Should I Get LASIK? Questions and Concerns

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Should I Get LASIK?

People with vision issues often turn to LASIK surgery as an alternative to glasses or contact lenses. If you want to improve your visual acuity, LASIK may be a good choice for you.

LASIK is among the most popular choices for laser vision correction. LASIK stands for Laser-Assisted In Situ Keratomileusis, and it is a procedure that permanently changes the shape of the cornea with an excimer laser.

diagram showing six steps of lasik eye surgery

LASIK is a type of refractive eye surgery. These procedures correct vision problems from refractive errors including:

  • Presbyopia, or age-related vision changes, including farsightedness
  • Myopia, or nearsightedness, which makes objects that are far away difficult to see and read
  • Hyperopia or farsightedness makes objects that are far away easier to see than closer objects
  • Astigmatism, an imperfection in the curvature of the eye’s cornea 
graphic comparing normal vision, myopia refractive error, and hyperopia refractive error

Who Is an Ideal Candidate for LASIK Surgery?

Not everyone is eligible for LASIK surgery. However, most adults with mild vision problems, who wear glasses or contacts, will get better vision from LASIK surgery.

A good candidate fits the following 8 criteria:

1. Good general health

If you have an autoimmune disease or degenerative condition that makes it harder for your body to heal, you might not qualify for LASIK. This includes, but is not limited to rheumatoid arthritis, Sjogren's syndrome, type 1 diabetes, and AIDS. Some medications such as immunosuppressants may also interfere with your ability to heal from eye surgery.

2. Healthy eyes

Certain conditions and eye diseases can affect your eyes' ability to heal or respond to refractive eye surgery. These may include severe dry eye syndrome, cataracts, or glaucoma. If you have an eye injury, conjunctivitis (pink eye), or an infection, you'll have to wait until this condition is resolved before getting eye surgery.

3. Vision that falls within a specific prescription limit

If your prescription is too high, your eye doctor may advise against laser surgery. FDA-approved excimer lasers for LASIK in the United States can correct approximately:

  • -11.00 diopters of nearsightedness
  • +5.00 D of farsightedness
  • 5.00 D of astigmatism

However, each eye surgeon will have their own limits on how poor your vision can be. Most surgeons offer a free consultation to determine whether you're a good candidate or not.

4. Stable vision

Many people's prescriptions for glasses or contact lenses change as they age. In order to be a good candidate, your vision needs to remain stable for at least 12 months.

5. Normal cornea thickness

The LASIK surgery procedure removes part of your cornea. Your cornea needs to be sufficiently thick in order to achieve desired results.

6. Not pregnant

If you are pregnant or nursing, you should delay the procedure. Hormonal changes can alter your cornea and vision. This may take several months to return to stable levels.

7. Normal sized pupils

People with extra-large pupils have an increased risk of side effects, including:

  • Halos
  • Glares
  • Starbursts
  • Poor night vision, especially while driving

8. Have realistic expectations

LASIK surgery has a very high success rate. However, you should be fully aware of the potential side effects and complications. 99 percent of patients achieve 20/40 vision or better, but not everyone achieves perfect vision.

Be sure to pay close attention, ask questions, and address any concerns you might have at your pre-surgery consultation. Follow all instructions your surgeon gives you very carefully.

What are the Pros and Cons of LASIK Eye Surgery?

Like any laser refractive surgery or surgery in general, LASIK comes with its own set of pros and cons that anybody considering the procedure should keep in mind. 

Pros:

  • The surgery is quick, taking only 20 minutes, on average. LASIK is also safe. The FDA has approved a number of LASIK lasers
  • The results are fast. Patients will notice a difference in as short as a few hours
  • Live life without the need for glasses and contacts and enjoy a convenient eye care routine that is much less time-consuming 
  • Enjoy clear vision from the time you wake up until you go to bed

Cons:

  • LASIK is not for everybody. For example, many people over age 40 are deemed as not good candidates for the surgery. Older patients who have presbyopia can still receive LASIK, but they either need reading glasses after surgery or can elect monovision LASIK
  • LASIK may cause dry eyes for up to three months in some patients 
  • Nighttime glare or halos
  • The flaps that get created during LASIK can be injured and dislodged during the healing process
  • The chances are slim, but you may need LASIK more than once

Who Should Not Have LASIK Eye Surgery?

