LASIK has been a common outpatient procedure for decades. Millions of people around the world have their nearsightedness, farsightedness, or astigmatism successfully corrected without spending a lot of money. LASIK also heals quickly, making it one of the best options for people who do not want to wear glasses or contact lenses.

Some people experience changes in their vision 10 or more years after getting LASIK, so they may think the procedure is wearing off or the effects are diminishing over time.(Learn more)

Although LASIK technically does not wear off over time, you may find that your refractive error comes back and changes your vision a little after several years. It is also possible that you could develop a second refractive error as you get older, especially presbyopia or astigmatism.

Studies have found that it is somewhat common for people who have undergone LASIK to need, and pursue, another round at some point in the future.(Learn more)

As long as your cornea is not too thin, you should be able to get another round of LASIK. Your doctor will check for other underlying conditions that could impact your visual acuity, including glaucoma or cataracts, which can also appear as you get older.

It is important to get a full eye exam to check for any underlying conditions before undergoing even your first round of LASIK. Once that is complete and your eye doctor confirms you have enough corneal tissue, you may be a good candidate for a second round of LASIK.(Learn more)

Does LASIK Wear Off or Diminish Over Time?

Since the 1990s, laser-assisted in situ keratomileusis (LASIK) has improved vision for millions of people around the world who had refractive errors like nearsightedness, farsightedness, and astigmatism, and did not want to wear glasses or contact lenses.

LASIK is considered a permanent but simple and inexpensive solution to refractive errors. It takes no more than 10 minutes per eye, heals within days so you can return to work, and improves your vision to at least 20/40, if not better.

LASIK shaves layers off the inside of your cornea, reshaping this outer layer of cells to change how light is refracted through the lens and onto your retina. Refractive errors are caused by changes in the shape of your cornea, which means that light does not clearly hit the retina, and a clear image is not transmitted through your optic nerve to your brain. By reshaping the cornea, LASIK allows your lens to clearly focus light, so your brain interprets in full clarity.

Although you should not get LASIK if your eyes are still changing prescriptions, there is a chance that refractive errors may continue to change in small ways over time, even if you meet the criteria for LASIK. Many people also develop additional refractive errors throughout their lives, like astigmatism and presbyopia, which is farsightedness specifically related to getting older.

For some people, this may feel like LASIK is “wearing off” or diminishing. While this is not precisely true, it does mean you might want another round of LASIK. Another LASIK procedure could be possible, but you must meet stricter requirements for this second round.

LASIK: You May Slowly Develop Poor Eyesight Again

When you ask your optometrist or ophthalmologist about LASIK, you will need to meet certain qualifications. These include:

  • You have not changed your glasses or contact lenses prescription in the past year, indicating that your eyes are not changing rapidly.
  • You are at least 20 years old, so your eyes are becoming more stable.
  • You are not taking medications that cause visual fluctuations.
  • You have a thick enough cornea.

The FDA also does not recommend that people who have had previous refractive error surgeries pursue LASIK, and this includes having a round of LASIK some years earlier. In part, this is because refractive surgeries change the shape of your cornea by making it thinner, at least in some places. This tissue does not grow back, so you may have thin corneas that cannot withstand another round of LASIK.

If you have sufficient corneal tissue remaining after your first LASIK procedure, and enough time has passed that your eyes are fully healed, you may be able to get a second LASIK operation to correct changed vision. One study reported that about 35 percent of people who had LASIK earlier in life to correct a normal refractive error ended up choosing retreatment after 10 years. This was because their vision had shifted significantly enough that they needed corrective wear like glasses or contact lenses again.

A second study followed people who had either myopia or astigmatism. It found that about 12 years after their first treatment, 10 percent of former patients developed age-related vision changes, including presbyopia, and that led to needing vision correction again.

Few eye doctors will recommend LASIK for presbyopia, as this condition can change your eyesight rapidly. However, more people are pursuing LASIK retreatment about 10 years after their first procedure because their refractive error has come back a little, and they still do not want to use glasses or contact lenses to correct their vision.

There Could Be an Underlying Cause of Poor Eyesight

If your vision is changing and you have had LASIK to correct a refractive error already, there may be another underlying reason that you are having trouble seeing clearly.

For example, both glaucoma and cataracts lead to blurry vision as an early symptom. Getting regular eye exams can help your eye doctor diagnose these conditions and monitor potential problems like small spots or high intraocular pressure that might lead to these conditions. Neither cataracts nor glaucoma can be treated with LASIK or similar vision surgeries.

An optometrist will check your eyes if you are interested in another round of LASIK. Looking for these potential issues will be part of that process, and they will then manage any issues they find.

LASIK is designed to be needed only once, correcting your vision for a specific issue permanently. Although some people may pursue retreatment, their vision is not as bad as it was prior to undergoing their first LASIK procedure, according to the American Refractive Surgery Council (ARSC).

Your eyes may develop additional vision issues, including more serious ones like glaucoma or cataracts, as you get older. Even after having your vision corrected with LASIK, it is important to get regular eye exams. Contact your optometrist or ophthalmologist as soon as possible if your vision quickly changes and you struggle with blurry or poor eyesight.

Most people with standard refractive errors are excellent candidates for LASIK. You are likely to be a good candidate later in life if your refractive error returns or changes as you age. Ask your doctor about your options if your vision changes at some point after LASIK. While the original results of LASIK are unlikely to wear off or diminish over time, you may have developed a new vision issue that could be corrected with another round of LASIK.

References

What Is LASIK? (July 2018). United States Food and Drug Administration (FDA).

When Is LASIK Not for Me? (July 2018). United States Food and Drug Administration (FDA).

If You Had LASIK Surgery Over 15 Years Ago, and Your Vision Is Starting to Get Worse, Can You Have It Done Again? (April 2017). American Academy of Ophthalmology (AAO).

Clinical Outcomes After Topography-Guided LASIK: Comparing Results Based on a New Topography Analysis Algorithm With Those Based on Manifest Refraction. (June 2020). Journal of Cataract & Refractive Surgery.

Outcome of a 10-year Follow-Up of Laser In Situ Laser Keratomileusis for Myopia and Myopic Astigmatism. (December 2014). Taiwan Journal of Ophthalmology.

Twelve-Year Follow-Up of Laser In Situ Keratomileusis for Moderate to High Myopia. (May 2017). BioMed Research International.

LASIK – Laser Eye Surgery. (December 2019). American Academy of Ophthalmology (AAO).

Functional Outcome and Patient Satisfaction After Laser In Situ Keratomileusis for Correction of Myopia and Myopic Astigmatism. (January—March 2015). Middle East African Journal of Ophthalmology.

Effect of Age on Visual and Refractive Results after LASIK: Mechanical Microkeratome Versus Femtosecond Laser. (March 2019). International Journal of Ophthalmology.

Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK. (May 2017). American Family Physician.

Ask the Doctor: How Long Does LASIK Last? (May 2016). American Refractive Surgery Council (ARSC).

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies. (January 2017). JAMA Ophthalmology.