Q: What are the pros and cons of LASIK?

Pros You’ll most likely see results within the first 24 to 48 hours after the procedure. Recovery is extremely quick. “Most people are driving to work the very next day,” says Dr. Caster. When it’s successful, LASIK can be life-changing. It can also eliminate the need for (and expense of) glasses or contacts. “No more feeling my way, in the dark, to the bathroom in the middle of the night. No more worrying about packing glasses, contacts, and contact solution for trips,” says RealSelf member miss.che . While there can be complications with LASIK, they’re rare and usually temporary. Compared to LASEK (another type of laser eye surgery), recovery from LASIK is faster. Cons LASIK is not always 100% effective, and sometimes a second procedure is needed. The higher your vision prescription, the less likely it is that you’ll have a fully successful outcome. It’s considered somewhat riskier than LASEK, which involves no cutting of the corneal flap. LASIK is also typically more expensive. Common side effects include dry eye, glare, and halos. Some people develop serious LASIK complications, including eye infections, vision loss, pain, and detached retinas.

Question 1

What is LASIK?

Accepted Answer

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, “the farsightedness that develops in middle age and requires reading glasses,” he says.

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 they’ll 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.)

Question 2

What are the pros and cons of LASIK?

Accepted Answer

Pros

You’ll most likely see results within the first 24 to 48 hours after the procedure.
Recovery is extremely quick. “Most people are driving to work the very next day,” says Dr. Caster.
When it’s successful, LASIK can be life-changing. It can also eliminate the need for (and expense of) glasses or contacts. “No more feeling my way, in the dark, to the bathroom in the middle of the night. No more worrying about packing glasses, contacts, and contact solution for trips,” says RealSelf member miss.che.
While there can be complications with LASIK, they’re rare and usually temporary.
Compared to LASEK (another type of laser eye surgery), recovery from LASIK is faster.

Cons

LASIK is not always 100% effective, and sometimes a second procedure is needed. The higher your vision prescription, the less likely it is that you’ll have a fully successful outcome.
It’s considered somewhat riskier than LASEK, which involves no cutting of the corneal flap. LASIK is also typically more expensive.
Common side effects include dry eye, glare, and halos.
Some people develop serious LASIK complications, including eye infections, vision loss, pain, and detached retinas.

Question 3

How much does LASIK cost?

Accepted Answer

The price you pay will depend on your provider's technique, credentials, and location, as well as a few other key factors.

See our complete guide to LASIK costs

Question 4

Who makes a good candidate for LASIK?

Accepted Answer

The procedure can correct your vision if you have a refractive error, such as:

Nearsightedness (myopia), so nearby objects are clear but distant objects are blurry
Farsightedness (hyperopia), so far objects are in focus but anything near is not
Astigmatism, blurry vision caused by the shape of your cornea

To qualify for LASIK, you’ll also need to have:

An adequately thick cornea so that after some is removed by the laser during surgery, it’s still strong enough
A stable eyeglass or contact lens prescription for two to three years
Otherwise healthy eyes

If you’re very nearsighted or have thin corneas, you may be a better candidate for LASEK.

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. “The eyes may continue to grow into your late 20s or so,” says Dr. Lee Katzman, an ophthalmologist in La Mesa, California. This is the cause of myopic progression, or having your prescription get worse.

“I 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,” explains Dr. Emil Chynn, an ophthalmologist in New York City.

Eyesight can still diminish with age for some farsighted patients, so make sure your doctor measures your eyesight before and after dilation. If there’s a major difference, you may not be a good candidate for LASIK.

RealSelf Tip: LASIK can’t 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.

Question 5

What are the risks and possible side effects of LASIK?

Accepted Answer

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.

There’s 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 it’s important to resist the urge to rub, which could move the corneal flap.

The FDA confirms these additional potential LASIK risks.

Vision loss that can’t be corrected with glasses, contact lenses, or additional surgery.
Symptoms like diminished vision at night or in situations of low contrast (like fog), double vision, glare, starbursts, or halos, where you see spots or flashes of light.
Still needing corrected vision or reading glasses, due to undertreatment.
Headaches or eye strain, due to overtreatment.
A need for additional surgery to correct a complication (though this may not be possible, due to the state of your cornea or damage from the initial LASIK surgery).

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.

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 10–30%, with “vision distortions that persisted for years."

The FDA told CBS that it "has not found any new safety concerns associated with LASIK devices," but it also encourages patients to “carefully weigh the risks,” find an experienced surgeon who is transparent about their own complication rates, avoid deal shopping, and ensure that they’re truly a good candidate. The agency also notes that “even the best-screened patients under the care of most skilled surgeons can experience serious complications.”

