Laser eye surgery is often seen as a modern miracle for people who are tired of wearing glasses or contact lenses. From LASIK to SMILE (Small Incision Lenticule Extraction), these procedures promise sharper vision and greater freedom. However, not everyone is a good candidate. In fact, for some, laser vision correction might do more harm than good.
If you’re considering a refractive procedure, it’s important to understand when laser eye surgery may not be the right choice. This blog examines who should not undergo laser eye surgery, the associated risks, and why a thorough consultation is crucial before making a decision.
Understanding Laser Eye Surgery
Before we dive into the exclusions, let’s briefly go over what laser eye surgery is.
Laser eye surgery, including LASIK (Laser-Assisted In Situ Keratomileusis), PRK (Photorefractive Keratectomy), and SMILE, reshapes the corneal tissue to correct common refractive errors such as nearsightedness, farsightedness, and astigmatism. The goal is to reduce or eliminate the need for corrective lenses like glasses or contact lenses.
These procedures are incredibly popular and have high success rates. However, they require certain eye and health conditions to be met. Your eye surgeon will look for specific red flags to determine if you’re a good candidate.
Not Everyone Is a Good Fit for Laser Vision Correction
Your vision prescription keeps changing
To be eligible for laser eye surgery, your eye prescription should be stable for at least a year. Significant vision changes within a short period suggest that your eyes haven’t fully settled yet. Performing surgery on unstable eyes could result in worse vision or the need for further procedures.
You have thin or irregular corneas
LASIK and similar procedures require a certain corneal thickness to be performed safely. If you have thin corneas or an irregular cornea, the laser may compromise the integrity of your eye. This can lead to complications like corneal ectasia, where the corneal tissue weakens and bulges.
You’re dealing with severe dry eyes
If you already experience dry eye symptoms, LASIK may exacerbate them. The laser can interfere with the eye’s natural healing process, especially on the surface where tear production is essential. In some cases, patients with dry eyes are advised to treat the condition first before considering surgery, or avoid it entirely.
You have an autoimmune disease
Autoimmune diseases, such as rheumatoid arthritis or lupus, can interfere with how your body heals. They may also increase your risk of infection or delay healing after the procedure. Since a strong immune system is essential for proper recovery, individuals with autoimmune conditions are typically not good candidates for laser eye procedures.
You take certain prescription drugs
Some prescription drugs can complicate the healing process. For example, acne medications, steroids, and immunosuppressants can reduce your body’s ability to recover after surgery. These medications may also increase your risk for dry eyes and affect your body’s healing response.
You have a history of eye infections
A history of herpes eye infection can resurface due to the stress caused by surgery. The virus can damage your cornea and increase the likelihood of a poor surgical outcome. Your eye specialist may recommend an alternative to laser-assisted correction if this applies to you.
You are pregnant or nursing
Hormonal changes during pregnancy and breastfeeding can affect fluid retention, which may alter your glasses prescription. These temporary changes can affect the accuracy of the procedure. Most surgeons recommend waiting until your vision is stable and hormone levels return to normal.
Medical and Lifestyle Factors That May Disqualify You
You have uncontrolled diabetes
Uncontrolled diabetes can lead to eye diseases such as diabetic retinopathy, which affects your overall eye health. It also impairs healing. If your blood sugar levels are not stable, you may be at a higher risk of complications after refractive surgery.
You play contact sports regularly
High-impact contact sports like boxing, football, or martial arts may put pressure on your eyes and disrupt healing after LASIK surgery. A direct hit to the face can dislodge the corneal flap created during LASIK, leading to vision issues. Procedures like refractive lens exchange may be more suitable in such cases.
You’re too young or too old
Laser eye surgery is generally not recommended for individuals under 18. Young eyes haven’t reached a stable vision state. On the other end of the spectrum, older adults may experience age-related vision problems, such as cataracts. In those cases, a refractive lens exchange or another type of eye surgery may be more appropriate.
You expect perfect vision for life
Many people think permanent vision correction means they’ll never need glasses again. While laser vision correction greatly reduces dependence on glasses or contact lenses, it doesn’t stop the natural aging of your eyes. You may still need reading glasses as you get older. It’s crucial to have realistic expectations before you undergo laser eye surgery.
Special Considerations and Alternatives
If you have extreme nearsightedness or other severe vision problems
LASIK and SMILE have limitations in how much refractive error they can correct. If your refractive error is too severe, the surgery might not deliver the clarity you expect. Your eye surgeon might suggest refractive lens exchange or implantable contact lenses as alternatives.
If you have structural eye concerns
If you have structural eye concernsThe health of the natural lens inside your eye, the shape of your eye, and how light is focused are all factors. Individuals with unusual eye anatomy or issues affecting the deeper layers of the eye may not respond well to laser vision procedures.
If you experience double vision or blurry vision without an obvious cause
Unexplained double vision or blurry vision could indicate underlying issues not treatable by laser correction. A comprehensive eye health screening will help determine whether refractive errors or more serious concerns cause these symptoms.
Final Thoughts: Always Consult a Professional
If you’ve ever asked yourself, who should not have laser eye surgery, the answer is: it depends. Laser eye surgery can be life-changing, but only for the right candidate. Conditions such as autoimmune diseases, thin or irregular cornea, uncontrolled diabetes, and certain prescription drugs can increase risks and lead to worse vision outcomes.
That’s why it’s crucial to consult a trusted eye surgeon or eye specialist who can assess your unique case. They will consider your medical conditions, lifestyle, and overall health to determine if you’re a suitable candidate or if another form of vision correction might work better for you.
A thorough examination and an honest conversation with your provider are the best ways to make an informed, safe decision about pursuing LASIK or any other refractive procedure.
So, before you say goodbye to your glasses or contact lenses, make sure your eyes and body are ready for the change.
References:
https://www.fda.gov/medical-devices/lasik/when-lasik-not-me
https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/in-depth/lasik-surgery/art-20045751
https://www.verywellhealth.com/should-you-have-lasik-3421961
https://www.medicalnewstoday.com/articles/laser-eye-surgery