LASIK, or Laser-Assisted In Situ Keratomileusis, is a popular procedure for correcting vision, helping many reduce or eliminate their reliance on glasses or contact lenses. Individuals with diabetes often inquire about their suitability for this elective surgery. While a diabetes diagnosis introduces specific considerations, it does not automatically exclude someone from undergoing LASIK. Careful evaluation of overall health and eye condition is necessary.
How Diabetes Affects Eye Health
Diabetes can impact eye health due to its effects on blood vessels. Elevated blood sugar levels can damage the tiny blood vessels in the retina, leading to diabetic retinopathy. This damage can cause vessels to leak fluid or prompt the growth of abnormal new blood vessels, potentially blurring vision or causing dark spots.
Beyond retinopathy, diabetes can contribute to fluctuating vision. Changes in blood sugar levels temporarily alter the shape of the eye’s lens, leading to blurry sight that resolves once glucose levels stabilize. Individuals with diabetes also face an increased risk of developing cataracts earlier, which cloud the eye’s natural lens. Dry eyes are a common concern, as diabetes can reduce tear production or impair the eye’s ability to retain moisture.
LASIK Eligibility for Diabetics
For individuals with diabetes to be considered for LASIK, maintaining stable blood sugar levels is a primary factor. Ophthalmologists require a documented history of stable blood glucose and A1C levels, often recommending an A1C below 5.7% over a three to four-month period. This stability is important because uncontrolled diabetes can lead to unpredictable changes in vision, which could affect the accuracy of the LASIK procedure.
The absence of active or advanced diabetic eye complications is also a prerequisite for LASIK candidacy. This includes having no signs of advanced diabetic retinopathy or significant diabetic eye complications like severe dry eye or glaucoma that is not well-controlled. A comprehensive pre-operative eye examination assesses corneal health, thickness, and curvature, along with a review of the patient’s medical history. Both Type 1 and Type 2 diabetes are considered, with the overarching factor being the overall control of the condition and its impact on ocular health.
Potential Risks of LASIK for Diabetics
Even when diabetic patients meet the eligibility criteria, they may face increased risks and potential complications following LASIK. One concern is delayed corneal healing, as diabetes can slow the body’s natural wound healing processes. This can result in longer recovery times and a more gradual stabilization of vision after the surgery.
Diabetic patients may also have a heightened susceptibility to infection due to a reduced immune response, which could increase the risk of post-LASIK infections. Fluctuating blood sugar levels can lead to less predictable visual outcomes, as even stable diabetes can sometimes cause subtle shifts in prescription. Pre-existing dry eye, common in diabetic individuals, can be exacerbated by LASIK, potentially requiring increased application of lubricating eye drops.
Other Vision Correction Options
For individuals with diabetes who are not suitable candidates for LASIK, several other vision correction methods are available. Photorefractive Keratectomy (PRK) is a surface ablation procedure that reshapes the cornea without creating a flap. It might be considered if concerns about corneal healing are present. However, PRK can involve a longer healing period and a higher risk of corneal haze for diabetic patients compared to LASIK.
Phakic IOLs, or Implantable Collamer Lenses, offer another alternative, particularly for those with very high prescriptions or contraindications to laser surgery. These lenses are surgically implanted inside the eye, in front of the natural lens, providing permanent vision correction. For many, the continued use of eyeglasses and contact lenses remains a safe and reliable method for correcting refractive errors, especially when surgical options are not advised or preferred.