LASIK eye surgery

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LASIK surgery: Is it right for you?

LASIK surgery makes it possible to reduce or eliminate your need for corrective lenses. But for some, the surgery is too risky. Find out if that's the case for you.

By Mayo Clinic staff

If you're tired of wearing eyeglasses or contact lenses, you may be considering laser-assisted in-situ keratomileusis — more commonly known as LASIK surgery — an increasingly popular alternative to corrective lenses. LASIK surgery is one type of refractive eye surgery, during which an eye surgeon uses a laser to reshape your cornea and correct focusing problems in your eyes.

LASIK surgery has a good track record — many who undergo the procedure are satisfied with their results. However, the procedure isn't the best choice for everyone. And it's not without risk. Before deciding to have LASIK surgery, determine whether or not you're a good candidate and learn about alternatives to LASIK surgery.

Who's a good candidate for LASIK surgery?

LASIK surgery may improve your vision if you have a moderate degree of:

  • Nearsightedness (myopia)
  • Farsightedness (hyperopia)
  • Astigmatism

Some doctors are reluctant to endorse LASIK surgery, reasoning your eyes are basically healthy even if you have nearsightedness or farsightedness. A good surgical outcome depends on careful evaluation of your eyes before the surgery.

What might disqualify you from having LASIK surgery?

LASIK surgery carries higher risks if you have:

  • An immune system disease. Diseases that affect your immune system may impair your ability to heal after surgery. The risks of incomplete healing, infection and other complications are increased whether you have an autoimmune disease, such as rheumatoid arthritis, or an immunodeficiency disease, such as HIV. Taking an immunosuppressive drug also increases your risk of a poor outcome.
  • Persistent dry eyes. Any condition that causes dry eyes, including the autoimmune disease Sjogren's syndrome, is likely to impair healing.
  • Certain eye characteristics. If you have an extremely uneven corneal surface or an otherwise abnormally shaped cornea, LASIK surgery may be particularly challenging for your surgeon. Other anatomical characteristics, such as deep-set eyes, may make the surgery too difficult to perform.
  • Unstable vision. If the quality of your vision is fluctuating or progressively worsening, you may not be eligible for LASIK eye surgery.

You might also rethink having LASIK surgery if:

  • It jeopardizes your career. Jobs requiring very precise vision may preclude your having certain refractive procedures.
  • Cost is an issue. Although LASIK surgery is becoming less expensive, it's still a substantial cost and most insurance companies don't pay for the procedure.
  • You have severe nearsightedness. If the prescription for correcting your nearsightedness is unusually strong — that is, if you have a "high refractive error" — the possible benefits of LASIK surgery may not justify the risk.
  • You have fairly good vision. If you see well enough to need contacts or glasses only part of the time — referred to as having a "low refractive error" — improvement from the surgery may not be worth the risk of complications.
  • You have large pupils. If your pupils are prone to opening wide in dim light, LASIK surgery may result in debilitating symptoms such as glare, halos, star bursts and ghost images.
  • You actively participate in contact sports. If you're a boxer or martial arts enthusiast and you regularly get hit in the face and eyes, LASIK surgery may not be advisable.
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References
  1. Bower KS. Laser refractive surgery. http://www.uptodate.com/home/index.html. Accessed Nov. 4, 2008.
  2. When is LASIK not for me? U.S. Food and Drug Administration Center for Devices and Radiological Health. http://www.fda.gov/cdrh/lasik/when.htm. Accessed Nov. 4, 2008.
  3. Sakimoto T, et al. Laser eye surgery for refractive errors. The Lancet. 2006;367:1432.
  4. Bakri SJ, ed. Mayo Clinic Guide to Better Vision. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2007:179.
  5. Robertson DM (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 14, 2008.

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Dec. 12, 2008

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