Laser eye surgery is a popular and effective method for vision correction, allowing many people to reduce or eliminate their dependency on glasses or contact lenses. Whether it’s LASIK surgery or laser vision correction, millions of people undergo these refractive procedures yearly to improve their eyesight. However, laser eye surgery is not for everyone. While the procedure can significantly enhance the quality of life for many, there are several important factors to consider before deciding if it is the right choice for you.
This blog will explore who should not have laser eye surgery, discussing various conditions and factors that may make someone an unsuitable candidate. Understanding these factors is essential to deciding whether laser eye surgery is right for you.
What is Laser Eye Surgery?
Laser eye surgery is a broad term that describes a group of surgical procedures that use an excimer laser to reshape the corneal tissue of the eye, correcting refractive errors like nearsightedness, farsightedness, and astigmatism. Among the most popular procedures are LASIK (Laser-Assisted In Situ Keratomileusis) and photorefractive keratectomy (PRK), both of which aim to improve the focus of light entering the eye, allowing for clearer vision without the need for corrective lenses.
The procedure is quick, typically performed on an outpatient basis, and often provides long-lasting results. For many, the benefits include eliminating the need for glasses or contact lenses, offering visual freedom, and improving overall eye health. However, as with any surgery, laser eye surgery isn’t suitable for everyone.
Who Should Not Have Laser Eye Surgery?
There are several important reasons why laser eye surgery may not be the best choice for some individuals. These reasons are based on underlying medical conditions, age, eye health, and other factors that could affect the success and safety of the procedure. Below are key factors to consider when determining if laser eye surgery suits you.
1. Unstable or Severe Refractive Errors
One of the primary prerequisites for LASIK and other refractive procedures is that the patient’s refractive error (the measure of their vision problem) should be stable. If a person’s eye prescription changes frequently, it may indicate that the refractive error is not stable enough for surgery. Candidates must have a stable prescription for at least one to two years before surgery.
Why This is a Problem: If a person’s prescription is not stable, reshaping the cornea can lead to undercorrection or overcorrection, resulting in the need for follow-up procedures or further vision problems. The refractive error must be stable for laser vision correction to be successful.
2. Thin Corneas or Poor Corneal Health
A thin cornea is one of the most common factors that can disqualify someone from LASIK surgery. In LASIK, the surgeon uses a laser to remove and reshape tissue from the cornea. If the cornea is too thin, there may not be enough tissue to safely remove during the procedure, leading to complications like corneal ectasia, where the cornea becomes weakened and bulges forward.
Why This is a Problem: If the cornea is not thick enough to undergo the procedure safely, LASIK could cause more harm than benefit, resulting in vision problems like ghost images or even permanent vision loss.
3. Eye Diseases or Conditions
Certain eye diseases or conditions make laser eye surgery inappropriate or risky. These conditions can include:
- Glaucoma: A condition that causes increased pressure in the eye, which can damage the optic nerve. LASIK and other laser procedures could increase eye pressure or cause disease management complications.
- Dry Eye Syndrome: Individuals with dry eyes may experience exacerbated symptoms post-surgery, as laser eye surgery can temporarily reduce tear production. This can lead to discomfort, eye irritation, and dry eye symptoms.
- Herpes Simplex or Herpes Zoster: Active herpes eye infection or any history of eye herpes can increase the risk of complications following LASIK surgery, including corneal scarring.
- Diabetic Retinopathy: Those with uncontrolled diabetes or related eye diseases like diabetic retinopathy should avoid refractive surgery until their condition is well-managed, as fluctuating blood sugar can cause vision instability.
Why This is a Problem: Eye diseases like dry eye syndrome and glaucoma can increase the risk of post-surgical complications, including delayed healing, worsened symptoms, or further vision problems.
4. Autoimmune Disorders
People with certain autoimmune diseases, such as rheumatoid arthritis or lupus, may not be good candidates for laser eye surgery. These conditions can affect the body’s ability to heal properly, leading to complications during recovery. For example, autoimmune disorders may impair the body’s ability to heal the cornea after the LASIK procedure, leading to increased risk of infections, scarring, or prolonged healing.
Why This is a Problem: Autoimmune diseases can interfere with the healing process, increasing the likelihood of complications that can lead to long-term problems with vision or corneal health.
5. Pregnancy or Hormonal Fluctuations
Hormonal changes during pregnancy can affect vision and the corneal thickness. LASIK surgery should generally be postponed until the postpartum period when hormonal fluctuations have stabilized. Additionally, many women experience changes in their eye prescription during pregnancy, which could lead to inaccurate results post-surgery.
Why This is a Problem: Hormonal fluctuations can affect the eye’s ability to respond to laser eye surgery. Additionally, vision problems during pregnancy can resolve after childbirth, making surgery unnecessary at this time.
6. Age-Related Changes
While laser eye surgery is typically an option for individuals between 18 and 40, the healing process and results may not be as effective in older adults. As people age, they may develop presbyopia, which makes it difficult to focus on close objects and requires reading glasses.
Why This is a Problem: While LASIK and other laser procedures can correct refractive errors such as nearsightedness, older adults may still need reading glasses after surgery due to presbyopia. A procedure like refractive lens exchange may be a more appropriate for these individuals.
7. Unrealistic Expectations
Not everyone who seeks laser eye surgery is a good candidate. Some individuals may have unrealistic expectations about the outcomes of the procedure. It’s important to remember that laser vision correction can significantly improve vision, but it does not guarantee perfect vision for everyone.
Why This is a Problem: Patients who expect to achieve perfect vision or eliminate their need for corrective lenses might be disappointed. It’s crucial for individuals to have realistic expectations and understand that the procedure may not eliminate the need for glasses or contact lenses, especially for certain types of vision problems.
8. Certain Medications or Drug Use
Some medications can affect the success of laser eye surgery. For example, certain prescription drugs used to treat conditions like autoimmune diseases, rheumatoid arthritis, or even some types of antidepressants may have side effects that hinder healing or exacerbate dry eye symptoms post-surgery.
Why This is a Problem: Medications can affect the body’s ability to heal after refractive surgery, increase the risk of dry eyes, or cause vision problems that make laser eye surgery less effective.
Conclusion
Laser eye surgery is an effective and life-changing procedure for many people who want to correct their vision problems. However, laser vision correction is not suitable for everyone. Understanding who should not have laser eye surgery is crucial for ensuring the safety and success of the procedure. If you have thin corneas, eye diseases, autoimmune disorders, or other conditions that may interfere with the healing process, exploring alternative options for vision correction may be wise.
Consulting with an experienced eye surgeon or laser eye surgeon is the first step toward determining whether you are a good candidate for LASIK surgery or other refractive procedures. By carefully assessing your eye health, overall medical conditions, and realistic expectations, you can decide whether laser eye surgery is the right choice for you. Always seek professional advice to ensure the best possible outcome and long-term eye health.
References
https://www.verywellhealth.com/should-you-have-lasik-3421961
https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/in-depth/lasik-surgery/art-20045751
https://www.fda.gov/medical-devices/lasik/when-lasik-not-me#:~:text=You%20have%20a%20disease%20or,healing%20after%20a%20refractive%20procedure.
