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LASIK reduces refractive errors by reshaping the cornea, so you can get at least 20/40 vision, and not have to wear glasses or contact lenses anymore. Despite this, there are some reasons you may need contacts or glasses after LASIK surgery.
Different types of contacts can be safely fitted onto your eyes, including therapeutic contacts, soft or rigid contacts, or combination contacts. If you find glasses or contact lenses are necessary to see clearly after LASIK, you may have an undercorrection and could benefit from a second surgical procedure. LASIK does not protect against age-related eye changes, so you may need reading glasses as you age.
Most often, you will not need contacts or glasses after LASIK. If you are among the 95 percent of patients who get perfect visual acuity after LASIK, contacts or glasses will strain your eyes.
LASIK & Visual Acuity: You Should Not Need Glasses or Contacts
More than 40 million people all over the world choose laser-assisted in-situ keratomileusis (LASIK) rather than continue to wear glasses or contact lenses to correct their vision.
People who have had refractive errors like nearsightedness, farsightedness, or astigmatism for several years may be tired of caring for contacts or keeping their glasses prescription updated. LASIK reshapes your cornea, so light is refracted more clearly onto your retina, giving you better visual acuity without needing corrective wear.
More than 95 percent of LASIK procedures result in greatly improved vision. LASIK providers report that their patients get at least 20/40 vision, and most end up with 20/20 vision. While perfect eyesight cannot be guaranteed, you are not likely to need glasses or contacts to improve your vision after LASIK for at least several years.
Your LASIK surgeon may have you wear a protective contact lens for a few days after the operation. This lens does not correct your vision but instead keeps your eye safe from particles and irritants while your cornea heals.
After several years, your refractive error may change enough that you need corrective wear like glasses again. In very rare cases, LASIK may not work for your eyes, and you may need to return to wearing glasses or contact lenses.
It Is Safe to Wear Contact Lenses After LASIK With Your Optometrist’s Help
It is safe to wear contact lenses in specific situations after you undergo LASIK. There are some reasons you may have contact lenses after undergoing this laser-based refractive correction surgery.
- Therapeutic or “bandage” contacts: More invasive or older types of refractive surgery, like photorefractive keratectomy (PRK), required you to wear a protective, therapeutic contact lens to shield your eye for several days after the operation. It is not common to need a therapeutic contact lens (TCL) after modern LASIK procedures, but if your eye surgeon has concerns about healing your corneal flap, they may have you wear a TCL for one or two days after the operation.
- Hydrophilic or “soft” contacts: In the rare case that your refractive error is not corrected enough after LASIK, you can wear standard soft, gas-permeable contact lenses to get better visual acuity. You likely need a new eye exam and contact lens fitting, so your optometrist can update your refractive error and manage a contact lens that will fit over the new shape of your cornea.
Between 10 and 25 percent of people wear contact lenses after LASIK, one survey reports, so they can have full visual acuity including distance vision.
- Toric soft contacts: If you have a minor astigmatism that remains after LASIK, which causes overall blurry vision, toric lenses can adjust this refractive error. However, toric lenses are not capable of correcting an irregular astigmatism, before or after LASIK. They are also not recommended for higher degree astigmatism, regardless of LASIK.
- Rigid gas permeable contacts: These are considered the lenses of choice after most LASIK operations. They can correct refractive errors like astigmatism while managing thinner corneas and higher-order aberrations in sight.
- Combination contacts: Some people have extreme sensitivity to “hard” or “rigid” gas permeable lenses, causing a feeling of irritation or discomfort in the eye. Combination lenses are soft contact lenses with a rigid portion on top. The soft portion rests on the surface of the eye, while the hard part offers better correction of refractive errors. They also have better gas permeability than standard RGPs.
- Post-hypermetropic repair and iatrogenic corneal ectasia contacts: People with post-hypermetropia and iatrogenic corneal ectasia have a cornea that is steeper in the center than the periphery. This is similar to keratoconus, when the middle part of the cornea juts out with extra tissue. This requires contact lenses that fit in a special way over the cornea. Depending on how LASIK reshapes your cornea, they may reshape in an unusual way, so you need contact lenses fitted for these conditions.
- Scleral contacts: These lenses rest on the white part of your eye rather than just on top of the cornea and iris. They are considered a “lens of last resort” since they do not allow much of your eye to breathe, although they are considered gas permeable. If you have an unusually shaped cornea and contact lenses do not rest on it properly, even after having LASIK, you can try these to see if your vision improves.
Undercorrections: Wear Glasses Again or Get Another Surgery?
It is rare for someone to undergo LASIK and need glasses or contact lenses to improve their vision in the weeks after the surgery. If you find your vision has not improved enough that you can perform daily tasks without wearing glasses, this may indicate you have an undercorrection. Discuss options with your eye surgeon to fix this problem.
