Laser eye surgery (LASIK, PRK, SMILE) offers an effective solution for correcting vision imperfections. While many experience improved sight and reduced reliance on glasses or contacts, it is not universally suitable. Assessing eye health, general medical history, and lifestyle factors is essential to determine eligibility. Understanding disqualifying criteria is crucial for informed decisions.
Age and Vision Stability
Age and vision stability are primary considerations for laser eye surgery. The FDA approves laser eye surgery for individuals aged 18 and older. Many eye care professionals suggest the optimal age is 21-40, as vision can change during the late teens and early twenties. Surgery before vision fully matures could lead to less predictable or unsatisfactory long-term results.
A stable eye prescription, with no significant changes for one to two years, is also required. Unstable vision indicates ongoing refractive error changes, making precise correction challenging. Surgery on an unstable prescription could lead to undercorrection or overcorrection, necessitating further interventions. This stability ensures the laser treatment provides an accurate and lasting improvement to vision.
Existing Eye Conditions
Specific pre-existing eye conditions can render laser eye surgery unsafe or ineffective. Sufficient corneal thickness is a requirement, as laser procedures reshape the cornea by removing a precise amount of tissue. Corneas thinner than 0.5mm may not qualify, compromising structural integrity and leading to complications. A thin cornea also increases the risk of corneal ectasia, a condition where the cornea progressively thins and bulges, leading to distorted vision.
Severe dry eye syndrome is another common disqualifier, as laser eye surgery can exacerbate dryness, causing significant discomfort and affecting healing. Keratoconus, a progressive disorder where the cornea thins and bulges into a cone shape, is a contraindication for LASIK. Reshaping an already weakened cornea can worsen the condition and severely impair vision. Comprehensive diagnostic tools detect subtle corneal irregularities before surgery.
While some forms of glaucoma might allow for laser eye surgery, advanced stages or uncontrolled intraocular pressure can be problematic. The temporary increase in eye pressure during LASIK could pose a risk to the optic nerve in susceptible individuals. Cataracts, a clouding of the eye’s natural lens, cannot be corrected by laser refractive surgery. Cataract surgery, involving lens removal and replacement, is the appropriate treatment.
General Health Concerns
Systemic health conditions can impact the body’s healing processes and overall surgical outcomes, influencing eligibility for laser eye surgery. Autoimmune diseases, including lupus and rheumatoid arthritis, can impair the eye’s ability to heal predictably after surgery. These conditions may increase the risk of complications such as corneal thinning, ulcers, and irregular healing responses. While some with well-controlled autoimmune conditions might be considered, a thorough assessment is necessary due to unpredictable healing.
Uncontrolled diabetes presents another significant concern, as fluctuating blood sugar levels can lead to unstable vision and compromise wound healing. Poorly managed diabetes also increases the risk of post-operative infections and can exacerbate dry eye symptoms. Stable blood glucose levels are crucial to ensure accurate measurements for the procedure and to support optimal healing. Immunocompromised states, whether due to medical conditions or medications, also heighten the risk of infection and impaired healing, making laser eye surgery unsuitable.
Certain connective tissue disorders that affect collagen can compromise corneal integrity, potentially leading to unpredictable healing. Those with a tendency to form keloids (raised scars) may experience abnormal corneal healing, resulting in haziness. Full disclosure of medical history is necessary during pre-operative evaluation.
Temporary Circumstances and Medications
Some circumstances are temporary, delaying rather than permanently disqualifying a candidate. Pregnancy and breastfeeding are common temporary contraindications. Hormonal fluctuations can cause temporary vision changes, making an accurate and stable prescription difficult. Medications used during and after the procedure could affect the developing fetus or nursing infant. Waiting until vision stabilizes, several months after breastfeeding concludes and menstrual cycles return to normal, is recommended.
Certain medications can also temporarily preclude laser eye surgery. Isotretinoin, an acne medication also known as Accutane, can cause severe dry eye and impair the eye’s healing capacity. Individuals taking this medication are advised to discontinue its use for at least six months before and after surgery to ensure safe healing. Amiodarone, a medication for heart rhythm issues, has been associated with visual disturbances following laser eye surgery. Active eye infections or recent eye injuries also require complete resolution and healing before any laser procedure can be safely performed.