LASIK (laser-assisted in situ keratomileusis) is a laser eye surgery that can dramatically improve eyesight. The procedure was approved by the U.S. Food & Drug Administration (FDA) in 1999, but it was performed even before then. LASIK can fix any vision problem glasses can correct, according to Beverly Hills, California, ophthalmologist Dr. Andrew Caster. It can also address presbyopia, âthe farsightedness that develops in middle age and requires reading glasses,â he says.Â
The American Refractive Surgery Council (ARSC) touts a high LASIK success rate, saying that more than 90% of LASIK patients end up with 20/20 vision (normal visual acuity) and 99% come away with better than 20/40 vision, which means theyâll still need to be as close as 20 feet to see what someone with normal vision could see at 40 feet. They also cite a complication rate of less than 1 percent, though recent reports have challenged this figure. (Read on for more about potential risks.)
Pros
Cons
The price you pay will depend on your provider's technique, credentials, and location, as well as a few other key factors.
The procedure can correct your vision if you have a refractive error, such as:Â
To qualify for LASIK, youâll also need to have:
 If youâre very nearsighted or have thin corneas, you may be a better candidate for LASEK.Â
Some eye doctors on RealSelf say that the best age for LASIK is at least 21 or even older, to ensure your vision has stabilized. âThe eyes may continue to grow into your late 20s or so,â says Dr. Lee Katzman, an ophthalmologist in La Mesa, California. This is the cause of myopic progression, or having your prescription get worse.Â
âI always ask patients for all their old prescriptions so we can graph out how their prescription is changing over time. We can estimate what it will stabilize at by age 30, so we know how much to overcorrect, to minimize the change an enhancement will be needed later in life,â explains Dr. Emil Chynn, an ophthalmologist in New York City.Â
Eyesight can still diminish with age for some farsighted patients, so make sure your doctor measures your eyesight before and after dilation. If thereâs a major difference, you may not be a good candidate for LASIK. Â
RealSelf Tip: LASIK canât fix crossed eyes, which happens when one or more of the muscles that control eye movement are too strong or weak. This can be fixed by eye alignment surgery, also called strabismus surgery.
The most common LASIK side effect is dry eye. Your physician will send you home with eye drops to counteract it, but more than 95% of patients still report some form of dry eye. Continued symptoms after a year may be a sign of dry eye syndrome. A study from 2016 shows that the discomfort from dry eye can be classified as chronic pain, and it can become permanent. Beyond being uncomfortable, it can contribute to vision loss.
Thereâs also the possibility of corneal flap dislocation. If you play sports, doctors suggest wearing protective eyewear for several months after LASIK. Some RealSelf members also say they felt as if they had hair or sand in their eyes immediately after the procedure, but itâs important to resist the urge to rub, which could move the corneal flap.Â
The FDA confirms these additional potential LASIK risks.Â
If your intent with LASIK is to have monovision (usually to have one eye corrected, for distance viewing, and one eye a little less corrected, for up-close reading), you risk having poorer vision overall and a decrease in depth perception.Â
In late 2019, CBS News reported that retired FDA adviser Morris Waxler, who had originally voted to approve LASIK eye surgery, now advocates having it taken off the market. His own analysis of industry data shows complication rates of 10â30%, with âvision distortions that persisted for years."Â
The FDA told CBS that it "has not found any new safety concerns associated with LASIK devices," but it also encourages patients to âcarefully weigh the risks,â find an experienced surgeon who is transparent about their own complication rates, avoid deal shopping, and ensure that theyâre truly a good candidate. The agency also notes that âeven the best-screened patients under the care of most skilled surgeons can experience serious complications.â
Most RealSelf members report a positive experience with LASIK, but knowing all the possible outcomes can help you make the best decision for you.
Related: Former FDA Advisor Says LASIK Should âAbsolutelyâ Be Banned
The procedure takes about 10 minutes per eye. Your doctor will start by numbing the eyes with drops. If youâre especially anxious, you may be given an oral sedative.Â
Your eyelids will be held wide open with a speculum as your doctor uses a laser or microkeratome blade (a thin oscillating metal blade operated by a machine) to separate the top layers of the cornea, making a thin flap. It shouldnât be painful, but you may feel pressure.
âCutting a flap in the cornea during LASIK, lifting it up, then lasering the underlying bed and replacing the cornea flap means faster recovery than with PRK or LASEK, where no flap is cutâso the laser is applied directly to the corneal surface. However, the [other] procedures may be slightly safer because the cutting step is avoided,â says Dr. Chynn.
âThen your doctor will use a second laser to vaporize the corneal âbedâ under the lifted flap, to reshape the cornea to change its curvature,â continues Dr. Chynn. âIf youâre nearsighted, the cornea will be flattened; if youâre farsighted, itâll be made steeper. The laser can also make a football-shape cornea into a spherical shape, to correct astigmatism.â
Youâll rest for a bit after your procedure before someone takes you home.Â
RealSelf Tip: Take a nap! After surgery, itâs good to rest your eyes as much as possible. Shut-eye helps the ocular surface heal faster.
âOn the way home, I had to wear some protective sunglasses, and everything looked as if I had my eyes open under water. I went home and slept for about two hours, and my vision was crystal-clear when I woke up.ââKeshiab83, RealSelf member
You can expect blurry vision as well as sensitivity to light after your procedure, but it should start to get better within 24 hours and continue to improve over that first week.Â
Youâll likely have a follow-up visit the day after the procedure, when your doctor will determine if youâre OK to drive without glasses or contacts.Â
Along with giving you drops to ease dry eye symptoms, your eye doctor will prescribe steroid drops to help you heal. Just keep in mind that if you use the steroid eye drops for too long or improperly, you could damage your eyes, causing cataracts or glaucoma.Â
As the corneal flap heals, avoid introducing bacteria to your eyes. Donât get water in your eyes and skip eye makeup for at least a week. You can carefully clean the skin around your eyes with a saline-soaked cotton ball.
Most people have better vision within 48 hours, but for some, it can take a few weeks to see full results. âSome patients have an abnormal healing responseâwhich can lead to less than perfect results, like an over- or undercorrection, which may require an enhancement,â explains Dr. Chynn.
For most patients, results are permanent, but a small percentage (3â5%) will need a follow-up surgery, called an enhancement.Â
Itâs very similar to a regular LASIK procedure, only this time, your surgeon wonât cut a flap in your cornea. Instead, theyâll use special instruments to lift the flap that was already created.
If youâre not a candidate for LASIK or are wary of the risks, there are a few other options.
American Refractive Surgery Council:Â What Is the LASIK Success Rate? (2017)
CBSÂ News:Â LASIK eye surgery should be taken off market, former FDA adviser says (2019)
Shtein R.M., Post-LASIK dry eye (2011)
University of Miami Miller School of Medicine:Â 'Dry eye' linked to chronic pain syndromes (2016)
Updated February 21, 2024