Is LASIK Surgery Safe?

LASIK surgery is a widely performed vision correction procedure, but safety is a key concern for many considering the treatment. While LASIK can effectively reduce or eliminate the need for glasses or contact lenses, no medical procedure is without risks.

This article takes an evidence-based look at the safety of LASIK surgery, including potential risks, side effects, and how it compares to other options like contact lenses and lens replacement surgery. If you're considering LASIK, this guide will help you make an informed decision with realistic expectations. If you are based in Adelaide, contact us at IVISION Laser to discuss the suitability of LASIK in Adelaide. If you are considering LASIK and you have astigmatism, you may wish to take a look at our article 'Can you get LASIK with astigmatism?' for more information.

How safe is LASIK surgery for vision?

LASIK (Laser-Assisted In Situ Keratomileusis) is one of the most common elective surgeries performed today, offering many people the chance to see clearly without glasses or contact lenses. But when it comes to your vision, safety is the top priority.

Just like any medical procedure, LASIK isn’t completely risk-free. While most patients achieve significantly improved vision, understanding potential complications can help you make an informed decision.

Can LASIK surgery cause vision loss?

The idea of losing vision from LASIK can sound alarming, but in reality, severe vision loss is extremely rare, with the risk of sight-threatening complications after LASIK eye surgery being very low, at 0.66%

¹Wu YT, Ho A, Naduvilath T, Lim C, Carnt N, Keay LJ, Edwards KP, Stapleton F. The risk of vision loss in contact lens wear and following LASIK. Ophthalmic Physiol Opt. 2020 Mar;40(2):241-248. doi: 10.1111/opo.12663. Epub 2020 Jan 9. PMID: 31916275. https://pubmed.ncbi.nlm.nih.gov/31916275/ .

That said, it’s still a surgical procedure, and complications—though rare—can happen. As with any medical treatment, individual risks vary, and consulting with a qualified specialist remains essential. Having a thorough eye examination beforehand can help identify any risks specific to you.

What is the failure rate of LASIK surgery?

LASIK is considered one of the safest and most effective surgical procedures

² https://www.mariettaeye.com/eye-care-info/lasik-eye-surgery-statistics/ in the world of eye care. But does it work for everyone?

Studies show that about 90% of LASIK patients achieve at least 20/20 vision. However, success doesn’t necessarily mean perfect vision forever. Some patients may still need glasses for certain tasks, like night driving or reading as they age.

The rate of serious complications is less than 1%, according to clinical studies

³ https://www.gwsvision.com/lasik/lasik-success-rates-how-safe-is-lasik/ .

Can LASIK surgery go wrong?

While LASIK is safe for the vast majority of patients, no medical procedure is completely without risks. Here are some potential side effects to be aware of:

1. Dry eyes

Ever worn contact lenses for too long and felt like your eyes were a desert? That’s similar to how post-LASIK dry eye can feel. Up to 28% of patients report dry eye symptoms three months after surgery

⁴ https://www.fda.gov/medical-devices/lasik/lasik-quality-life-collaboration-project .

2. Visual disturbances

Some patients see halos or glare around lights, especially at night - a bit like looking through a foggy window. This is usually temporary, and for most people, it fades as the eyes heal. Less than 1% of patients experience significant difficulty with visual symptoms that affect daily life

⁵ https://www.fda.gov/medical-devices/lasik/lasik-quality-life-collaboration-project .

3. Flap complications

LASIK involves creating a thin flap on the cornea, which is then lifted so the laser can reshape the underlying tissue. In rare cases, this flap may not heal properly, leading to issues like inflammation or flap dislocation. The risk of flap complications is between 0.1 - 4%

⁶Moshirfar et al. (2023) Laser In Situ Keratomileusis (LASIK). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-35813/ . It's important to note that complication rates may vary depending on factors such as surgeon experience, technology used, and patient characteristics. Most complications can be managed effectively with minimal impact on final visual outcomes⁷Ambrósio and Wilson (undefined) Complications of laser in situ keratomileusis: etiology, prevention, and treatment. Journal of refractive surgery (Thorofare, N.J. : 1995). https://pubmed.ncbi.nlm.nih.gov/11383767/ .

So while the vast majority of LASIK patients experience clear vision with minimal side effects, understanding the risks—no matter how small—is key to making the right decision.

If you’re considering LASIK, talk to an experienced ophthalmologist, ask questions, and make sure you fully understand both the potential benefits and the possible risks before proceeding. Your vision is worth the extra research.

Is there a risk of pain in LASIK surgery?

LASIK surgery is a popular method for correcting vision issues, but concerns about potential pain during and after the procedure are common. Understanding what to expect can help alleviate these worries.

Does LASIK hurt during surgery?

The LASIK procedure itself is generally painless. Before the surgery begins, anaesthetic eye drops are applied to numb the eyes, ensuring comfort throughout the process. Patients may experience a sensation of pressure when the corneal flap is created, but this is typically brief and not painful

⁸ Daniel Yetman (2021) Does Laser Eye Surgery Hurt? What to Expect Before and After . healthline.com. https://www.healthline.com/health/does-laser-eye-surgery-hurt . The entire procedure usually takes about 10 minutes per eye.

What about discomfort during recovery?

