LASIK (Laser-Assisted In Situ Keratomileusis) corrects common vision issues like nearsightedness, farsightedness, and astigmatism. Many people consider the surgery a permanent fix, but years later, their vision may change again. Understanding the long-term effectiveness requires knowing what part of the eye LASIK changes and how the eyes continue to age regardless of surgery.
How LASIK Works to Correct Vision
LASIK corrects refractive errors by altering the shape of the eye’s primary focusing surface. These errors occur when the eye’s shape prevents light from focusing directly on the retina, causing blurred vision. The procedure uses a precise excimer laser to reshape the clear, dome-shaped tissue at the front of the eye.
The process begins by creating a thin flap on this outer tissue using a specialized laser. The surgeon lifts the flap to access the underlying tissue. The excimer laser then applies controlled pulses of energy to remove microscopic amounts of tissue, carefully sculpting the surface curvature.
This ablation changes the way light enters the eye, allowing it to focus correctly onto the retina. Once the reshaping is complete, the surgeon repositions the flap, which naturally adheres without the need for stitches.
The Longevity of the Corneal Change
The structural change made during the LASIK procedure is permanent. The tissue removed by the laser, which determines the new, corrected shape of the outer surface, does not regenerate or grow back. This means the correction of the original refractive error is a lasting alteration to the eye’s anatomy.
However, a small percentage of patients may experience regression, a slight return of their original vision problem. This shift is typically minor and often occurs within the first year as the eye completes its natural healing. Regression is not a failure of the permanent correction but rather a subtle biological response to the procedure. For the vast majority of patients, the new curvature remains stable for decades.
Natural Vision Changes After Surgery
Vision changes that occur years after LASIK are due to the natural aging process, which the surgery does not prevent. The most common age-related change is presbyopia, which typically begins to affect people around age 40. This condition makes it difficult to focus on objects up close, sometimes called age-related farsightedness.
Presbyopia happens when the eye’s natural lens, located behind the iris, becomes less flexible and harder over time. Because LASIK only changes the outer surface of the eye, it cannot halt this internal hardening of the lens. Patients who had excellent distance vision after LASIK may still require reading glasses for near tasks later in life.
Another common age-related issue is the development of cataracts, which involves the clouding of the natural lens. Cataracts are an inevitable part of aging that occurs regardless of whether a person has had LASIK. This clouding causes progressive blurring, glare, and faded color perception.
Addressing Post-LASIK Vision Decline
If vision declines significantly in the years following the procedure, patients have several options depending on the cause. For the small number of people who experience true regression, an enhancement procedure is often an option. This involves lifting the existing flap and using the laser to apply a minor, secondary correction to fine-tune the result.
For those experiencing presbyopia, the most straightforward solution is the use of reading glasses. Alternatively, patients may opt for multifocal contact lenses or a surgical approach called a refractive lens exchange, which replaces the stiff natural lens.
LASIK does not complicate or prevent the future need for cataract surgery. This is a common procedure that replaces the cloudy lens with an artificial one to restore clarity.