LASIK eye surgery is a widely recognized elective procedure designed to correct vision problems. It reshapes the cornea, the clear front part of the eye, to improve how light focuses on the retina. Many individuals consider LASIK to reduce their reliance on glasses or contact lenses.
Baseline Requirements for LASIK
Several fundamental requirements apply to almost all LASIK candidates. Individuals need to be at least 18 years old, as vision can continue to change during adolescence. A stable vision prescription is also necessary, meaning no significant changes in glasses or contact lens prescriptions for at least one to two years.
Beyond age and prescription stability, good general eye health is important, free from active eye infections, inflammation, or other serious conditions that could interfere with healing or the surgical outcome. Candidates should also have realistic expectations about potential outcomes.
Refractive Error Limits and Corneal Health
For nearsightedness (myopia), LASIK can correct prescriptions up to -10.00 to -12.00 diopters (D), though some advanced techniques might push this range. Farsightedness (hyperopia) generally corrects up to +4.00 to +6.00 D, with higher levels often leading to less predictable results. Astigmatism, which involves an irregularly shaped cornea, can be treated up to approximately 6.00 D, with effectiveness depending on the specific corneal shape.
A minimum corneal thickness is crucial for safe LASIK. The procedure involves creating a thin flap and removing underlying tissue, so sufficient corneal material must remain to ensure the eye’s stability after surgery. Corneal thickness is precisely measured during the evaluation process. Significant corneal irregularities, such as unusual shapes or asymmetry not linked to a specific disease, can also make a person unsuitable because the laser treatment relies on a predictable and uniform corneal surface for accurate reshaping.
Pre-existing Eye Conditions That Disqualify
Certain pre-existing eye diseases and chronic conditions can disqualify individuals from LASIK, regardless of their prescription. Keratoconus, a progressive thinning and bulging of the cornea, is a contraindication because LASIK can further weaken it. Severe dry eye syndrome is another common disqualifier, as LASIK can exacerbate dryness, potentially leading to discomfort and vision issues after surgery.
Glaucoma, particularly advanced or uncontrolled cases, can be a contraindication due to concerns about intraocular pressure changes and overall corneal health. Individuals with significant cataracts are not candidates, as LASIK cannot correct the clouding of the eye’s natural lens; lens replacement surgery is more appropriate. Retinal diseases, such as advanced diabetic retinopathy or macular degeneration, or a history of retinal detachment, may affect candidacy. Any active eye infections, like herpes simplex keratitis, or chronic inflammation, such as uveitis, must be fully resolved before LASIK can be considered to prevent complications.
Systemic Health and Other Disqualifiers
Overall systemic health can influence LASIK eligibility. Autoimmune diseases, including rheumatoid arthritis, lupus, or Sjögren’s syndrome, can impair the body’s healing response and increase the risk of complications after surgery. These conditions may lead to unpredictable healing or severe dry eye symptoms, making LASIK less safe. Immunocompromised states, whether due to conditions like HIV or long-term use of medications such as steroids, can hinder proper healing.
Pregnancy and nursing are typically temporary disqualifiers due to hormonal fluctuations that can affect vision stability and corneal shape. It is recommended to wait several months after breastfeeding ceases for hormones to stabilize. Certain medications, including isotretinoin (used for acne) or amiodarone, can also impact corneal healing or cause severe dry eye, making LASIK risky. Uncontrolled diabetes can affect eye health and the body’s ability to heal properly, though well-controlled diabetes may allow for candidacy after careful assessment.
Options When LASIK Isn’t Possible
Several other vision correction options exist. Photorefractive Keratectomy (PRK) is a surface-based laser procedure that can be an alternative for those with thinner corneas or other mild contraindications. Variations like LASEK and Epi-LASIK are also available, similar to PRK in their approach to reshaping the corneal surface.
Implantable Collamer Lenses (ICL) offer a solution for very high prescriptions or thin corneas, where a small, permanent lens is placed inside the eye. Refractive Lens Exchange (RLE) is another option, particularly for older patients or those with early cataracts, involving the replacement of the eye’s natural lens with an artificial one. For many, traditional glasses and contact lenses remain reliable and effective non-surgical methods for vision correction. A thorough eye examination and consultation with an eye surgeon are the most effective ways to determine the best course of action for individual vision needs.