After LASIK, you will have several follow-up appointments for weeks or months, so your doctor can monitor your vision as it improves and ensure that your cornea heals without scarring or inflammation. If you have an undercorrection, your eye doctor will catch it during the healing process. They can discuss different surgeries to adjust your refractive error further.
Refractive surgeries may include:
- Another round of LASIK, if your corneas have enough tissue and there is enough refractive error left to correct.
- Photorefractive keratectomy (PRK) for thinner corneas or more minor adjustments.
In very rare cases, you may not be eligible for a second surgery. You will need to wear contacts or glasses to continue correcting your refractive error.
Again, these cases are very rare. The vast majority of people do not need corrective eyewear after LASIK.
Will Contacts Improve My Vision Even More?
LASIK surgery is the most recommended treatment procedure for people suffering from refractive errors. While not everyone may be eligible to undergo LASIK surgeries, most vision patients pass the basic LASIK legibility requirements. Additionally, after the procedure, you generally won’t need to wear glasses or contact lenses long-term because surgery improves your eyesight to the range between 40/20 and 20/20.
However, a small number of patients may still need corrective eyewear after LASIK surgery. While your doctor may ask you to wear glasses for a day or two after the procedure, some people may need to keep wearing glasses for a longer period. In the days following the procedure, you still require glasses to help your eyes adjust and protect harmful particles from undoing the progress made.
It would be rare, however, for your surgeon to recommend wearing contact lenses following LASIK. Because of what the surgery does – it creates a flap and reshapes the cornea – contact lenses could create negative effects.
Long-term, if you attempt to wear glasses or contacts to further improve your vision, you’ll be disappointed. This can stress your eyes and worsen your vision.
It’s possible that you will experience diminished sight years after having LASIK surgery. Wearing contact lenses at this point would be fine. You will have the approval of an eye doctor because the doctor will have to write a new prescription for glasses or contacts.
Other Reasons Why Contact Lenses are Needed after LASIK Surgery
Although the need to wear contacts or corrective glasses after LASIK is rare, there are situations in which your doctor may ask you to wear glasses after the procedure. It could be for therapeutic reasons, because it did not resolve an astigmatism or because there is another underlying reason why your vision did not improve.
Before LASIK was enhanced as a surgery to fix refractive errors, other procedures like photorefractive keratectomy (PRK) were widely used. While they were helpful, these traditional procedures were not as effective or successful as LASIK.
As a result, it was not uncommon to be required to wear glasses or contacts after PRK procures. These eyewear products were fashioned to shield your eyes after the procedure, which would give your eyes the best opportunity to heal. If the procedure was only partially successful, you might have been required to wear glasses for some time.
While rare, you may be asked to continue wearing your therapeutic contact lenses after LASIK surgery. Today, however, you only need to wear the glasses for a day or two following the procedure.
Hydrophilic or Soft Contacts
LASIK procedures enjoy a high success rate for improved vision (95 percent) and a high patient approval rating (96 percent). But in some rare cases, the underlying condition may not resolve during surgery. If this happens, you may have to wear standard soft, gas-permeable contacts to improve your vision.
After the procedure, you'll have several follow-up appointments where the doctor will examine the procedure's effectiveness in vision correction and restoration. These appointments can reveal any weaknesses in the procedure, and when found, it may result in you wearing corrective glasses.
Astigmatism is one of the tougher refractive errors to correct as the deterioration gets worse with age. That is why most corrective refractive surgeries stem from astigmatic conditions. If some traces of astigmatism remain even after the procedure, you may experience discomfort and blurry vision.
In these cases, specialists recommend Toric glasses to adjust the refractive error. However, on their own, these glasses cannot fix astigmatism, and they may not get worse where there's a high astigmatic rate.
High Refractive Errors
Some refractive error patients have extreme sensitivity to rigid gas permeable lenses. This can result in discomfort and irritation in the eyes. In such cases, you may be required to wear soft contact lenses with a rigid portion on the top.
The soft contact lens rests on the eye's surface and causes little-to-no irritation, while the hardtop part offers corrective measures to help with refractive errors.
People who experience post-hypermetropic repair and iatrogenic corneal ectasia may also have steep corneas. Like keratoconus, the steep cornea has birth issues with the peripheral view. While LASIK can fix the condition, your vision largely depends on the cornea's shape after the procedure. Special contacts can be used to correct and improve your vision.
While these lenses are considered gas permeable, they are often the last resort in fixing refractive errors. Scleral contacts are placed on the white part of the eye instead of the conventional cornea. However, they offer little breathing space and may feel a bit unusual and uncomfortable at first.
Scleral contacts are used when irregularly shaped corneas don't incorporate the lenses effectively after LASIK surgery.
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