Lasik Eye Surgery While Breastfeeding

When patients come to my practice to be evaluated for LASIK and report that they are pregnant, I recommend that they wait until they are 3 months post-partum before having LASIK. Pregnant women tend to retain fluid and this can be true of pregnant women's eyes as well. With more fluid, the shape of the eye may change causing a chance in your prescription. As far as breast-feeding is concerned, I did my Fellowship in Utah and many of my female patients nursed their children for a year or longer. Some surgeons may not feel comfortable performing surgery on this population, but I frequently performed LASIK on these women without any problems. Hope that helps!

Using a breast pump can allow breast feeding women to consider LASIK. I am more concerned about the post-operative meds (eye drops) than changing vision which is unlikely.

There is this fallacy in the older teaching that breastfeeding somehow changes your eyeglass RX, or the outcome of your LASIK or LASEK. This is simply not true. I've personally lasered dozens of women who actually didn't even know they were pregnant (because they didn't miss their 1st period yet), since I’ve done 15,000 cases by now, and all of them turned out fine without any effect on their final prescription or outcome.

If they're breastfeeding, we just tell them to pump-and-dump their milk for a week, and perhaps store a week's worth of milk beforehand, as we are now only doing the non-cutting LASEK procedure, which is safer than LASIK but requires more medications--so we don't want these to get into the breast milk. After a week, the medications are essentially 0, so they can safely breastfeed again.

We also put in punctal plugs to reduce the systemic absorption of the eye drops. But the total dose of the prescription drops is tiny, as the dose per drop is small to begin with, then it has to go down the nasolacrimal duct, get swallowed, go through the GI tract, get absorbed, get into the bloodstream, then into the breast, into the breast milk, then absorbed by the infant's gig tract. By the time all these dilutions happen, the dose to the infant is essentially zero.

So, when moms ask me about this problem, I do all of the above; avoid using restacks and mitomycin c as those are contraindicated as they may cause problems. But 99 times out of 100, when we get these questions from moms, I know it's their 1st pregnancy, because by their 2nd or 3rd they're not so nervous about such small hypothetical risks:( (Like they're already having a glass of wine with dinner by then!)