure. People may experience burning or itching and some mild discomfort or pain. While some see very well the next day, vision can be blurry for the first few days and may fluctuate over the next few months.

The Food & Drug Administration (FDA) states it can take 3–6 months for vision to stabilize after LASIK surgery.

According to the AAO, good candidates for LASIK surgery should:

  • be aged 18 or older (ideally over 21 years old) — this is so the cornea has stopped developing by the time of the surgery
  • have an eye prescription that has not changed significantly in the last 12 months
  • have a refractive error that LASIK surgery can treat
  • have realistic expectations about the procedure and what it can achieve
  • have thick and healthy corneas and overall good eye health

The AAO also outlines who is not suitable for LASIK eye surgery. These include people with:

  • unstable refractive errors that change
  • extreme nearsightedness, farsightedness, or astigmatism
  • certain eye health conditions, including dry eyes, cataracts, thin corneas, glaucoma, and a history of eye infections
  • underlying health conditions that a person may have difficulties managing, such as diabetes

Additionally, people who are pregnant or nursing cannot have LASIK surgery.

As with any surgical procedure, there are risks of side effects or complications.

Side effects are usually temporary and may include:

  • eye pain or discomfort
  • blurred, hazy, or foggy vision
  • a scratchy feeling in the eye
  • eye disturbances, such as glare, halos, or starbursts
  • sensitivity to light
  • patches of blood on the eyeball

The AAO reports that the risks of longer or permanent side effects are low, with 95% of patients reporting a good outcome after surgery. A 2017 analysis also stated that the use of modern lasers has significantly reduced unwanted side effects.

The AAO says complications from LASIK surgery are rare. However, the FDA says the treatment is relatively new, having first gained approval in 1998. So, the long-term safety and effectiveness of LASIK surgery are not yet known.

Potential complications from LASIK eye surgery may include:

  • eye infections
  • dislocation of the corneal flap
  • loss of vision that glasses, contact lenses, or further surgery cannot treat
  • permanent visual problems such as double vision or halos
  • severe dry eye syndrome, which can reduce vision

A 3-year study in 2016 looked at the visual satisfaction of people who had undergone LASIK surgery after wearing contact lenses. They reported improved vision at night while driving, no increase of dry eye syndrome, and higher satisfaction during yearly follow-ups.

The same research also found that LASIK eye surgery significantly reduced the rate of common side effects in people who wear contact lenses, such as eye infections, ulcers, and abrasions.

Compared to surgery and contact lenses, reading or prescription glasses are much less likely to irritate the eye or cause any side effects. They are also a cheap and effective way of correcting vision. However, a person can easily damage or lose their glasses, and they can be unsuitable for certain activities. Over a lifetime, glasses may also cost more to replace and update than one successful LASIK procedure.

Learn about the cost of glasses.

The FDA provides advice on selecting the right doctor for a LASIK procedure, which includes considering:

  • Cost: Avoid choosing the cheapest option without conducting thorough research. Compare several doctors and practices and ask about the surgeon’s level of experience.
  • Advertising: Do not trust deals that seem too good to be true. Reading up as much as possible about the procedure will help people identify deals that make exaggerated claims or are too cheap to be reliable or safe.
  • Expectations: According to the FDA, not everyone will have perfect vision after surgery. Some may still need to wear glasses or lenses when performing certain tasks, such as driving at night or reading small print. People should be aware of this before agreeing to undergo the procedure.

LASIK eye surgery can be an effective and quick way to correct certain vision problems, but not everyone can undergo the procedure. People looking to have LASIK surgery should be aware of the criteria that make someone suitable for this type of surgery. They should also make a careful selection of their doctor based on experience rather than cost.

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Luke Everdeen

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