Many people who seek out LASIK want the convenience of never having to wear glasses or contact lenses again. While the majority of people who get LASIK experience greatly improved vision, not everyone achieves perfect 20/20 vision. In fact, most ophthalmologists treat 20/40 vision as the ideal outcome, and 95 percent of people who undergo LASIK attain this outcome. (Learn More)

However, with 20/40 vision, you may find you still need glasses or contact lenses for a few select activities. If you have worse than 20/40 vision, though, you may qualify for a second LASIK procedure, or another refractive surgery. (Learn More)

This article can help you understand when you may want to wear glasses or contact lenses after getting LASIK, what some difficulties may be with these options, and when you may qualify for further enhancements. Not everyone can get a LASIK enhancement, but many people do. Sometimes they do 5 to 10 years after their first LASIK because their eyes start to change again, and they want a touchup.

Businessman working at office desk, he is staring at the laptop screen close up and holding his glasses, workplace vision problems

 

Does LASIK Eliminate the Need for Glasses or Contact Lenses?

 

LASIK is a laser-assisted surgery that corrects refractive errors by reshaping the lens of the eye. Refractive errors include nearsightedness (myopia), farsightedness (hyperopia, or presbyopia when caused by age), and astigmatism. When the lens is misshapen, light will be refracted differently onto the retina, so images will be processed incorrectly in the brain. You may have trouble seeing distances, or you may have difficulty focusing on close objects. LASIK uses a guided laser to reshape the lens, allowing clear images to be refracted onto the optic nerve.

The LASIK procedure is a short outpatient surgery, and you should experience improvements in your vision within a few hours after getting home. You will not be able to drive yourself home immediately after the procedure, but you will be able to drive yourself to your follow-up appointment the next day. You may receive medicated eye drops to prevent infection and a mask to protect your eyes from being bumped or scratched at night, but you should be able to return to most normal activities.

macro human eye

What to Expect After LASIK, Including Imperfect Vision

 

There are some things you should not do after LASIK surgery, like high-impact sports or swimming. You will also be asked to avoid makeup and facial lotions for several weeks, as they may irritate your eyes. Your vision may fluctuate for three to six months after the procedure. You may see halos or glares around lights, experience dry eyes, and have difficulty driving at night for that length of time.

Although your vision will be greatly improved by LASIK, you may not get perfect 20/20 vision. While some people do achieve this result after LASIK, many achieve 20/30 or 20/40 vision — enough to see distance things mostly clearly and to perform up-close tasks. However, you may find that you still want or need vision correction in some instances.

Partly, your visual acuity will depend on how good your vision was before surgery. The less reshaping of the lens, the easier it will be for you to achieve clear vision. If your vision fluctuates for six months or less, you may find that you need to keep glasses with you, but you may not need or want contact lenses. Immediately after your procedure, you should not put contact lenses in your eyes because your cornea is still healing.

But what happens if your vision is not clear enough after LASIK, and you still need corrective wear? You can wear glasses or contact lenses after LASIK, and if your vision is continuing to change as your refractive error returns or changes, you may find you need them again. Below are some options after getting LASIK.

  • Glasses are a simple solution. Typically, 95 percent of patients get 20/40 vision after LASIK surgery, and about 85 percent achieve 20/20 vision. If you do not get clear vision after one LASIK procedure, you may opt for a lower prescription of glasses. This can be a good option for people who have an ongoing refractive error, like myopia (nearsightedness) or astigmatism, which will continue to change their vision.People who have presbyopia, or farsightedness caused by getting older, are much more likely to need glasses — especially reading glasses — in the near future after their first LASIK procedure. This is because their eyes are not just changing, but changing faster than at other points in their life.However, you should be able to enjoy the majority of daily activities — driving, using a computer, reading a book, watching television, or taking a walk to enjoy the scenery — without using corrective wear. If this is not the case, speak with your ophthalmologist because you may have an undercorrection, which requires different steps than just settling for wearing glasses again.
  • Contacts are more complicated after LASIK. If you find that your vision has not improved within four weeks, or one month, after your surgery, you may find that you want to return to contact lenses. Many people choose contacts because they do not want the hassle of glasses, and they chose LASIK to add more convenience to their daily lives.Unfortunately, some doctors have discovered that they have difficulty fitting their patients for contact lenses after the patient undergoes LASIK. This is due to changes in the corneal surface after the surgery. The topography of a cornea that has had a flap cut for the laser, then healed over several weeks, is different than the topography of a cornea that has not undergone any surgery, injury, or illness.For example, in people with myopia who underwent LASIK so they could see distances again, the corneal surface will have a very flat region with a comparatively steep periphery. Among people who had hyperopia or presbyopia, the central area will be steeper in comparison to the periphery.Traditional soft contact lenses may not be an option for people who have undergone LASIK. Instead, you may be fitted with rigid gas permeable (RGP) lenses, reverse geometry lenses, or another specific type that is harder to find and may be more expensive.Again, if you do not have improved enough vision — typically described as your vision remaining worse than 20/40 — you may have had an undercorrection. Your ophthalmologist will make recommendations after diagnosing you with this side effect.
  • LASIK retreatment or enhancement may be an option. If you underwent LASIK in the past and your vision has changed again, or if you went through LASIK but have an undercorrection so you cannot see better than 20/40, you may be eligible for a LASIK retreatment or enhancement. Retreatment after one LASIK operation varies from 3 to 37.9 percent, depending on whether the patient did not receive the outcome they wanted from the first surgery or they are treating an enhancement as a “touchup.”If you genuinely struggle with an undercorrection, or worse than 20/40 vision, after one LASIK procedure, your ophthalmologist can assess whether you are able to get a second LASIK procedure, or enhancement, based on how well your cornea healed and how thick your lens is. Because LASIK removes cells from the lens to reshape it, people with thin lenses may not be able to have a second LASIK procedure. This is a very individual issue, and your ophthalmologist will be able to inform you if this is the case and if you have other options for refractive procedures after one LASIK operation.

If you do not get perfectly clear vision after one LASIK procedure, you are not alone. Your ophthalmologist will be able to guide you through options, from enhancement to other refractive operations. You can also choose to still wear glasses for specific activities, like driving at night, that may require additional help.

References

What Is LASIK? (July 11, 2018). U.S. Food and Drug Administration (FDA).

What Should I Expect Before, During, and After Surgery? (July 11, 2018). U.S. Food and Drug Administration (FDA).

Your Vision After LASIK. (September 7, 2018). Verywell Health.

Contact Lenses after LASIK. (November 17, 2017). EyeWiki, American Academy of Ophthalmology (AAO).

LASIK – Laser Eye Surgery. (December 12, 2015). American Academy of Ophthalmology (AAO).

Management of Unsuccessful LASIK Surgery. (2007). Medscape.