Evidence Based

How Long Does LASIK Last?

LASIK is a procedure that treats vision conditions such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. One of the most common concerns people have regarding LASIK is how long the results last.

Contrary to popular belief, the effects of LASIK are permanent. During the procedure, the laser reshapes your cornea by removing some corneal tissue. After surgery, this tissue does not grow back. However, your vision may continue to change for other reasons. 

Vision Changes After LASIK

There are several factors to consider before deciding on LASIK surgery. These things can affect how long you retain clear vision post-LASIK.

Refractive Error

The focusing power of your eye comes from your cornea and lens. The cornea is responsible for two-thirds of your focusing power, while the lens comprises about a third. If your focusing power is inaccurate, this results in refractive errors.

graphic comparing normal vision, myopia refractive error, and hyperopia refractive error

For example, if you have a myopic refractive error, your eye’s focusing power is too strong. If you have hyperopia, your eye is under focused. 

LASIK alters the focusing power of your cornea to correct your refractive error. However, the focusing power of your lens can still change over time. When this happens, your vision may worsen post-LASIK. This is called regression. Even if you regress, it is unlikely that your vision returns to its pre-LASIK state.

Studies show that only 1 to 2 percent of patients regress enough to require an enhancement procedure in the first year after LASIK. After ten years, about 10 percent of patients need enhancement to restore their vision. 

Additionally, the higher your refractive error is pre-LASIK, the more likely you are to regress. This is particularly true for people with highly nearsighted corrections.

Age

Age is another important consideration for LASIK. Typically, your vision stabilizes in your mid-20s. If you receive LASIK before your vision is stable for at least a year, you have a higher chance of regression.

As we get older, many age-related changes in the eye take place. Around age 40, most people start to notice difficulties seeing up close. This process, called presbyopia, continues until about age 60. LASIK cannot prevent presbyopia from progressing. 

While LASIK does correct vision in people approaching their 40s, they should keep in mind that they will need reading glasses once presbyopia begins. Although this is not a form of regression, presbyopia causes continual changes in the vision after LASIK. 

A common side effect of LASIK is dryness. The frequency of dry eye also increases with age, particularly in menopausal or post-menopausal women. Dry eye complications can affect the overall quality of vision, which may emphasize symptoms of blurred vision related to regression.

Cataracts

Cataracts are another age-related change that affects almost everyone over the age of 60. Although there is no age limit on LASIK, older patients should consider potential vision changes due to cataracts.

cataracts scaled e1598035826129

Cataracts develop in the lens of your eye, not the cornea, so LASIK does not affect cataracts. If you develop cataracts after receiving LASIK and your vision worsens, there is a chance you also need to have cataract surgery.

One benefit of cataract surgery is that it can correct your vision. During the procedure, the surgeon places an artificial lens implant into your eye. This implant corrects your vision so that you may not need to wear glasses after surgery. 

Some people who have mild cataracts choose not to have LASIK, knowing they may need cataract surgery in the near future. This way, only one operation is necessary, as opposed to two.

Does One Type Of LASIK Last Longer Than Others?

There are two ways the surgeon can create a corneal flap during LASIK. One method uses a femtosecond laser, which is known as bladeless LASIK. The traditional method uses a surgical blade called a microkeratome. Both ways are safe and effective, delivering excellent visual results.

However, some studies have concluded that in the first year after surgery, bladeless LASIK carries a lower risk for regression versus bladed LASIK.

What Can I Do If My LASIK Results Don’t Last?

An enhancement is a second LASIK procedure that can be performed if your vision worsens after the first treatment. The enhancement can be done several months after LASIK, or several years later. 

Not everyone is eligible for an enhancement. For example, if your corneas are too thin, the surgeon may feel it is too risky to perform another LASIK procedure. 

In some cases, the surgeon performs PRK (photorefractive keratectomy) instead of LASIK for the enhancement procedure. PRK does not require lifting the corneal flap, which may reduce your risk for certain complications. 

If your near vision worsens due to presbyopia, your surgeon can perform a procedure called monovision LASIK. If your distance vision is still good, the surgeon may only need to correct one eye for reading, usually your non-dominant eye. 

After the surgery, you will use one eye to see far, and the other eye to read up close. Some people have trouble adapting to monovision, so you can ask your doctor to test this method out with contact lenses before you commit to LASIK.

Author: Melody Huang, O.D. | UPDATED June 24, 2020
Resources

Alió, Jorge L., et al. “Laser in Situ Keratomileusis for −6.00 to −18.00 Diopters of Myopia and up to −5.00 Diopters of Astigmatism: 15-Year Follow-Up.” Journal of Cataract & Refractive Surgery, vol. 41, no. 1, 2015, pp. 33–40., doi:10.1016/j.jcrs.2014.08.029

El-Naggar, Mohamed Tarek, and Dikran Gilbert Hovaghimian. “Assessment of refractive outcome of femtosecond-assisted LASIK for hyperopia correction.” Electronic Physician, vol. 9, no. 3, Mar. 2017, pp. 3958-3965., doi:10.19082/3958

Garcia-Gonzalez, Montserrat, et al. “Effect of age on visual and refractive results after LASIK: mechanical microkeratome versus femtosecond laser.” International Journal of Ophthalmology, vol. 12, no. 3, Mar. 2019, pp. 488-495., doi:10.18240/ijo.2019.03.21

Lim, Sung A, et al. “Factors Affecting Long-Term Myopic Regression after Laser In Situ Keratomileusis and Laser-Assisted Subepithelial Keratectomy for Moderate Myopia.” Korean Journal of Ophthalmology, vol. 30, no. 2, Mar. 2016, pp. 92–100., doi:10.3341/kjo.2016.30.2.92.

Lin, Meng-Yin, et al. “Cox Proportional Hazards Model of Myopic Regression for Laser in Situ Keratomileusis Flap Creation with a Femtosecond Laser and with a Mechanical Microkeratome.” Journal of Cataract & Refractive Surgery, vol. 38, no. 6, Jun. 2012, pp. 992–999., doi:10.1016/j.jcrs.2012.01.025

Zhou, Jihong, et al. “Predictors Affecting Myopic Regression in − 6.0D to − 10.0D Myopia after Laser-Assisted Subepithelial Keratomileusis and Laser in Situ Keratomileusis Flap Creation with Femtosecond Laser-Assisted or Mechanical Microkeratome-Assisted.” International Ophthalmology, vol. 40, no. 1, Sept. 2019, pp. 213–225., doi:10.1007/s10792-019-01179-5

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