Can Vision Go Bad After LASIK?

Is Vision Regression After LASIK Common? Factors & Prevention

LASIK is a widely performed refractive surgery known for its high success rate in correcting vision problems such as myopia, hyperopia, and astigmatism. 

Deciding to opt for LASIK surgery can be one of those decisions for which you would thank yourself for the rest of your life, as many patients achieve 20/20 vision or better post-surgery. However, you may sometimes feel confused about whether your vision can worsen after the surgery.

If the above scenario is true in your case, there is no need to worry, as these doubts are completely normal. 

Understanding How Long the Results of LASIK Surgery May Last

LASIK produces permanent changes in the refractive capacity of your eyes. It involves the removal of a specific area of tissue to change the cornea's shape. This, in turn, changes the way light enters your eye, thus ensuring sharper vision. 

The rigorous pre-operational screening, combined with qualified surgeons' skills, usually results in high-quality, complication-free LASIK treatment and excellent outcomes for patients. However, a handful of individuals may not experience the desired outcome after the first round. In such cases, doctors execute a simple enhancement procedure later on. 

Factors Influencing Post-LASIK Vision Changes

Here are the key factors that can affect your vision after LASIK:

1. Age-Related Changes

Presbyopia is a common cause of vision changes after LASIK. This is an age-linked condition that affects near vision, typically starting around age 40. This condition is unrelated to LASIK and occurs due to the natural ageing of the eye's lens. 

2. Vision Regression

In some cases, patients may experience a slight return of their original refractive error, known as regression. This can occur due to factors like under-correction during the initial surgery or the natural healing response of the cornea. Studies suggest that approximately 10% of patients may experience some degree of regression over 12 years. ​ 

3. Development of Other Eye Conditions

LASIK does not prevent the onset of other eye conditions, such as cataracts or glaucoma. These conditions can affect vision independently of the corneal correction achieved through LASIK. ​ 

What to Expect During LASIK? 

Your surgeon will keep you awake throughout the LASIK treatment but will give you a relaxing medication to help you stay calm. While not painful, you could experience some pulling or a sensation of pressure on your eye.

The basic stages of this process include:

1. Numbing eye drops are applied to both eyes to ensure a lack of sensation.

2. An instrument holds your eye open by retracting the eyelids.

3. A thin layer, or flap, is created on the surface of your cornea using either a precise blade or a laser. This is the point where you might perceive some pressure and mild discomfort.

• All-laser LASIK: A femtosecond laser emits pulses of energy towards your cornea, gently separating its outermost layer. It then makes an incision to form the flap.
• Conventional or Bladed LASIK: A tool known as a microkeratome is positioned on your eye. It features a ring that sticks to the surface of your eye and a tiny blade. The suction from the ring lifts the cornea, allowing the blade to cut a flap.

1.The surgeon carefully lifts the corneal flap.

2.Your cornea is reshaped using one of the following methods:

• Excimer Laser: This laser is employed to remove minute amounts of corneal tissue. Your eyeglass or contact lens prescription determines the quantity of tissue removed.
• Custom (Wavefront-guided) Laser: The unique characteristics of your eye are analysed using light waves, generating a detailed map. A laser then removes corneal tissue based on this individualised map.

1.The surgeon repositions the flap to its original place, where it naturally heals without the need for stitches.

Managing Post-LASIK Vision Changes

If vision changes occur after LASIK, several options are available:​

• Enhancement Procedures: For those experiencing regression, a follow-up LASIK enhancement can fine-tune vision correction.
• Reading Glasses: In cases of presbyopia, using reading glasses for close-up tasks can be an effective solution.​
• Regular Eye Exams: Routine check-ups can help detect and manage age-related eye conditions early.​

While LASIK offers permanent correction for specific refractive errors, it is important to recognise that the eyes can change due to ageing and other factors. Maintaining regular eye care and consultations with an eye care professional can help manage and address any vision changes that arise post-LASIK.

Also Read:

→ Does LASIK Change Eye Colour

→ Can You Blink During LASIK

→ Are There LASIK Side Effects

→ How Long After LASIK Can I See