LASIK, or Laser-Assisted In Situ Keratomileusis, is a widely sought-after procedure for vision correction, allowing many individuals to reduce their reliance on glasses or contact lenses. Over 10 million people in the U.S. have undergone laser vision surgery since its FDA approval, with nearly 800,000 procedures performed annually. This elective surgery offers a path to clearer sight, prompting a common inquiry: does LASIK provide a permanent solution for vision problems?
How LASIK Works to Correct Vision
LASIK permanently changes the shape of the cornea, the clear, dome-shaped front surface of the eye, using precise lasers to correct common refractive errors like myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. During the procedure, a femtosecond laser creates a thin, hinged flap on the corneal surface. This flap is lifted to expose underlying tissue, which an excimer laser precisely reshapes. After reshaping, the flap is repositioned, typically healing without stitches. This lasting alteration allows light to focus more accurately on the retina for improved vision.
Factors Affecting Vision After LASIK
While the corneal reshaping from LASIK is permanent, a person’s vision can still change over time due to natural biological processes unrelated to the surgery itself. One common change is presbyopia, age-related farsightedness that typically becomes noticeable around age 40. This condition affects the eye’s natural lens, making it harder to focus on close-up objects. LASIK does not prevent its development, as the decreasing flexibility of the eye’s natural lens is distinct from the corneal correction.
Vision can also be affected by the progression of certain underlying conditions. For instance, if myopia was still advancing before the procedure, it might continue to do so afterward, potentially leading to a slight return of nearsightedness. New eye conditions can also develop as part of the natural aging process or due to other health factors. Cataracts, which involve clouding of the eye’s natural lens, and glaucoma, a condition that damages the optic nerve, are examples of eye diseases that can occur regardless of previous LASIK surgery. These occurrences do not indicate a “failure” of the LASIK procedure itself, but rather represent typical changes or new conditions that affect the eyes over a lifetime.
Understanding Vision Changes After LASIK
If vision changes occur after LASIK, various options are available to address them, including a “LASIK enhancement” or “touch-up” procedure. This secondary procedure may be considered if there is residual refractive error or a slight regression in vision over time. During an enhancement, the surgeon typically re-lifts the original corneal flap created during the initial LASIK surgery and uses a laser to perform a minor reshaping. This process is generally quick and involves minimal additional tissue removal.
Enhancements are relatively uncommon, with studies indicating that only about 0.7% to 5% of LASIK patients require a second procedure to fine-tune their vision. For some, alternative solutions like glasses or contact lenses might be more suitable, particularly for age-related changes such as presbyopia. Specialized rigid gas permeable (GP) or scleral contact lenses are often preferred after LASIK due to changes in corneal shape. Patients can also explore options like monovision LASIK or refractive lens exchange (RLE) to address presbyopia if an enhancement is not ideal.
Maintaining Healthy Vision Post-LASIK
Maintaining overall eye health after LASIK is important for long-term visual stability, similar to general health practices for everyone. Regular comprehensive eye exams are recommended, even after achieving clear vision without corrective lenses. These annual check-ups allow eye care professionals to monitor eye health, detect any new conditions like cataracts or glaucoma early, and address issues such as dry eye syndrome.
Protecting the eyes from harmful ultraviolet (UV) light by wearing sunglasses that block 100% of UV rays helps prevent potential damage. Managing screen time and digital eye strain is also beneficial, especially since temporary dryness and sensitivity can occur after LASIK. Applying artificial tears, adhering to the 20-20-20 rule (looking 20 feet away for 20 seconds every 20 minutes), and optimizing screen settings can help alleviate discomfort. A healthy lifestyle, including a balanced diet and adequate hydration, further supports eye health and can contribute to maintaining good vision.