LASIK surgery: Is it right for you? Show
LASIK eye surgery may mean no more corrective lenses. But it's not right for everybody. Learn whether you're a good candidate and what to consider as you weigh your decision. By Mayo Clinic StaffIf you're tired of wearing eyeglasses or contact lenses, you may wonder whether LASIK surgery is right for you. LASIK is a type of refractive eye surgery. In general, most people who have laser-assisted in situ keratomileusis (LASIK) eye surgery achieve 20/20 vision or better, which works well for most activities. But most people still eventually need glasses for driving at night or reading as they get older. LASIK surgery has a good track record. Complications that result in a loss of vision are rare, and most people are satisfied with the results. Certain side effects, particularly dry eyes and temporary visual disturbances (such as glare), are fairly common. But these usually clear up after a few weeks or months, and very few people consider them to be a long-term problem. Your results depend on your refractive error and other factors. People with mild nearsightedness tend to have the most success with refractive surgery. People with a high degree of nearsightedness or farsightedness along with astigmatism have less-predictable results. Read on to learn more about what to consider as you decide whether this surgery is right for you. What does LASIK eye surgery involve?There are several variations of laser refractive surgery. LASIK is the best known and most commonly performed. Many articles, including this one, will use the term "LASIK" to refer to all types of laser eye surgery. Typically, images are focused on the retina in the back of the eye. With nearsightedness, farsightedness or astigmatism, they end up being focused either in front of or behind the retina, resulting in blurred vision.
Traditionally, blurry vision is corrected by bending (refracting) light rays with glasses or contact lenses. But reshaping the cornea (the dome-shaped transparent tissue at the front of your eye) itself also can provide the necessary refraction and vision correction. Before a LASIK procedure, your eye surgeon will assess detailed measurements of your eye and assess the overall health of the eye. You may be instructed to take a mild sedative medication just prior to the procedure. After you are lying comfortably on an operating table, eye-numbing drops will be administered. Then he or she will use a special type of cutting laser to precisely alter the curvature of your cornea. With each pulse of the laser beam, a tiny amount of corneal tissue is removed, allowing your eye surgeon to flatten the curve of your cornea or make it steeper. Most commonly, the surgeon creates a flap in the cornea and then raises it up before reshaping the cornea. There are also variations in which a very thin flap is raised or no flap is used at all or no flap at all, is raised. Each technique has advantages and disadvantages. Individual eye surgeons may specialize in specific types of laser eye procedures. The differences among them are generally minor, and none are clearly better than any others. Depending on your individual circumstances and preferences, you may consider:
It was thought that these drawbacks were outweighed by the theoretical advantage that PRK was safer for people who are more likely to be struck in the eye — for example, those involved in contact sports, law enforcement or the military. But even with standard LASIK, the risk of eyeball rupture is still very low, so there is probably no significant advantage with PRK. LASIK is also a better option than PRK for correcting more severe nearsightedness (myopia). Are your eyes healthy?In general, laser eye surgery is most appropriate for people who have a moderate degree of refractive error and no unusual vision problems. Your eye surgeon will ask detailed questions about your eye health and evaluate your eyes to make sure you don't have any conditions that might result in complications or poor outcomes of surgery. These include:
You might also rethink having LASIK surgery if:
Are you healthy?Your eye surgeon will also ask detailed questions about your general health. Certain medical conditions, unrelated to your eyes, can increase the risks associated with LASIK surgery or make the outcome less predictable. These include:
Is your vision stable?If you have myopia, your vision may continue to change throughout your teenage years, or even longer, requiring periodic changes in the prescription of your glasses or contact lenses. Therefore, people should be over age 18, and preferably older, before considering LASIK eye surgery. Certain conditions and medications — pregnancy, breastfeeding, steroid drugs — may cause temporary fluctuations in your vision. Wait until your vision has stabilized before considering LASIK eye surgery. Can you afford it?Most insurance plans consider laser eye surgery to be an elective procedure and don't cover the cost. Know what the surgery will cost you. Do you understand possible side effects and complications?While complications that result in a loss of vision are rare, certain side effects, particularly dry eyes and temporary visual disturbances, are fairly common. But these usually resolve after a few weeks or months, and very few people consider them to be a long-term problem.
