Is LASIK Safe?

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Is Lasik Safe Long-Term?

LASIK eye surgery can enhance your quality of life, making it more convenient and stress-free by eliminating the need for glasses or contacts.

In the Food and Drug Administration’s PROWL (Patient-Reported Outcomes with LASIK) studies, 96 to 99 percent of participants who received LASIK were satisfied with their results.

Jama Opthalmology, January 2017

The American Refractive Surgery Council states that LASIK is safe as well. This has been proven through a "huge amount of clinical research supporting its impressive record for both safety and effectiveness."

This refractive surgery makes changes to the cornea. LASIK surgery can permanently correct vision problems, including astigmatism, nearsightedness, and farsightedness. The treatment can improve vision and have a positive and long-lasting effect.

During eye surgery, LASIK surgeons use an excimer laser to reshape the cornea. This procedure eliminates refractive errors instead of correcting them like glasses and contact lenses do. 

diagram showing six steps of lasik eye surgery

The procedure is generally safe long-term. However, like with any refractive surgery, there are some potential risks. A small percentage of LASIK patients may experience side effects, but most side effects clear up within a few days to weeks.

LASIK laser eye surgery is designed to be permanent. However, aging does occur. Your eyes can change and may sometimes need secondary or enhancement surgery.

It’s essential to know that LASIK eye surgery is considered elective and cosmetic. This means that it isn’t usually considered medically necessary. 

Insurance doesn’t usually cover elective procedures like LASIK vision correction. This is mainly because the surgical procedure's visual corrections are usually achieved by wearing glasses or contacts.

Overall, LASIK eye surgery is considered safe and effective, giving patients improved vision and eye health. However, it’s essential to weigh the risks with the reward to see if you’re a good candidate for the LASIK procedure.

PRK, which stands for photorefractive keratectomy, is an alternative laser surgery technique used to improve eyesight. During PRK, your eye surgeon removes the top layer of the cornea, known as the epithelium. Your surgeon then reshapes the other layers of the cornea and fixes any unusual or irregular curvature in your eye using lasers.

LASIK Eye Surgery Success Rate

LASIK is one of the most effective and common elective surgeries available. Patient satisfaction with LASIK laser eye surgery is very high.

In 2016, the American Refractive Surgery Council published results of the annual meeting of the American Society for Cataract and Refractive Surgery. These findings showed:

  • Up to 98 percent patient satisfaction
  • Nearly 100 percent of patients achieved at least 20/40 vision
  • More than 90 percent achieving 20/20 vision
  • Less than 1 percent of patients lost two or more lines (on the eye chart) of best corrected visual acuity (BCVA)

Most people undergoing LASIK laser vision correction hope to see correctly without the help of glasses, contacts, or corrective lenses. Nearsightedness is the most commonly corrected refractive issue with LASIK. However, the treatment is most effective in those who are correcting mild myopia.

Generally, if you have reasonably good vision with only mild refractive errors before LASIK surgery, you’ll have improved vision and excellent results following the procedure.

Before LASIK surgery, it’s essential to consider what you hope to achieve with the procedure. This helps you define and meet your expectations. LASIK surgery results in a permanent change to your eyes, so you should know as much about the procedure as possible before committing to it.

Common Side Effects of LASIK 

There are some common side effects of LASIK eye surgery. These include:

  • Temporary discomfort
  • Vision disturbances
  • Light sensitivity 
  • Itchy or scratchy eyes
  • Dry eyes
  • Halos and Vision Fluctuations

Close to half of patients who receive LASIK surgery report one visual disturbance. Halos are the most common. These are bright circles surrounding a light source, resembling headlights. 

Nearly a third of patients experience dry eyes that persist for at least three months following surgery.

However, these side effects are often mild. During the first year after surgery, one percent of those who undergo LASIK report that the visual side effects require corrective lenses or prevent them from continuing with normal everyday tasks and activities.

LASIK Risks & Potential Complications 

There are various LASIK risks and potential complications. However, they are rare. Long-term LASIK complications generally result from poor aftercare, infections, or wound healing. If the eye correction is more significant, LASIK complications are more likely to occur. Likewise, the procedure and results may be less predictable.

The following are severe risk factors associated with LASIK vision correction surgery:

  • Decreased ability to see 
  • Corneal infection
  • Scarring in the cornea
  • Reduced or complete vision loss
  • Undercorrections
  • Overcorrections 
  • Glare, halos, and double vision
  • Astigmatism
  • Flap problems
  • Regression
  • Night vision problems
  • Severe dry eye syndrome
  • Diffuse lamellar keratitis 

In rare cases, vision may eventually return to previous levels. This is often due to difficulties and issues with the healing process, pregnancy, hormone imbalances, or other vision problems. 

Vision loss is another incredibly rare complication of LASK. This complication occurs in one percent of patients undergoing the procedure.

It’s essential to undergo a proper assessment before LASIK vision correction surgery to discuss the potential risk factors with your surgeon.

