Whether LASIK “wears off” is a common concern for people considering laser vision correction. LASIK (Laser-Assisted In Situ Keratomileusis) reshapes the cornea to correct common vision problems like nearsightedness, farsightedness, and astigmatism. The correction itself is permanent. However, the human eye is a living organ that naturally changes over a lifetime, independent of the surgery. This distinction often causes confusion when new visual changes develop years after a successful procedure.
The Permanent Nature of the Procedure
LASIK provides a permanent solution for the original refractive error by altering the physical structure of the eye’s front surface. The procedure uses an excimer laser to precisely remove microscopic amounts of tissue from the corneal stroma, a process known as ablation. This reshaping changes how light is focused onto the retina, correcting the original vision problem. Once this corneal tissue is removed, it does not grow back. Therefore, the correction for the initial prescription is fixed indefinitely, and the results of the LASIK procedure itself cannot “wear off.” Surgeons require a patient’s prescription to be stable for at least one year before surgery due to the permanence of this structural change.
Understanding Vision Changes Over Time
The most common reason people perceive that their LASIK has failed is the natural aging of the eye. This process continues regardless of surgery. LASIK corrects the cornea, but it does not stop other parts of the eye from aging, meaning these changes are separate from the original surgical outcome.
Presbyopia
Presbyopia is the gradual loss of near-focusing ability that typically begins around age 40. This occurs because the eye’s natural lens, located behind the iris, becomes less flexible and stiffer over time. Since LASIK only affects the cornea, it cannot prevent this change. Most people who have had LASIK will eventually need reading glasses for close-up tasks.
Cataracts
Another age-related condition is the formation of cataracts, which involves the progressive clouding of the internal lens. Cataracts are a universal part of aging, usually developing later in life, causing vision to become hazy or blurred. If a cataract develops years after LASIK, it requires a separate procedure to replace the cloudy lens, not a re-treatment of the cornea.
Regression and the Need for Enhancements
While the procedure is permanent, a small number of patients may experience regression. Regression is a slight return of the original refractive error, such as mild nearsightedness, occurring after the initial healing period. This is not the procedure wearing off, but the eye’s natural healing response subtly altering the surgically corrected shape.
This shift is usually due to the corneal epithelium, the outermost layer, undergoing remodeling or thickening over the treated area. This cellular response reduces the initial correction and is more likely in patients who had a very high initial prescription. Regression is typically minor and often stabilizes within the first year post-surgery. If the regression is significant enough to interfere with vision, an enhancement procedure may be recommended. This is a second, minor LASIK surgery performed to restore the vision to the intended target. Only about five percent of patients may require an enhancement, distinguishing this possibility from the inevitable age-related changes that affect everyone.