Laser eye surgery has become a highly sought-after procedure for improving their vision. LASIK, in particular, is known for its ability to correct refractive errors like nearsightedness, farsightedness, and astigmatism, offering patients the possibility of permanent vision correction. However, as with any medical procedure, laser eye surgery is unsuitable for everyone.
While many individuals may benefit from laser vision correction, it’s essential to understand that certain people may not be ideal candidates. Various factors determine whether someone is suitable for this type of surgery. In this blog, we will explore who should not have laser eye surgery, the reasons behind these limitations, and alternative options for those who may not be good candidates for LASIK or similar procedures.
What Is Laser Eye Surgery?
Laser eye surgery, or refractive surgery, includes procedures like LASIK (Laser-Assisted in Situ Keratomileusis) and PRK (Photorefractive Keratectomy). These surgeries use lasers to reshape the cornea, the clear front part of the eye, to improve vision by correcting refractive errors. These errors occur when light entering the eye does not focus directly on the retina, resulting in blurry vision.
LASIK and other laser-assisted surgeries are popular because they help people reduce or eliminate their dependence on corrective lenses, such as glasses or contact lenses. Sometimes, the procedure offers permanent vision correction, meaning patients may no longer need corrective lenses after the surgery.
However, not everyone is a suitable candidate for laser eye surgery. Below are some of the most common factors determining if someone should not undergo this type of surgery.
Age and Development of Vision
Age is one of the first considerations for anyone interested in laser eye surgery. Most eye surgeons recommend that individuals be at least 18 before undergoing LASIK surgery. This is because vision may still be changing during the teenage years, and having surgery before the eyes have fully stabilized could result in less predictable outcomes.
Typically, individuals between 18 and 40 are considered the ideal candidates for laser eye surgery. However, individuals over 40 may experience difficulty with LASIK surgery due to natural age-related eye changes, such as presbyopia (the inability to focus on close objects). In these cases, LASIK may not provide the same level of effectiveness, and the patient may still require reading glasses after the procedure.
Refractive Errors That Are Too Extreme
Laser eye surgery is effective for correcting various refractive errors, including nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. However, it is not suitable for individuals with extremely high prescriptions. LASIK surgery can only correct a certain degree of refractive error, and those with prescriptions that fall outside the operable range may not experience optimal results.
For example, someone with a very high level of nearsightedness or farsightedness may not be a good candidate for LASIK surgery. In such cases, alternative options such as a refractive lens exchange (RLE) or other vision correction treatments may be more suitable. The same goes for patients with irregular corneas or those who are not suitable for corrective lenses in the first place.
Thin or Irregular Cornea
The cornea plays a vital role in the effectiveness of laser eye surgery. LASIK surgery, in particular, involves creating a corneal flap, which is lifted so that the underlying tissue can be reshaped using a laser. The procedure’s success depends on the cornea’s thickness and regularity. If the cornea is too thin or irregular, it may not be able to handle the stress of the surgery, potentially leading to complications.
In cases where the cornea is too thin, the surgeon may recommend an alternative procedure, such as PRK (Photorefractive Keratectomy). PRK does not require the creation of a corneal flap and may be suitable for individuals with thin corneas. However, an eye surgeon should carefully evaluate patients with thin or irregular corneas to determine whether laser vision correction is viable.
Eye Diseases or Disorders
Another critical factor in determining who should not have laser eye surgery is the presence of existing eye diseases or disorders. Certain medical conditions can affect the outcome of laser eye surgery or make it unsafe. These conditions include:
- Dry Eye Syndrome: Individuals with chronic dry eye may experience worsened symptoms after LASIK. The procedure can temporarily reduce the number of tears produced, which may exacerbate dryness and discomfort.
- Corneal Disease: Conditions like keratoconus (a disease that causes the cornea to thin and bulge) or corneal ectasia can make laser eye surgery dangerous. These diseases affect the cornea’s strength and shape; laser surgery could cause further damage.
- Retinal Problems: Individuals with retinal conditions like diabetic retinopathy or macular degeneration may not be ideal candidates for laser eye surgery. These conditions can affect the retina’s ability to process images properly, making surgery less effective.
Refractive lens exchange or other treatment options may be more appropriate for those with eye diseases. Your eye surgeon will conduct a thorough evaluation to ensure that laser eye surgery is safe for your eyes.
Autoimmune Diseases and Certain Medical Conditions
Autoimmune diseases and certain medical conditions may also disqualify someone from having laser eye surgery. These conditions can interfere with the body’s ability to heal after surgery and increase the risk of complications. For example, rheumatoid arthritis and lupus are known to delay healing, and they can also contribute to dry eyes, which could worsen following LASIK.