Diffuse Lamellar Keratitis

Diffuse lamellar keratitis (DLK) is a type of inflammation that leads to significant itching and discomfort. Between two to four percent of people who undertake LASIK experience DLK.

DLK occurs underneath the corneal flap created during LASIK. Issues may arise within around 24 hours after the surgical procedure.

People with DLK may feel as if their eyes are itching. When they visit their eye doctors or ophthalmologists, they may have an eye exam delivering unusual results. Their eyes may appear hazy and cloudy.

Without treatment, DLK can result in severe eye damage. Cells in the eye may swell, and the cornea may scar. 

To treat DLK, eye doctors or ophthalmologists use eye drops to reduce swelling, clear haze, and alleviate discomfort. After treatment, the condition resolves within five to eight days. Frequent checkups are made to ensure that patients are healing correctly.

LASIK & Dry Eye

According to the FDA PROWL study:

  • More than half of patients (59%) with dry eye symptoms before surgery reported having no symptoms of dry eye 3-months after LASIK. For those reporting residual dry eye symptoms, there were statistically significant decreases in the severity of symptoms at 3 months post LASIK
  • For those patients with no symptoms of dry eye prior to surgery, approximately 30 percent reported experiencing symptoms at 3 months after LASIK. The typical clinical experience with dry eye post LASIK is a gradual improvement of symptoms throughout the healing process, up to one year after surgery.
  • LASIK also benefitted those with visual symptoms (glare, starbursts, ghosting and halos) before surgery. More than twice the number of patients reported their pre-operative visual symptoms were gone at 3-months than those who reported an increase in symptoms at 3-months.

Is LASIK Better Than Glasses and Contacts?

Depending on the person, LASIK vision correction surgery can be an excellent alternative to glasses and contact lenses. 

In 2014, a study was presented at the American Academy of Opthalmology Meeting stating:

"LASIK significantly reduced difficulties with night driving and nighttime visual disturbances among former contact lens users and former glasses users. The proportion with dry eye symptoms at 1, 2, or 3 years after LASIK was not significantly increased relative to baseline contact lens wear but was significantly increased relative to baseline glasses use, consistent with many glasses users having tried and abandoned contact lenses because of latent dry eye problems. Compared with continued contact lens wear, LASIK significantly reduced the self-reported rates of eye infections, ulcers, and abrasions each year."

Three-Year Longitudinal Survey Comparing Visual Satisfaction with LASIK and Contact Lenses

Essentially:

  • LASIK improves your night vision, especially while driving compared to glasses and contact lenses
  • LASIK and contacts present similar risks of dry eye, while glasses typically cause less dry eye symptoms
  • LASIK reduces the rates of eye infections, ulcers, and eye abrasions
  • Compared to contacts, LASIK resulted in higher levels of satisfaction at 1,2, and 3 years at follow-up appointments

If you have healthy eyes, corneas that are not thin, and stable vision, you are a good candidate for LASIK surgery.

While there is no promise that you’ll never have to wear glasses or contact lenses following LASIK, many people who undertake the vision correction procedure don’t have to rely on vision correction devices.

Besides the convenience and lifestyle advantages, that means less money spent on glasses, contacts, and maintenance supplies.

Resources
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Eydelman, Malvina, et al. “Symptoms and Satisfaction of Patients in the PROWL Studies.” JAMA Ophthalmology, JAMA Network, 1 Jan. 2017, jamanetwork.com/journals/jamaophthalmology/fullarticle/2587831.

“Is LASIK Safe? What You Need to Know.” American Refractive Surgery Council, 1 July 2021, americanrefractivesurgerycouncil.org/lasik-safe-need-know/.

“New Research: LASIK Safety and Performance Continue To Impress.” Refractive Surgery Council, 20 May 2016, americanrefractivesurgerycouncil.org/new-research-lasik-safety-performance-continue-to-impress/.

Somani SN, Moshirfar M, Patel BC, Photorefractive Keratectomy (PRK) [Updated 2020 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan, https://www.ncbi.nlm.nih.gov/books/NBK549887/ 

When is LASIK not for me?, United States Food and Drug Administration (FDA), 2018, https://www.fda.gov/medical-devices/lasik/when-lasik-not-me 

What are the risks and how can I find the right doctor for me?, United States Food and Drug Administration (FDA), 2018, https://www.fda.gov/medical-devices/lasik/what-are-risks-and-how-can-i-find-right-doctor-me 

What is LASIK?, United States Food and Drug Administration (FDA), 2018, https://www.fda.gov/medical-devices/lasik/what-lasik 

LASIK eye surgery, MedlinePlus, September 2020, https://medlineplus.gov/ency/article/007018.htm 

The basics of LASIK eye surgery, Federal Trade Commission Consumer Information, 2012, https://www.consumer.ftc.gov/articles/0062-basics-lasik-eye-surgery

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