LASIK (Laser-Assisted In Situ Keratomileusis) is a widely performed surgical procedure that corrects common vision problems, often freeing individuals from glasses or contact lenses. A frequent question concerns its long-term effectiveness and whether its benefits remain throughout one’s life. Understanding LASIK’s durability helps set realistic expectations for those considering the procedure.
How Permanent is LASIK Vision Correction?
LASIK surgery permanently reshapes the cornea, the clear front part of the eye, to correct refractive errors like nearsightedness, farsightedness, and astigmatism. This permanent alteration provides stable, long-term vision correction for the vast majority of patients. Studies indicate many experience sustained improvements in vision, with high satisfaction rates extending for decades. For instance, a twenty-year analysis found LASIK maintained high safety and effectiveness, with patients reporting greater independence from glasses and contacts even two decades after surgery.
However, LASIK does not stop the natural aging process of the eye. While corneal reshaping is permanent, the eye can undergo other changes over time that may affect vision. These changes are typically unrelated to the LASIK procedure itself but are a normal part of aging.
Why Vision Might Change After LASIK
Even after successful LASIK, vision may change years later due to factors unrelated to the initial corneal reshaping. One common reason is the natural aging process, particularly the development of presbyopia. Presbyopia, often noticed around age 40, is the gradual loss of the eye’s ability to focus on close objects, like reading material. This occurs because the eye’s natural lens stiffens and loses flexibility, a process LASIK does not prevent as it reshapes the cornea, not the lens.
Vision changes can also result from the progression of the original refractive error, especially in individuals with higher prescriptions before surgery. Myopia (nearsightedness) can continue to worsen over time, a phenomenon known as myopic regression. This regression can occur if the cornea gradually shifts back towards its original shape, or if the eye itself undergoes changes in length. Studies show myopic regression can manifest years after initial surgery, with some patients experiencing a change of about -0.11 diopters per year over 15 years.
Less commonly, initial under-correction or over-correction during LASIK can lead to vision changes. Undercorrection occurs when too little corneal tissue is removed, leaving residual refractive error, more frequent in nearsighted patients. Overcorrection occurs when too much tissue is removed, potentially causing farsightedness in a previously nearsighted eye or making a farsighted eye more nearsighted. While modern LASIK technologies minimize these risks, they can still occur, and the eye’s unique healing response can contribute to these outcomes. Other factors like dry eye syndrome, hormonal changes, or underlying eye conditions can also influence vision stability post-LASIK.
Considering LASIK Retreatment
If vision changes occur after initial LASIK, retreatment or enhancement may be an option to restore optimal clarity. This is not a complete “redo” of the original surgery but rather a fine-tuning to address new or residual refractive errors. Retreatment involves lifting the previously created corneal flap or creating a new one, then using the laser to reshape the cornea further.
Candidacy for retreatment depends on several factors, including the amount of corneal tissue remaining after the initial surgery and the overall health of the eye. Adequate corneal thickness is essential to ensure the safety and effectiveness of the enhancement procedure. Evaluation typically includes a comprehensive eye exam to determine the vision change and assess corneal thickness and eye stability.
While retreatment is generally safe and can achieve good outcomes, it carries similar considerations to the initial LASIK procedure, such as potential for dry eyes or glare. The decision to undergo retreatment is made in consultation with an eye care professional who can assess individual circumstances and discuss the potential benefits and considerations. For many, an enhancement can successfully restore desired vision without glasses or contacts.
Alternative Vision Correction Solutions
For individuals whose vision has changed after LASIK and who are not suitable candidates for retreatment, other vision correction options are available. One alternative is Photorefractive Keratectomy (PRK), which involves reshaping the cornea’s surface without creating a flap, making it a viable option if corneal tissue is insufficient for LASIK retreatment. Another advanced solution is the implantation of collamer lenses (ICL), small, flexible lenses surgically placed inside the eye to correct refractive errors. This option does not involve corneal tissue removal and can be particularly beneficial for those with higher prescriptions or thin corneas.
Beyond surgical interventions, traditional vision aids like glasses or contact lenses remain common and effective solutions. For age-related presbyopia, options include reading glasses, bifocals, or multifocal contact lenses. These non-surgical methods provide flexible and immediate correction for near vision difficulties. Consulting an eye care professional can help determine the most appropriate and personalized solution based on specific vision needs and eye health.