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When one of Kristina Alton’s contact lenses fell out at her office in New York City, she had to make the hour-long commute back to her apartment to get a replacement.
“It was such a disaster,” she recalls. “I just couldn’t function without them.”
But after undergoing LASIK surgery to correct her vision, Alton won’t ever have to worry about such problems again.
In this article, we dive into the benefits and risks of LASIK surgery to help you decide if — like Alton — it’s the right decision for you.
What Is LASIK Surgery?
LASIK, which stands for laser-assisted in situ keratomileusis, is a refractive surgery that corrects common vision problems, including nearsightedness (myopia), farsightedness (hyperopia) and astigmatism (an imperfection in your eye’s shape or curve).
This revolutionary procedure was first approved by the U.S. Food and Drug Administration in 1999. Since then, an estimated 20 million to 25 million procedures have been completed, allowing many people to see clearly without their glasses and contact lenses, notes a 2021 report in the journal Clinical Ophthalmology.
[READ: Foods That Are Good for Your Eyes.]
What Happens During LASIK Surgery?
During LASIK surgery, your ophthalmologist cuts a thin flap on your cornea — the clear, outer layer of the eye — using either a laser or a surgical blade.
Once the flap is folded back, the doctor uses a cool-beam laser to remove pieces of corneal tissue, sculpting your cornea into the ideal shape to focus light on your retina and create sharp images.
As part of this process, your doctor uses a preprogrammed, computer-controlled laser to address your unique vision problems. For example, if you’re nearsighted, the laser will remove tissue to flatten your cornea. If you’re farsighted, it will make your cornea steeper. If you have an astigmatism, it will trim your cornea to be more spherical.
Once those structural changes have been made, your doctor closes the flap and your cornea heals over the incision.
You’ll be awake during the procedure, but your ophthalmologist will give you numbing eye drops and a mild sedative to help you relax. Surgery typically takes about 10 minutes.
During Alton’s surgery, she recalls hearing “popping sounds” of the laser and smelling pieces of her cornea “burning,” but she didn’t feel any pain.
When the surgery was over, “I remember I smiled so big because I looked up, and I could see the ceiling tiles were crystal clear,” Alton recalls.
[READ: How to Recover From Surgery]
Risks and Potential Side Effects of LASIK Surgery
All surgeries carry some degree of risk.
“Fortunately, LASIK eye surgery is one of the safest procedures we perform in all of ophthalmology,” says Dr. Terry Kim, a professor of ophthalmology at the Duke University School of Medicine in North Carolina and chief of the cornea, external disease and refractive surgery division.
While LASIK is considered safe and severe complications that lead to vision loss are very rare, there are some common side effects that can occur after the procedure. These include:
— Dry eyes.
— Haloes, glare and double vision.
— Over- or under-correction of vision.
— Astigmatism.
— Problems with the corneal flap.
— Corneal ectasia (when the cornea bulges and thins).
— Regression or changes to vision.
Side effects typically resolve within six months, but they can persist in rare cases.
As with any surgery, it’s important to seriously consider the risks and do your research before going under the laser.
[SEE: Reasons You Should Call Off a Surgery.]
Am I a Candidate for LASIK Surgery?
While LASIK can be a total game changer for many people who must wear corrective lenses to see clearly, it’s not for everyone.
“I’m not going to offer an elective procedure to someone who’s not a perfect candidate,” says Dr. Kendall Donaldson, medical director of Bascom Palmer Eye Institute in Plantation, Florida.
Good candidates for the surgery have thick, healthy corneas and have had a stable corrective vision prescription for at least a year. Younger patients tend to have better outcomes than older patients, but the surgery is not intended for anyone under the age of 18.
Those with certain eye conditions, such as dry eye or an autoimmune disorder that affects the eyes, may be cautioned against undergoing the procedure because LASIK can exacerbate those symptoms. Other disqualifying conditions include:
— Cataracts.
— Glaucoma.
— Eye diseases that affect the cornea, such as keratoconus or corneal ectasia, which cause inflammation to the cornea.
— Other diseases that can affect the eyes, such as uveitis and herpes simplex when it impacts the eye area.
— HIV and other conditions involving immunosuppressant medications that can reduce your immune system’s response.
— Pregnancy or breastfeeding.
If you’re pregnant, LASIK surgery will have to wait, with most experts recommending new moms wait three to six months after they’ve finished nursing to have the surgery due to hormonal changes associated with pregnancy and breastfeeding that can affect the eyes and your vision. You’ll need to be back at your baseline level before undergoing LASIK surgery.
If you have large pupils or thin corneas, which your ophthalmologist will be able to tell you, you may be a candidate for other types of refractive surgery, such as photorefractive keratectomy (PRK), a procedure used to correct refractive errors, which occur when your eyes aren’t bending light properly. This procedure also uses a laser to correct your vision, but it’s a different approach to LASIK.
What Are the Potential Gains of LASIK Surgery?
The big selling point of LASIK surgery is that you’ll most likely be able to ditch corrective lenses after you get it — though it’s not always a given.
“We never guarantee 20/20 vision,” Donaldson says, “even though that’s what most patients do get.”
More than 90% of eyes (one eye for some patients, two eyes for others) reach 20/20 vision or better, and 99.5% get at least 20/40, according to an analysis of articles published between 2008 and 2015.
Overall 20/20 vision is considered “perfect,” and 20/40 is half as good, but good enough to pass an eye exam at the DMV without having to use corrective lenses.
If you don’t get your desired eyesight after the initial surgery, you might be eligible for an enhancement procedure. This option entails lifting your corneal flap and applying a little more laser to bring your vision closer to 20/20. These procedures are fairly rare and are more commonly needed in those who had worse eyesight to begin with, Donaldson notes.
Can I Get Both Eyes Done at Once?
LASIK is one of the few surgeries in which doctors can work on both eyes on the same day, Donaldson says.
This is different than other, larger surgeries, like cataract surgery or glaucoma surgery, where doctors nearly always work on one eye at a time to mitigate risk.
“If we had significant reservations about the safety of LASIK, then we wouldn’t be doing two eyes at the same time,” Donaldson adds.
How Much Does LASIK Surgery Cost?
LASIK can cost between $2,000 and $5,000, but prices can vary significantly depending on your location, the technology used and whether follow-ups and enhancement procedures are included in the price. The same 2021 report in Clinical Ophthalmology found that in 2020, the average cost for LASIK surgery in the United States was $2,632 per eye.
Most health insurance plans do not cover LASIK surgery because it’s an elective procedure, meaning it’s not considered medically necessary.
How Long Do Improvements Last?
The vision gains that patients obtain through LASIK typically last a lifetime, Kim says. This longevity is due to LASIK permanently changing the corneal shape.
“However, there are multiple factors that can cause a change in prescription after LASIK,” says Dr. Hema Ramkumar, an ophthalmologist and retinal surgeon with Providence St. Jude Medical Center in Fullerton, California.
The development of presbyopia or cataracts, for instance, can affect your vision post-LASIK.
Presbyopia is age-related inflexibility of the lens that makes it more difficult to read and see items up close. Nearly everyone starts to develop presbyopia once they’re over the age of 40, and as it progresses, you may need reading glasses to correct for this shift.
Cataracts are also a common age-related condition that affects vision. You may need surgical intervention to restore eyesight when they become too cloudy.
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What to Know About LASIK Surgery originally appeared on usnews.com
Update 04/26/24: This story was previously published at an earlier date and has been updated with new information.