Other medical conditions that could impact the success of laser eye surgery include:
- Diabetes: If your diabetes is poorly controlled, the risk of infection and delayed healing may increase.
- Pregnancy: Hormonal changes during pregnancy can affect the shape of the eyes, leading to fluctuating prescriptions. It’s typically recommended to wait until after pregnancy to undergo LASIK surgery.
- Unrealistic Expectations: Having unrealistic expectations about the outcome of the surgery can also disqualify someone from laser vision correction. If a person expects perfect vision without considering the potential risks or limitations of the surgery, they may not be a good candidate.
It is essential to have realistic expectations regarding the surgery’s results and understand that LASIK and other laser procedures cannot always guarantee perfect or 20/20 vision for everyone.
Prescription Medications
Certain prescription medications can interfere with the healing process after laser eye surgery or increase the risk of complications. Steroids, often used to treat inflammation, can slow down the healing process and increase the risk of infection. Patients must disclose their medication use to their eye surgeon before undergoing LASIK or other laser surgery.
In some cases, medication adjustments may need to be made before surgery. Your surgeon will work with your primary care doctor to ensure your medications do not interfere with the surgery or recovery process.
High Expectations or Anxiety
Patients who have high expectations for immediate results or feel anxious about the procedure may not be suitable for laser eye surgery. While minimally invasive, the LASIK procedure involves creating a corneal flap and reshaping the cornea, which can cause temporary discomfort. Additionally, recovery can take several weeks before full results are noticeable.
Patients need to clearly understand the recovery process and what they can expect from the surgery. If you are experiencing significant anxiety about the procedure or have unrealistic expectations regarding the outcome, it may be helpful to explore alternative options.
Benefits of Laser Eye Surgery
Laser eye surgery, particularly LASIK (Laser-Assisted in Situ Keratomileusis), has revolutionized the world of vision correction, offering a safe and effective solution for people with refractive errors. For those who rely on glasses or contact lenses, LASIK can provide a life-changing opportunity to achieve clearer vision without the hassle of corrective lenses. However, as with any medical procedure, it’s important to understand the benefits before deciding if this is the right option for you.
Improved Vision Quality
The primary benefit of laser eye surgery is the significant improvement in vision. LASIK eye surgery effectively corrects common refractive errors such as nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. By reshaping the cornea, LASIK helps focus light directly onto the retina, improving how the eye processes visual information. For many patients, the results are remarkable.
Most individuals who undergo LASIK surgery achieve 20/25 vision or better, sufficient for everyday activities like driving, reading, and watching television. Some patients may even achieve 20/20 vision or better after the procedure, eliminating their need for glasses or contact lenses. The procedure’s success rate is a key reason why LASIK remains one of the most popular eye surgeries worldwide.
Permanent Vision Correction
One of the most appealing aspects of LASIK surgery is that it offers permanent vision correction. Unlike prescription glasses or contact lenses, which require constant maintenance, replacement, and care, LASIK provides a more permanent solution to refractive vision problems. The changes are generally permanent once the laser reshapes the cornea, meaning patients no longer need corrective lenses.
While some people may experience mild changes in their vision as they age, most LASIK patients enjoy stable vision for many years following surgery. Most people do not need to worry about renewing glasses prescriptions or replacing contact lenses ever again.
This permanence is a major advantage over traditional vision correction methods, often involving gradual vision changes and constant prescription updates.
Reduced Dependence on Corrective Lenses
For many, glasses and contact lenses are a constant part of daily life. Corrective lenses can be frustrating, whether it’s dealing with foggy lenses, cleaning contacts, or worrying about lost glasses. LASIK eye surgery eliminates or reduces the need for these daily inconveniences.
After LASIK surgery, many patients no longer need to wear prescription glasses or contact lenses. This newfound freedom allows individuals to enjoy activities that the need for vision correction might have complicated. For example, athletes may no longer worry about their glasses slipping off or fogging up during a game. Similarly, people who enjoy swimming no longer need prescription swimming goggles or to worry about their contacts getting dislodged.
While some people may still need reading glasses in later years due to presbyopia (the natural aging of the eyes), LASIK eliminates the need for glasses or contacts for distance vision, making it a convenient and desirable option for many individuals.