LASIK versus reading glassesBy their early to mid-40s, all adults lose some ability to focus on nearby objects (presbyopia), which results in difficulty reading small print or doing close-up tasks. One possible benefit of having been nearsighted most of your life is that this condition actually compensates for the presbyopia that inevitability develops as you get older. A nearsighted eye will focus near objects by itself without reading glasses. LASIK surgery removes this near focus because the nearsightedness has been corrected. This means that as you get older you will need to use reading glasses. Many people are happy to trade clear distance vision when they are younger for having to wear "cheaters" for reading when they are older. If you are an older adult considering LASIK, you might choose to have monovision to maintain your ability to see objects close up. With monovision, one eye is corrected for distant vision, and the other eye is corrected for near vision. Not everyone is able to adjust to or tolerate monovision. It's best to do a trial with contact lenses before having a permanent surgical procedure. Can you go without your contact lenses for several weeks before surgery?This is usually not an issue, but know that you'll have to completely stop wearing your contact lenses and switch to glasses for at least a few weeks before your surgery. Contact lenses distort the natural shape of your cornea, which can lead to inaccurate measurements and a less than optimal surgical outcome. Your doctor will provide specific guidelines depending on your situation and how long you've been a contact lens wearer. What are your expectations for LASIK?Most people who undergo LASIK surgery will have good to excellent vision in most situations, for many years or decades. You'll be able to play sports and swim, or even just see the clock first thing in the morning, without having to worry about your glasses or contact lenses. But as you get older or in low-light conditions, you may still need to wear glasses. Most people report high satisfaction after LASIK surgery. But long-term results often aren't available or haven't been well studied. Part of the reason for this is that people are overall satisfied after surgery, so they don't feel a need for repeat examinations and follow-up data is not collected. Also, the LASIK procedure has been refined over time — the techniques and technology is continually changing. This makes it difficult to draw conclusions from the data that is reported. Keep in mind that even when postoperative follow-up is done and reported, vision is measured under optimal testing conditions. Your vision in dim light (such as at dusk or in fog) may not be as good as published reports suggest it will be. Over time, your refraction may slowly worsen with age and your vision may not be quite as good as it was immediately after surgery. This does not seem to be a large problem, but the exact degree of change to be expected is sometimes unpredictable. How do you choose an eye surgeon?Most people don't have firsthand knowledge about LASIK or an eye surgeon. A good starting point when choosing an eye surgeon is to talk with the eye professional you know and trust. Or ask friends or family members who have had successful LASIK. Your eye surgeon will probably work with a team, who may help with your initial evaluation and measurements. But it is your surgeon who takes the ultimate responsibility for determining whether LASIK is an appropriate choice for you, who confirms the measurements to guide the procedure, who performs the procedure and who provides postoperative care. Talk with your eye surgeon about your questions and concerns and how LASIK will benefit you. He or she can help you understand the benefits and limitations of surgery. The final decisionWhen it comes to LASIK eye surgery, there are no right answers. Carefully consider the factors outlined here, weigh your preferences and risk tolerance, and make sure you have realistic expectations. Talk to an eye surgeon in whom you feel confident and get your questions answered. In the end, if it feels right, then proceed, but if it doesn't, don't rush into anything. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing
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. Is laser eye surgery worth it if you have astigmatism?So, does LASIK work for astigmatism? The answer is usually yes. LASIK is successful in treating most people's astigmatism, as long as it's the right type and it falls within the treatment limits. With the technology used in our practice, we are typically able to treat patients who have high levels of astigmatism.
Does laser eye surgery permanently fix astigmatism?In a word: yes! If you're tired of blurry vision and relying on glasses or contact lenses to stop it, laser eye surgery for astigmatism offers a great and more permanent solution. Laser eye surgery for astigmatism is slightly more complicated than treating myopia or hyperopia, however.
What is the downside of laser eye surgery?Complications that result in a loss of vision are very rare. But certain side effects of LASIK eye surgery, particularly dry eyes and temporary visual problems such as glare, are fairly common. These usually clear up after a few weeks or months, and very few people consider them to be a long-term problem.
Can astigmatism get worse after LASIK?It is unusual to see an increase in corneal astigmatism after laser vision correction. Similar to myopic patients, a patient who has significant with-the-rule astigmatism prior to surgery can develop with-the-rule astigmatism after surgery. Oblique astigmatism cases are more worrisome.
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