What Are the Pros and Cons of LASIK Surgery?

Over 20 million LASIK surgery procedures have been performed in the U.S. since the FDA approved the first excimer laser in 1998.^1-3 

LASIK (laser-assisted in situ keratomileusis) is an elective outpatient procedure. It provides laser vision correction for the following refractive errors:

• Nearsightedness (myopia)
• Farsightedness (hyperopia)
• Astigmatism (irregular-sized cornea)
• Presbyopia (age-related farsightedness)

Although most people who get LASIK attain clear vision without problems, there are some potential drawbacks.

This article covers the pros and cons of LASIK, including potential side effects, risks, and candidacy for the surgical procedure. Getting LASIK is a personal choice; you should discuss it with a qualified eye professional.

Pros of LASIK

LASIK has helped millions of people achieve a clearer vision. Here are the pros of LASIK eye surgery:

Excellent Patient Satisfaction

LASIK is one of the most successful elective procedures in the world. In studies reporting on patient satisfaction, 98.8 percent of people were satisfied with their results.⁵ 

Quick Procedure

The entire LASIK procedure should take less than 30 minutes. Each eye takes approximately 10 minutes to complete. So you’ll probably be in and out of the doctor’s office in under 2 hours.

Safe and Effective

According to the Refractive Surgery Council, there has never been a case of blindness from LASIK.³ It’s also very effective, with 99% of people achieving visual acuity of 20/40 or better.⁴ 

Fast Results

Most people experience improved vision within a few hours. Fluctuating vision is common but usually resolves itself within a couple of hours. 

Sometimes, it can last up to 48 hours. If it lasts more than a week, see your doctor.

You Might Not Need Glasses or Contact Lenses  

Over 90 percent of people achieve 20/20 vision after surgery. These people usually don’t need to wear glasses or contacts anymore.

Over 99 percent of people achieve 20/40 vision. These people may or may not need to wear contacts or glasses for reading or driving. 

Even if you don’t get perfect vision, your reliance on glasses or contacts should be decreased dramatically by LASIK.

Cons of LASIK

Like all surgeries, LASIK comes with risks and side effects. It’s up to you and your surgeon to determine whether you’re a good candidate and how you can minimize risks.

Here are some potential cons of LASIK surgery:

It’s Expensive

The cost is one of the biggest barriers preventing people from getting LASIK. The average cost of LASIK is $2,200 per eye or $4,400 for both.

Because LASIK is an elective procedure, insurance companies typically don’t cover it. Neither Medicaid nor Medicare pays for LASIK.

Side Effects Are Possible

Dry eye is the most common side effect of LASIK. About 30% of people report dry eyes 3 months after surgery. This usually improves within the first year.⁴

Other common side effects of LASIK include:

• Nighttime glare
• Halos or starbursts around lights
• Light sensitivity
• Double vision
• Blurry vision
• Decreased night vision
• Eye pain or discomfort
• A scratchy sensation in the eye

Most side effects clear up within 48 hours. If they last longer, make an appointment with your eye surgeon. They can help you manage or, if necessary, treat side effects.

Rare side effects include eye infections and vision worse than before LASIK, even while wearing glasses or contact lenses.

Risk of Corneal Flap Complications

The laser creates a small flap on your cornea during the LASIK procedure. This flap needs to heal properly to help avoid complications after the surgery.

The corneal flap can become injured or dislodged if it doesn't heal properly. It starts healing almost immediately after surgery.

However, it can take a few weeks or months for the deep layers of the cornea to heal fully. During this time, it’s important not to rub your eyes or play contact sports.

Not Everyone Is a Good LASIK Candidate

Unfortunately, not everyone is eligible for LASIK. The next section will cover who should and shouldn’t get LASIK.

Is LASIK Safe?

Many people are scared of the idea of laser eye surgery. But LASIK is a very safe refractive procedure.

An extensive amount of clinical evidence shows that LASIK surgery is safe and effective, with 98% of people satisfied with the results.⁴ However, all surgical procedures come with certain risks.

Considering the pros and cons before getting any vision correction surgery is crucial.

Who Is a Candidate for LASIK?

Here are 7 criteria that good candidates for LASIK should meet:

1. Good Eye Health

If you have any eye conditions that affect your cornea, you might not qualify for LASIK. Your surgeon will give you a thorough eye exam to determine your eligibility for LASIK. 

Any temporary eye infections, abrasions, or inflammation should be resolved before surgery.

If you don’t have any preexisting eye conditions and are in good overall health, you should qualify.

2. Your Vision Prescription Is Within Range

There are limits on the degrees of refractive errors LASIK can correct. Excimer lasers have been FDA-approved to correct approximately:

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

However, each LASIK surgeon has their own limits on what types of vision they will correct.

3. Average Corneal Thickness

LASIK requires cutting your cornea. Therefore, you need at least an average thickness to your cornea to qualify for the procedure.

People with thin corneas may be eligible for a different refractive procedure, such as PRK surgery.

4. You Are Within the Proper Age Range

You have to be at least 18 to get LASIK. However, it’s best to wait until at least your mid-20s. There is no upper age limit for LASIK. 

The average age range to get LASIK is approximately 20 to 40. Speak with your eye doctor to confirm whether you qualify.

5. Stable Vision

You should have stable vision for at least 1 to 2 years before getting LASIK. This reduces your chance of vision regression.

6. Your Pupils Are Not Too Large

Previously, doctors linked large pupils to additional side effects. However, with modern technologies, pupil size might not matter.

7. Realistic Expectations

LASIK success rates are very high, but expecting perfect vision may not be realistic. Your surgeon cannot perfectly predict how your eyes will heal after surgery.

You might need to continue wearing glasses after surgery, especially for reading or night driving. 

Who Isn’t a Candidate for LASIK? 

Here are 6 criteria that probably disqualify you for LASIK:

1. Pregnancy or Nursing

Fluctuating vision is common during pregnancy. Also, medications for LASIK might not be safe for babies. It’s best to get LASIK before pregnancy or after breastfeeding.

2. General Health Problems

People with certain medical conditions, such as autoimmune or immunodeficiency diseases and diabetes, are at higher risk for healing complications.

3. Cataracts

LASIK is usually not recommended for anyone with cataracts. Your eye doctor may recommend cataract surgery instead, which will correct your vision and remove your cataract simultaneously.

4. High-Impact Activities

If you play contact sports, LASIK might not be a great option. Speak with your doctor about possible outcomes.

5. Medications 

Certain drugs are not safe to use before or after LASIK. These include:

• Immunosuppressants 
• Anti-inflammatories that can affect the healing process
• Steroids
• Isotretinoin (Accutane)
• Amiodarone

Your eye surgeon will tell you how long you must discontinue the medications before surgery. 

6. Previous Eye Injury or Surgery

Previous eye injuries or surgeries can increase your risk for LASIK complications. Be sure to give the eye surgeon your complete health history.

Summary

LASIK is a popular and well-established laser vision correction procedure. It’s helped many people achieve clear vision and is considered one of the most successful elective surgeries.

However, LASIK surgery involves potential risks and side effects. Dry eyes and temporary vision problems are common. There’s also a risk of corneal flap complications.

Additionally, not everyone is a candidate for LASIK surgery. Talk to your eye surgeon about the risks and benefits of the procedure to help decide if it’s right for you.