Unfortunately, some people are not good candidates for LASIK and should forgo the procedure altogether. You should not get LASIK if one or more of the following statements apply to you:

  • You have cataracts, diabetes, or another autoimmune disease that can prevent proper healing after surgery
  • You’re on certain medications, including corticosteroids and certain acne medications
  • You are pregnant
  • LASIK will jeopardize your career. Some jobs don’t allow certain refractive procedures. It’s essential to check with your employer before you undergo any procedure
  • You had to change your contact lens or glasses prescription within the last year, also known as refractive instability
  • You are a boxer, wrestler, or participate in other contact sports where blows to the face and eyes are common
  • You are not at least 18
  • You have large pupils, which can cause symptoms including glare, halos, double vision, and starbursts after surgery
  • You suffer from chronic dry eyes. LASIK can aggravate this condition
  • People with keratoconus, a condition in which the cornea’s tissue bulges outward

Other conditions to speak about with your eye doctor while considering LASIK:

  • You have blepharitis, inflammation of the eyelids that includes crusting eyelashes that can increase the risk of corneal infection or inflammation after the procedure. 
  • You have thin corneas. Since LASIK is a refractive procedure that reshapes the cornea, if the cornea is too thin, it can become damaged during surgery and lead to blinding complications.
  • You have glaucoma. You must ensure your glaucoma is properly controlled before undergoing LASIK surgery.

As always, it’s important to consult with your ophthalmologist before embarking on any surgical procedure. Some of LASIK’s side effects that you may want to discuss with your ophthalmologist when talking about your candidacy for LASIK eye surgery include dry eyes, problems with night vision, and regression. These side effects typically last for a month or two after the procedure, but about 20 percent of LASIK patients continue to have symptoms long-term.

How Much Does LASIK Cost?

The average cost of LASIK surgery in the United States is approximately $2,200 per eye or $4,400 for both.

Most health insurance plans do not cover LASIK surgery. Most health insurance companies deem laser eye surgery an elective procedure — meaning not medically necessary. Neither Medicare nor Medicaid pay for elective eye surgery like LASIK surgery.

Some larger vision insurance carriers offer laser vision correction benefits, including discounts on laser vision correction procedures with specific providers and frame benefits for non-prescription sunglasses after vision correction surgery. UnitedHealthcare vision insurance offers its members 35% off LASIK at over 900 locations.

Alternative Vision Correction Options

There are several alternatives to the LASIK procedure on the market, including: 

  • Photorefractive keratectomy (PRK). Like LASIK, PRK adjusts the cornea’s shape to improve vision. PRK can treat myopia, hyperopia, and astigmatism. PRK is actually considered a better laser eye surgery than LASIK for people with active lifestyles. There is no cutting a flap of the cornea during PRK, reducing the healing time and risk of post-procedure accidents. 
  • Glasses and contact lenses. The more traditional approach to vision problems is to get a prescription for glasses and/or contact lenses. While people have been doing this for decades, they often get tired of keeping up with their eyeglasses and contacts and turn to more modern approaches, like LASIK, to fix their vision.
  • Refractive Lens Exchange Surgery. During this process, an eye surgeon will remove the eye’s natural lens and replace it with an artificial intraocular lens. This procedure corrects farsightedness, nearsightedness, and astigmatism.

Common Questions and Answers

Can LASIK fail?

The risk of complications from LASIK is very low. Less than one percent of patients experience serious complications like eye infections, detached retinas, vision loss, or chronic eye pain.

Is LASIK safe?

Yes, LASIK eye surgery is considered to be safe with a very low risk of complications.

Is LASIK painful?

Numbing eye drops are placed into both of your eyes before the procedure. Therefore, LASIK is not painful.

Does LASIK last forever?

LASIK can last your entire life. However, some patients need to undergo LASIK more than once.

Is LASIK worth it over 40?

The ideal age range to get LASIK is between 19 and 40. This is when your eyes are the healthiest. If your vision is not stable enough, LASIK may not be recommended over age 40.

Resources
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Are you a Candidate for LASIK? 5 Guidelines You Should Know. (2019, November 12). https://americanrefractivesurgerycouncil.org/general-lasik-candidate-guidelines/.

Joy, K. (2017, December 13). Pros and Cons of LASIK: Are the Risks Worth the Cost? https://healthblog.uofmhealth.org/eye-health/pros-and-cons-of-lasik-are-risks-worth-cost.

Center for Devices and Radiological Health. (n.d.). LASIK. https://www.fda.gov/medical-devices/surgery-devices/lasik.

Alternative Refractive Surgery Procedures. (2018, July 16). https://www.aao.org/eye-health/treatments/refractive-surgery-alternative-procedures.

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