LASIK is considered an elective and cosmetic surgery, meaning that it is not usually deemed medically necessary. Insurance generally doesn't cover it, and the visual corrections the procedure makes can usually be accomplished by wearing glasses or contacts. LASIK can improve your quality of life by potentially eliminating the need for glasses or contacts. The American Refractive Surgery Council reports that 99 percent of individuals who undergo LASIK achieve 20/40 vision, and over 90 percent achieve at least 20/20.

LASIK makes changes to the cornea that can permanently correct for astigmatism, nearsightedness, and farsightedness. (Learn More) LASIK can improve vision and have a positive, lasting impact. (Learn More)

There are some potential risks associated with LASIK surgery that a small percentage of the population may struggle with after surgery, but most of the possible side effects clear up in a few days to weeks. (Learn More) LASIK surgery is permanent and designed to last the duration of your lifetime, but aging does occur. Your eyes can change and require a secondary or enhancement surgery as a result. (Learn More)

Overall, LASIK is considered safe and effective to give you the benefit of improved vision. It is important to weigh the potential risks against the reward, to determine if you are a good candidate for LASIK surgery, and to assess how it can improve your personal quality of life.

Beautiful sunset over the east baltic sea "Ostsee".

How Long Does LASIK Last?

 

LASIK is a procedure that uses an excimer laser to ablate and remove some of the stroma, the internal tissue of the cornea, in order to correct refractive vision errors such as astigmatism, myopia (nearsightedness), and hyperopia (farsightedness). This makes permanent changes to the shape and size of the cornea to improve vision.

The Journal of Refractive and Cataract Surgery reports that LASIK is one of the most successful and most common elective surgeries and that the vast majority of patients who undergo the procedure are happy with the results. LASIK is intended to be a permanent change that does not have an expiration date. It actually reshapes the cornea to eliminate the refractive errors instead of just correcting them as glasses and contacts do. In general, people who have relatively good vision before LASIK and are correcting for mild to moderate nearsightedness will experience even better vision after the procedure.

Aging is a natural process. As you get older, your eyes can change. Just like you would have to potentially get a new pair of eyeglasses or contacts as you age and your eye prescription changes, this can also be the case with LASIK, which may mean that your vision will decrease slightly over time. This does not mean that LASIK has failed, however.

After age 35, and most commonly after age 40, many people will struggle with what is called presbyopia or "aging eyes." The National Eye Institute explains that presbyopia is very common and impacts a person's ability to clearly focus on things up close. This focusing difficulty involves the lens of the eye and not the cornea, which is what LASIK corrects. Generally, this means that reading glasses will be required.

Even if you have undergone LASIK, you can still develop presbyopia, but LASIK does not increase the risk for this condition. Presbyopia is a natural aging of the eyes that is not directly impacted by LASIK.

A person may decide to undergo a corrective laser surgery that creates what is called "monovision," where one eye is corrected for distance sight and the other for close sight. This can take some time to adjust to, and it may not be ideal for everyone.

The American Refractive Surgery Council publishes that LASIK corrects for specific vision errors permanently; however, natural aging changes may impact the eyes and vision down the road — with or without corrective surgery.

Long-Term Effects of LASIK

 

LASIK has been around since the 1990s. The U.S. Food and Drug Administration (FDA) warns that there have not been very many long-term studies on the longevity and effects of LASIK over time, as the procedure is still considered to be fairly new. That being said, most people who get LASIK are happy with the results and the improvement in their vision.

The most obvious and hopeful effect of LASIK is the potential to lose your glasses or contacts, and to be able to see without the need for corrective lenses. Nearsightedness is the most commonly corrected refractive error with LASIK, and the procedure is most successful in those who are correcting mild myopia. In general it is considered that if you have fairly good vision with only mild errors before LASIK, you will have improved vision and good results after the procedure.

It is important to consider what it is you are hoping to accomplish with LASIK surgery in order to define your expectations and ensure that they will be met with the procedure. As LASIK is a permanent change to your eyes, you should have as much information as possible before committing to it.

A detailed assessment and evaluation should be done prior to LASIK to ensure you are a good candidate for the surgery. LASIK reshapes your cornea and uses a femtosecond laser to create a thin flap in the outer layer. Technology is constantly improving in this field. In the past, a blade was used to create the corneal flap, but now, a second laser is used, and this has improved outcomes of the procedure. According to studies, advances in LASIK procedures and technology since its inception have improved on the already positive long-term effects of LASIK, and most people report sustained accurate vision for years after surgery.

