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Can You Get LASIK After Cataract Surgery? Who Is a Candidate?

Home / Laser Eye Surgery Guide 2023 / LASIK After Cataract Surgery

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If your level of visual acuity is poorer than you’d like after cataract surgery, LASIK is one option to improve it. While not a viable option for everyone, many people can benefit from a LASIK post-cataract procedure, potentially regaining the ability to read or drive without corrective lenses.

Am I a good candidate for LASIK after cataract surgery?

If you are over 18, have good eye and general health, and have had stable prescriptions for at least one year, you may be a candidate for laser eye surgery.

woman talking to doctor after Cataract Surgery about LASIK

Is LASIK After Cataract Surgery Necessary?

LASIK surgery isn’t always necessary after cataract surgery. For instance, one estimate claims about 6 percent of patients who have a premium intraocular lens (IOL) implanted require laser refractive surgery.1 The most common surgeries used are LASIK and PRK.

Current research suggests it can be difficult to predict when LASIK may be necessary after a given cataract surgery, but it is not the norm.2

Who Is a Good Candidate?

Ideal candidates for LASIK surgery have good general health and eye health and have had stable glasses or contact lens prescriptions for at least a year.3 Generally, LASIK is a good option for those who have had cataract surgery and have minor residual refractive errors that can be easily corrected with LASIK.4

Who is Not a Good Candidate?

LASIK involves using a precise laser or blade to cut a flap into the eye. Once the procedure is done, it is important that this flap has time to heal properly. If you have a lifestyle or career that doesn’t allow for a break from heavy physical activity, LASIK won’t be a good option for you, regardless of whether you’ve had cataract surgery previously or not. You can return to most normal activities the day following the surgery.5

Similarly, people who have health conditions that may interfere with the healing process also should generally avoid LASIK.

Some other factors might mean LASIK isn’t a good fit for you, such as these:5

  • Large pupils
  • Thin corneas
  • Dry eyes
  • Previous refractive work
  • Autoimmune conditions, such as lupus
  • Immunodeficiency states, such as HIV
  • Diabetes
  • Pregnancy or breastfeeding
  • Medications that cause vision changes
  • A job that prohibits certain refractive procedures
  • Participation in contact sports like boxing or rugby

Additionally, if you required a change to your glasses or contact lens prescription in the past year then LASIK likely isn’t the right fit for you.5

Currently, LASIK is also only approved by the FDA for people 18 and older.

Benefits of LASIK After Cataract Surgery

LASIK helps correct a person’s visual acuity, and it can work for people after cataract surgery. It is a safe, medically accepted procedure for those who are considered good candidates.

The data on LASIK is promising, showing that people who undergo LASIK post-lens implant frequently got within ±1.00 D of the target refraction level. This represents a level of correction that could potentially allow a given patient to perform activities like reading or driving without further corrective measures, like glasses, or require that they only wear very mild lenses.6

Another benefit of receiving LASIK surgery after lens replacement surgery is that laser eye surgery can correct refractive errors that occur post-cataract surgery, such as blurred vision at a certain distance. This can greatly improve patient satisfaction.

Alternatives to LASIK After Cataract Surgery

There are a few alternatives to LASIK when it comes to post-cataract surgery care.

Photorefractive Keratectomy (PRK)

One of the most common is photorefractive keratectomy (PRK). This procedure involves removing the epithelium of the eye in order to get to the cornea underneath, as opposed to LASIK, which involves creating a flap for a similar purpose.

PRK often represents a viable option even for patients who aren’t eligible for LASIK. The overall resulting visual acuity level is comparable to the results from LASIK. If you are a candidate for both LASIK and PRK, your doctor will assess your eyes and vision goals, and recommend the best option for your situation.

IOL Exchange

Another alternative to LASIK is an IOL exchange. In this procedure, an IOL is swapped with a new IOL, which can theoretically work to correct any refractive error and help improve your visual acuity. This procedure is not common after cataract surgery, but it can have good visual outcomes.7,8

Surgeons can also piggyback IOLs, which means they introduce a second lens rather than replace the lens already introduced in the initial cataract surgery.9

LASIK After Cataract Surgery FAQs

Is it safe to have LASIK after cataract surgery?

Yes. Assuming a patient doesn’t have any notable risk factors, getting LASIK after cataract surgery is well within the acceptable level of risk for most people.

Any eye surgery carries the potential for complications, LASIK included, but permanent harm is unlikely. The surgery has the notable benefit of permanently improving visual acuity. It is considered a low-risk, high-reward procedure.

Why is laser surgery necessary after cataract surgery?

For most people, laser eye surgery isn’t necessary after their cataract surgery if they’re happy with their current level of visual acuity. This is especially true if they don’t mind wearing corrective lenses, such as glasses or contacts.

Laser eye procedures, such as LASIK, can help people who experienced complications as a result of their cataract procedure that reduced their level of visual acuity or who otherwise are unhappy with their current acuity levels. For viable candidates, laser eye procedures can dramatically improve the clarity with which they can see without further corrective lenses.

Will cataract surgery improve my vision?

Your vision will improve after cataract surgery because the cataract that was obstructing your vision will be gone. Your surgeon can also address any refractive errors during cataract surgery, often replacing your natural lens with a prescription IOL that can improve visual acuity.

Will cataract surgery fully correct my refractive error?

Some degree of minor refractive error may remain after cataract surgery. In these cases, LASIK may be a good option to correct the issue.

References

  1. LASIK Enhancements For Premium IOLs More Accurate With Less Dry Eye. (February 2017). Ophthalmology Times.
  2. Predicting the Necessity of LASIK Enhancement After Cataract Surgery in Patients With Multifocal IOL Implantation. (September 2011). Clinical Ophthalmology.
  3. LASIK Candidate. (n.d.) Harvard Medical School, Department of Ophthalmology.
  4. Resolving Refractive Error After Cataract Surgery: IOL Exchange, Piggyback Lens, or LASIK. (August 2013). Journal of Refractive Surgery.
  5. When is LASIK not for me? (n.d.) U.S. Food and Drug Andministration
  6. PRK Versus LASIK After Cataract Surgery. (July 2016). Cataract & Refractive Surgery Today.
  7. Incidence of Intraocular Lens Exchange after Cataract Surgery. (September 2019). Scientific Reports.
  8. Out With the Old: Successful IOL Exchange. (October 2021). Review of Ophthalmology.
  9. Piggyback IOLs for Residual Refractive Error After Cataract Surgery. (August 2012). Cataract & Refractive Surgery Today.

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