The LASIK procedure is an outpatient surgery that uses lasers to correct imperfections on your cornea, which can cause unclear vision like nearsightedness or farsightedness. (Learn more) The goal is to reshape the cornea, so light is refracted onto your retina properly, allowing your brain to process clear images rather than fuzzy information. (Learn more)
Since it is a form of surgery, there are risks to LASIK that you need to understand. Effects ranging from three months of dry eyes to loss of vision are possible with this procedure. (Learn more) You may accidentally dislodge the flap on the cornea during the healing process, which can complicate results. If you have any underlying health conditions, they may interact poorly with LASIK, so you may not get the kind of correction you want. (Learn more)
These are rare complications, and millions of people around the world have benefitted from undergoing this surgery. If you want the convenience of normal vision without corrective glasses or contact lenses, LASIK might be a good choice for you. (Learn more)
What Is LASIK and Who Benefits?
In the average eye, the cornea helps to refract light onto the retina to create a clear image of your surroundings. Sometimes, problems with the shape of the cornea lead to conditions called refraction errors because the way the light refracts onto the retina leads to blurry or fuzzy vision. Common refraction errors include:
- Nearsightedness (myopia)
- Farsightedness (hyperopia)
- Presbyopia (farsightedness from aging)
The goal of LASIK surgery is to adjust the cornea by using lasers to shave off cells from some areas, which creates a uniform shape that refracts light well. This is a common procedure to improve vision for people who have refraction errors as long as no other underlying conditions are adding to vision problems.
Because LASIK is a surgical procedure — although it is minimally invasive and outpatient — there are risks and complications associated with it. However, there may be many benefits too. It is important to understand these when asking your optometrist or ophthalmologist about LASIK.
Pros of LASIK Surgery
If you have worn glasses or contacts for almost your whole life, you may be tired of them and want to have normal vision. LASIK is one approach to solving this problem. There are huge benefits to the convenience and stress relief of being able to see well without wearing glasses that may slip off your face or putting in contact lenses that can become uncomfortable over the course of the day. There are other pros of the procedure.
- It is a quick, simple procedure. It is outpatient, so there are no overnight hospital stays, you do not go under general anesthesia, and the whole thing takes only 20 minutes on average.
- During the procedure, there are automatic safety shutoffs if you move your eye suddenly, or there is another movement, so the laser will not cause any damage.
- Recovery is quick, with most people returning to their normal lives in 48 hours.
- Vision improvement begins quickly, within a few hours after surgery. Most people report noticing a huge difference the next day.
- Side effects occur about 10 percent of the time, and they typically go away within three months.
- Most people regain 20/20, or normal, vision. If they do not, most eye doctors aim for slightly less than 20/20, so an additional LASIK procedure, called an enhancement, can bring vision to full correction.
Cons of Undergoing LASIK
Although you may want the convenience of normal vision without corrective wear, there are several potential side effects and health impacts that may mean LASIK is not the right choice for you.
- You may physically not be eligible. For example, if you are younger than 20 or older than 40, your risk of changes to your cornea is higher, so LASIK is a much more temporary vision fix as your eyes change.
- Common side effects occur in 10 percent of cases, and they last for three months. These include hazy or blurry vision, trouble with night vision, sensitivity to light, itchiness or scratchiness in the eyes, dry eyes from less tear production, discomfort or pain, and glares, halos, or starbursts around light.
- Some side effects may become permanent, and they can be uncomfortable.
- If your vision is not properly corrected, you may need to continue wearing glasses or contacts until you can have a second surgery, called a retreatment or enhancement, to bring your vision up to normal.
- Your vision may be overcorrected, which can be uncomfortable due to eye strain. This may require ongoing treatment over several months to bring it down to normal.
- Although your vision improves within a day, healing the corneal flap takes much longer. Any amount of trauma to that area, including accidentally rubbing your eyes, hitting your head, or jostling the eye during high-impact sports, can dislodge the flap and lead to more serious vision problems.
- Ectasia, or bulging of the cornea, may develop during the healing process, become uncomfortable, and lead to vision problems.
- If your eyes continue to change, even if you are within the standard age range, you may need LASIK again.
The Food and Drug Administration (FDA) lists some additional reasons that LASIK may not be for you.
- You are not a risk-taker. There is a small chance uncomfortable side effects could get worse or become permanent. While rare, it could happen.
- Your career may be jeopardized. Some people’s jobs require that they do not undergo surgical procedures that could impact their vision even if they need corrective wear.
- Cost is an issue. LASIK may be partially covered by your insurance, but it is an elective procedure for nearly everyone, and it is expensive.
- You struggle with wound healing. Either because of a medication you take or a disease like diabetes, autoimmune conditions, or HIV, if you do not heal quickly, the LASIK procedure could lead to additional vision problems due to poor healing.
Medical Conditions Impact Whether You Can Benefit From LASIK
In addition to the general cons that might turn you away from LASIK, you may not qualify or may decide not to pursue the procedure if you have the following medical conditions:
- Dry eye syndrome, which can get worse after surgery
- Large pupil size, which may make photosensitivity after surgery worse
- Keratoconus or a family history of this condition, which is a generative corneal condition that can be adjusted with other surgical procedures but disqualifies you from LASIK
- Thin corneas, which is not inherently bad or disabling, but may mean that removing layers of cells is not a good approach to vision correction
- High levels of refractive error, like extreme nearsightedness or farsightedness, because it may be too difficult to bring the cornea into alignment for normal vision
- Pregnancy, hormonal conditions, or medications that adjust hormones because these can change vision
The Convenience May Be Worth It
Of course, informed consent means that you must understand the potential health risks from inconvenient to potentially damaging. You may suffer a few months of dry eyes, or you may lose your vision if something goes wrong during surgery. It is also important to know that long-lasting or permanent side effects are unlikely to occur, and you should speak candidly with your optometrist or ophthalmologist to understand the severity of these risks. If you are still worried but think LASIK may be a good solution for you, get a second opinion from a different eye doctor.
Ultimately, pursuing LASIK is a personal choice. If you want greater convenience in your life, safety while driving or performing other activities, and you do not want the hassle of getting new prescriptions, then LASIK is a great option for you. If you are more than a little concerned about any of the side effects, you may decide to pursue alternatives to good vision.
What Is LASIK? (July 11, 2018). U.S. Food and Drug Administration (FDA).
LASIK – Laser Eye Surgery. (December 12, 2015). American Academy of Ophthalmology (AAO).
Pros and Cons of LASIK: Are the Risks Worth the Cost? (December 13, 2017). University of Michigan Health.
When Is LASIK Not for Me? (July 11, 2018). U.S. Food and Drug Administration (FDA).
Is LASIK for Me? A Patient’s Guide to Refractive Surgery. American Academy of Ophthalmology (AAO).