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 “Absolutely” Be Banned

Question 6

What happens during LASIK eye surgery?

Accepted Answer

The procedure takes about 10 minutes per eye. Your doctor will start by numbing the eyes with drops. If you’re especially anxious, you may be given an oral sedative.

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 shouldn’t be painful, but you may feel pressure.

“Cutting 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 cut—so the laser is applied directly to the corneal surface. However, the [other] procedures may be slightly safer because the cutting step is avoided,” says Dr. Chynn.

“Then your doctor will use a second laser to vaporize the corneal ‘bed’ under the lifted flap, to reshape the cornea to change its curvature,” continues Dr. Chynn. “If you’re nearsighted, the cornea will be flattened; if you’re farsighted, it’ll be made steeper. The laser can also make a football-shape cornea into a spherical shape, to correct astigmatism.”

You’ll rest for a bit after your procedure before someone takes you home.

RealSelf Tip: Take a nap! After surgery, it’s good to rest your eyes as much as possible. Shut-eye helps the ocular surface heal faster.

“On 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.”—Keshiab83, RealSelf member

Question 7

What should you expect during LASIK recovery?

Accepted Answer

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.

You’ll likely have a follow-up visit the day after the procedure, when your doctor will determine if you’re OK to drive without glasses or contacts.

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.

As the corneal flap heals, avoid introducing bacteria to your eyes. Don’t 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.

Question 8

When will you see LASIK results?

Accepted Answer

Most people have better vision within 48 hours, but for some, it can take a few weeks to see full results. “Some patients have an abnormal healing response—which can lead to less than perfect results, like an over- or undercorrection, which may require an enhancement,” explains Dr. Chynn.

Question 9

How long will your LASIK results last?

Accepted Answer

For most patients, results are permanent, but a small percentage (3–5%) will need a follow-up surgery, called an enhancement.

It’s very similar to a regular LASIK procedure, only this time, your surgeon won’t cut a flap in your cornea. Instead, they’ll use special instruments to lift the flap that was already created.

Question 10

What are the alternatives to LASIK?

Accepted Answer

If you’re not a candidate for LASIK or are wary of the risks, there are a few other options.

PRK eye surgery was the primary surgery done to correct vision before LASIK came on the scene. It delivers similar results, but instead of cutting a flap into the cornea, it removes the epithelium, the outermost layer of your eye, before using a laser to reshape your cornea. Recovery time is a lot longer—it takes about a week to heal, which can be painful. But if you have a thin cornea and/or a high prescription, PRK is a safer option.
LASEK is a combination of LASIK and PRK. Similar to PRK, the laser is applied to the corneal surface and no flap is cut, so it’s safe to treat thinner corneas or higher prescriptions than are possible with LASIK. But it’s less painful and has a faster recovery time than PRK.
Implantable contact lenses (ICL): Putting a permanent acrylic or silicone implant behind your iris can correct vision and eliminate the need for glasses or contact lenses. “For people over 60, lens replacement surgery, which is identical to cataract removal, can also be done as an alternative to LASIK,” says Dr. Caster. But he also says that these procedures are more dangerous and should be used only when LASIK is not appropriate. “Since it’s intraocular, it can cause glaucoma, bleeding inside the eye, or cataracts—unlike LASIK, PRK or LASEK,” cautions Dr. Chynn.

Question 11

Sources & studies

Accepted Answer

American Refractive Surgery Council: What Is the LASIK Success Rate? (2017)

CBS News: LASIK eye surgery should be taken off market, former FDA adviser says (2019)

López-Montemayor P., Valdez-García J.E., Loya-García D., Hernandez-Camarena J.C., Safety, efficacy and refractive outcomes of LASIK surgery in patients aged 65 or older (2018)

Shtein R.M., Post-LASIK dry eye (2011)

University of Miami Miller School of Medicine: 'Dry eye' linked to chronic pain syndromes (2016)

U.S. Food and Drug Administration: What are the risks and how can I find the right doctor for me? (2018)

LASIK

Emil William Chynn, MD, FACS, MBA

Krista Bennett DeMaio

Emil William Chynn, MD, FACS, MBA

Krista Bennett DeMaio

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Emil William Chynn, MD, FACS, MBA

Krista Bennett DeMaio

Emil William Chynn, MD, FACS, MBA

Krista Bennett DeMaio

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