As you get older, you may develop cataracts, which is a clouding of the lens in your eye. But you may have had LASIK earlier in life, so will this affect your cataract surgery? (Learn More)

Fortunately, LASIK changes your cornea, not the lens in your eye. If you have had LASIK previously, you can safely have cataract surgery if you develop cataracts. (Learn More)

Your cataract surgeon will need to know about your LASIK procedure, so they can accurately calculate what power you need for your artificial lens. (Learn More)

More middle-aged and older adults are also pursuing LASIK after having cataract surgery, to improve their refractive errors. If you need cataract surgery, your eye doctor will tell you when the time is appropriate. (Learn More)

Cataracts & Refractive Errors

eye with cataracts

Cataracts occur in the lens of the eye, the organ that refracts light to the retina. As you age or after suffering physical trauma, proteins can begin to clump together in the lens, creating white spots, yellow or dark areas, or distortions that cause blurry or double vision. You may have blind spots that you do not notice as you start to develop cataracts.

If you develop cataracts, you will not notice serious changes in your vision until they are advanced. Your eye doctor will notice them before you do, at a routine eye exam. They can then monitor the cataract’s progress over several years and manage changes to your vision with updates to a prescription for glasses or contact lenses.

Eventually, you will need to have cataracts removed surgically. This requires removing your natural lens from your eye and replacing it with an artificial lens. However, since the Food and Drug Administration (FDA) approved laser-assisted in situ keratomileusis (LASIK) about 20 years ago, there are more middle-aged and older adults who have had LASIK and are starting to develop cataracts.

Can they have cataract surgery safely, after having a cosmetic surgery to manage their refractive error years earlier? The short answer is yes, but there may be some points of caution.

LASIK Treats the Cornea; Cataract Surgery Treats the Lens

If you have had LASIK in the past, you are understandably concerned about the safety of other surgeries involving your cornea and lens.

There are several types of LASIK using basically the same procedure. Create a flap on the surface of your cornea, reshape the inside of the cornea using an excimer laser, and allow the eye to heal and cornea to reshape so your refractive error is corrected to at least 20/40 visual acuity. Many people get 20/20 vision after LASIK.

Because LASIK has been a popular cosmetic surgery since the 1990s, the first generation of participants is old enough to get eye conditions related to aging, like cataracts. If you are at least 40 years old, you are at risk for cataracts, and you should see your optometrist regularly to monitor your vision. People who are at least 60 years old are likely to develop cataracts and approaching the age to undergo surgery to replace their lens.

Cataract surgery has been successfully performed on people who have previously had LASIK to improve a refractive error. While you will have thinner corneas than someone who has not undergone LASIK, cataract surgery treats a different part of your eye than LASIK. The LASIK procedure reshapes the cornea, which is in the clear surface of your eye over your pupil and lens. The lens, which develops cataracts, is beneath your pupil, inside your eye.

Since LASIK alters the surface curvature of your eye, you should ensure your cataract surgeon has all your medical records involving previous eye conditions. This allows your surgeon to have a full record of all your eyes’ changes, so they can plan your cataract surgery to take your healing process into account. It is important to note that cataract surgeries have been successfully performed on people who previously had LASIK, without the cataract surgeon knowing this history.

Your Cataract Surgeon Needs Your LASIK Information to Help Your Vision

laser eye surgery

Knowing your history will help your surgeon calculate the power of the artificial lens that needs to be implanted in your eye. They will use your prescription prior to LASIK and your current prescription power to understand how your eye has changed and how this may impact the artificial lens they choose.

Your surgeon needs accurate measurements of:

    • Corneal power.
    • Axial length.
    • Anterior chamber depth (underneath your lens).
    • Corneal diameter.

Refractive surgeries like LASIK can also change the relationship of the posterior and anterior corneal surfaces, which can affect how well your eye focuses. People who have undergone LASIK will have a slightly different power in their eyes that can lead to a bias toward farsightedness. If your cataract surgeon knows about your history of refractive surgery, they can easily correct for this measurable bias.

Your Eye Doctor Will Not Rush Cataract Surgery

Since LASIK is relatively new compared to cataract treatment, there is no set amount of time to wait between having LASIK and undergoing cataract surgery. Giving your eyes enough time to properly heal between both procedures is important, so you may ask your optometrist or ophthalmologist.

Since cataract surgery does not specifically treat refractive errors, some older adults are asking about having LASIK after cataract surgery, so they can have clearer distance and close vision. Artificial lenses often give you clear middle and distance vision, but you may still need glasses for up-close work.

Your eye doctor is unlikely to recommend cataract surgery until your vision is significantly impaired. Cataracts are not life-threatening and, for most people, develop slowly. You also cannot have elective cataract surgery. In the meantime, you can still undergo LASIK if you want to manage a refractive error.

 

References

What Are Cataracts? (October 2019). American Academy of Ophthalmology (AAO).

Can I Have Cataract Surgery After LASIK? (August 2017). All About Vision.

Cataract Surgery Is Possible for Most People Who’ve Had LASIK. (December 2011). Mayo Clinic.

When Cataract Develops Long After LASIK. (October 15, 2008). Review of Optometry.

Cataract Surgery After Refractive Surgery. (April 2017). U.S. Department of Veterans Affairs (VA).

Should You Have LASIK if You Have Cataracts? (March 2014). American Academy of Ophthalmology (AAO).