Your eyes will need to be carefully measured to determine your specific eligibility. These measurements will help predict how LASIK will impact your future vision. Your ophthalmologist will discuss your options with you and explain exactly what to expect both during and after surgery.

The Need for Enhancement Surgery

 

Around 80 percent of people who get LASIK surgery will have no need for glasses or contacts after the procedure, and there is a good chance for obtaining 20/25 vision after the procedure. It is possible for the refractive error to be undercorrected, meaning that not enough tissue was removed from the cornea. This can result in the need for a follow-up or secondary surgery to further improve vision and completely correct the error. In rare cases, vision can slowly return to previous levels, often due to difficulties with the healing process, pregnancy, hormonal imbalances, or additional eye problems.

More common is the need for an eventual cataract surgery, as cataracts can form with age. A cataract involves cloudiness of the lenses, and it does not impact the cornea. LASIK does not impact cataracts one way or the other; it cannot prevent them, improve them, or create them. Cataracts can be corrected through an artificial lens implant surgery.

Per the journal Review of Ophthalmology, as LASIK procedures have improved over the years, the rate of people requiring an enhancement surgery after the procedure has greatly declined. If an enhancement, or a secondary surgery, is needed, it usually will not be required for at least 5 or 10 years. Enhancements are generally the result of your eyes changing naturally over time.

Potential Pitfalls of LASIK Surgery Down the Line

 

The American Refractive Surgery Council reports that visual disturbances and common side effects of LASIK typically clear up as your eyes heal within a few days to weeks after the procedure. The U.S. National Library of Medicine (NLM) reports the following as possible risk factors associated with LASIK:

  • Dry eyes
  • Night vision issues
  • Sensitivity to light
  • Halos or glares around lights
  • Decreased ability to see contrast
  • Corneal infection
  • Scarring in the cornea, making it difficult to wear contacts
  • Scratchiness
  • Reduced vision

According to studies publishes by the FDA, close to half of those who receive LASIK report one visual disturbance — halos are the most common — and nearly a third experience dry eyes persisting at least three months after surgery. The FDA further publishes that less than 1 percent of those who undergo LASIK report that the visual symptoms require corrective lenses or are debilitating and prevent them from participating in normal everyday activities.

The New York Times publishes that neuropathy, or nerve pain, is a possible complication of LASIK since every surgery can cause some level of nerve damage. In some cases, dry eyes and scratchiness may also be significant after LASIK. This is why the initial screening process is so important. People with a history of dry eyes before LASIK are more likely to suffer from issues related to dry eyes after the procedure.

Vision loss and blindness are possible complications of LASIK, but Consumer Reports explains that this is extremely rare and only occurs in less than 1 percent of those undergoing the procedure. Long-term complications are considered rare and generally the result of poor aftercare, wound healing, or infections.

If the correction to the eyes is more significant, it is more likely to mean that complications can arise, and the LASIK procedure and results can be less predictable. It is vital to undergo a thorough assessment prior to LASIK to discuss the possible risk factors with your surgeon.

References

 

What Is the LASIK Success Rate? (October 2017). American Refractive Surgery Council.

LASIK Outcomes: How Are We Doing and Can We Do Better? (August 2016). Journal of Cataract & Refractive Surgery.

Facts About Presbyopia. (July 2011). National Eye Institute.

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

What Are the Risks and How Can I Find the Right Doctor for Me? (August 2018). U.S. Food and Drug Administration.

LASIK Surgery: Is It Right for You? (March 2017). Mayo Clinic.

LASIK Eye Surgery Safe in Long-Term, Experts Say. (October 2015). Fox News.

LASIK Eye Surgery. (December 2017). Mayo Clinic.

How to Approach LASIK Enhancements. (October 2014). Review of Ophthalmology.

The LASIK Complications Facts: Should You Worry? (August 2017). American Refractive Surgery Council.

LASIK Quality of Life Collaboration Project. (September 2018). U.S. Food and Drug Administration.

Blurred Vision, Burning Eyes: Is This a LASIK Success? (June 2018). New York Times.

Lasik Eye Surgery. Will You Really Get Rid of Your Glasses? (February 2013). Consumer Reports.