Quick and Minimally Invasive Procedure
One of the standout features of LASIK eye surgery is its quick and minimally invasive nature. LASIK involves creating a small flap in the cornea, which is lifted to reshape the underlying corneal tissue with a laser. The entire procedure typically takes 15 to 30 minutes for both eyes.
Because LASIK is a non-invasive procedure, it typically doesn’t require any stitches or extensive recovery time. Most patients experience minimal discomfort during and after the surgery, and many can resume normal activities, including work and exercise, within a day or two. The recovery time is significantly shorter compared to more traditional eye surgery methods.
Minimal Discomfort and Fast Recovery
LASIK involves minimal discomfort and rapid recovery time compared to traditional eye surgeries. Following the procedure, many patients experience only mild irritation or a feeling of having something in their eye for the first few hours. After that, the discomfort usually subsides quickly. Most people report that the pain is minimal or nonexistent after the first day, with some experiencing improved vision immediately after surgery.
Additionally, the recovery time is incredibly short. While it’s important to follow post-operative care instructions carefully, many people return to their normal daily routines within 24 to 48 hours. The procedure is performed on an outpatient basis, meaning that you can typically go home the same day. You’ll be given specific instructions about eye care, and follow-up appointments with your eye surgeon will help ensure your healing process progresses smoothly.
Safe and Effective with a High Success Rate
Laser eye surgery, including LASIK, has an outstanding safety record. With advances in technology, modern LASIK procedures are safer than ever before. According to the American Refractive Surgery Council, LASIK has a 96% success rate, meaning most patients experience significant improvements in their vision after surgery.
Advancements in laser technology have also made LASIK even more precise. The lasers used in LASIK surgery are highly sophisticated, allowing the surgeon to create the corneal shape necessary for optimal vision correction. The procedure involves using an advanced laser to measure and correct even minute imperfections in the cornea. This precision reduces the risk of complications, making LASIK a safer option than ever before.
No More Prescription Drugs for Vision
One of the main reasons individuals opt for LASIK surgery is the desire to eliminate the need for prescription drugs and corrective lenses. For people who rely on prescription contact lenses, getting LASIK can eliminate the need for constant trips to the eye doctor for lens updates and prescription refills. LASIK can provide a permanent solution to refractive vision problems, eliminating the ongoing costs and maintenance of corrective lenses.
LASIK eye surgery means no longer worrying about prescription drugs for dry eyes or other common issues arising from long-term contact lens wear. Many LASIK patients find their eyes feel healthier and more comfortable after surgery, free from the irritation and dryness of contact lenses for long periods.
Customization and Precision
LASIK eye surgery offers a high degree of customization, as it can be tailored to each patient’s unique eye structure. Before surgery, an eye surgeon will conduct a comprehensive eye exam, including corneal thickness and topography measurements, to create a treatment plan specifically designed for your needs.
Lasik involves creating a precise cornea map, which helps the surgeon use the laser with incredible accuracy. This personalization ensures that the surgical procedure addresses your unique refractive errors. If necessary, LASIK can also be customized to treat nearsightedness, farsightedness, astigmatism, and more complex visual issues.
Long-Term Results
One of the most significant advantages of LASIK surgery is its long-lasting results. While some patients may experience mild vision changes as they age, LASIK generally offers stable results. Most patients will not need to return for additional surgeries once their eyes have healed, making LASIK a cost-effective long-term solution for vision correction.
With proper post-operative care, the effects of LASIK can last a lifetime, meaning that patients can enjoy clearer vision without the constant need for prescription glasses or contact lenses.
Conclusion
While laser eye surgery, including LASIK and other refractive procedures, offers a life-changing solution for many, it is not suitable for everyone. Individuals with certain medical conditions, eye diseases, irregular corneas, or those not ready for the responsibilities of post-surgery care may need to explore alternative options for vision correction.
If you are considering laser vision correction, it is essential to consult with a qualified eye surgeon who can thoroughly evaluate your eyes, medical history, and overall health. Doing so lets you determine whether LASIK or another refractive surgery is the right choice, ensuring the best possible outcome for your vision.
Laser eye surgery is a significant medical procedure, and it is vital to ensure you are a good candidate before proceeding. With careful evaluation and realistic expectations, laser vision correction can help you improve your vision and reduce or eliminate your dependence on corrective lenses.
References
https://www.fda.gov/medical-devices/lasik/when-lasik-not-me#:~:text=You%20have%20a%20disease%20or,healing%20after%20a%20refractive%20procedure.
https://www.verywellhealth.com/should-you-have-lasik-3421961
https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/in-depth/lasik-surgery/art-20045751