After LASIK surgery, it's common to experience mild discomfort as the eyes begin to heal. This can include sensations such as burning, itching, or the feeling of having something in the eye

⁹ Daniel Yetman (2021) Does Laser Eye Surgery Hurt? What to Expect Before and After . healthline.com. https://www.healthline.com/health/does-laser-eye-surgery-hurt . To minimise discomfort, patients are often advised to rest and keep their eyes closed immediately following the procedure. Using prescribed eye drops can also help alleviate dryness and promote healing.

In summary, LASIK surgery is generally not painful during the procedure, and post-operative discomfort is typically mild and short-lived. Understanding the expected sensations can help patients approach LASIK with greater confidence and peace of mind. While severe pain is uncommon, if significant discomfort persists, it's important to contact your ophthalmologist to rule out any complications.

What are the risks of LASIK surgical complications?

While LASIK surgery has a high success rate, it's essential to understand the potential risks and complications associated with the procedure.

As with any surgical procedure, LASIK carries inherent risks. Potential complications include:

• Dry eyes: Many patients experience temporary dry eye symptoms post-surgery, which typically resolve over a month or so¹⁰Toda (2018) Dry Eye After LASIK. Investigative ophthalmology & visual science. https://pubmed.ncbi.nlm.nih.gov/30481814/ .
• Visual disturbances: Some individuals report glare, halos, or double vision, especially in low-light conditions¹¹https://www.fda.gov/medical-devices/lasik/lasik-quality-life-collaboration-project .
• Flap complications: As stated previously, issues with the corneal flap, such as dislocation or improper healing, can occur but are rare at between 0.1 - 4% depending on the specific type of flap complication¹² Moshirfar et al. (2023) Laser In Situ Keratomileusis (LASIK). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-35813/ .

It's essential to have a thorough preoperative evaluation to determine if you're a suitable candidate for LASIK, as certain conditions can increase the risk of complications. Discussing your medical history and potential risks with a qualified ophthalmologist will help ensure the best possible outcome.

Who is not suitable for LASIK surgery?

LASIK may not be appropriate for everyone. Individuals with the following conditions or circumstances are generally advised against undergoing LASIK:

• Unstable vision: If your prescription has changed significantly within the last year, it's advisable to wait until your vision stabilises¹³Moshirfar et al. (2023) Laser In Situ Keratomileusis (LASIK). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-35813/ .
• Certain medical conditions: Autoimmune diseases (e.g., lupus, rheumatoid arthritis), immunodeficiency states (e.g., HIV), and diabetes can affect healing and increase the risk of complications¹⁴ https://www.fda.gov/medical-devices/lasik/when-lasik-not-me .
• Corneal abnormalities: Conditions like keratoconus or thin corneas may make LASIK unsafe¹⁵ https://www.health.harvard.edu/healthbeat/surgical-alternatives-to-lasik .
• Pregnancy or nursing: Hormonal changes can affect vision stability, making it prudent to postpone LASIK during these periods¹⁶ https://pubmed.ncbi.nlm.nih.gov/36114139/ .
• Age restrictions: Individuals under 18 years old are typically not considered suitable candidates, as their vision may still be changing¹⁷ https://eyelaserspecialists.com.au/who-should-not-have-laser-eye-surgery/ .

• High refractive errors: Implantable Collamer Lens (ICL) surgery can correct a broader range of vision issues and is an option for those with severe myopia or hyperopia¹⁸ https://www.icarespecialists.com/2016/12/3-lasik-alternatives-to-cons.
• Dry eye syndrome: Since LASIK can exacerbate dry eye symptoms, individuals with pre-existing severe dry eye may consider alternatives like PRK or ICL, which may have a lower risk of inducing dryness.
• Age-related vision changes: For those experiencing presbyopia or cataracts, Refractive Lens Exchange (RLE) might be a more effective solution, as it replaces the eye's natural lens with an artificial one, addressing multiple vision issues simultaneously¹⁹Alio et al. (undefined) Refractive lens exchange. Survey of ophthalmology. https://pubmed.ncbi.nlm.nih.gov/25127929/ .

What factors increase the risk of complications?

Several factors can elevate the likelihood of experiencing complications from LASIK surgery:

• High refractive error: Individuals with severe nearsightedness, farsightedness, or astigmatism may have a higher risk of undercorrection or overcorrection²⁰Mayo Clinic (2024) LASIK eye surgery. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774 .
• Large pupils: Having large pupils can increase the risk of visual disturbances, such as halos and glare, especially in low-light conditions in the first 3 months post-operatively²¹ Schallhorn et al. (2003) Pupil size and quality of vision after LASIK. Ophthalmology. https://pubmed.ncbi.nlm.nih.gov/12917181/ .
• Previous eye surgeries: A history of certain eye surgeries can complicate the LASIK procedure. Careful pre-operative screening is vitally important in such cases to minimise risk²²Ambrósio and Wilson (undefined) Complications of laser in situ keratomileusis: etiology, prevention, and treatment. Journal of refractive surgery (Thorofare, N.J. : 1995). https://pubmed.ncbi.nlm.nih.gov/11383767/ .
• Active participation in contact sports: Engaging in activities like boxing or martial arts, where there's a high risk of eye injury, may make LASIK less advisable²³ https://www.fda.gov/medical-devices/lasik/when-lasik-not-me .

Understanding these risks and discussing them with a qualified ophthalmologist can help determine whether LASIK is the right choice for you.

What are the risks of post-surgical complications?

While LASIK surgery is widely regarded as safe and effective, it's important to be aware of potential post-surgical complications. Understanding these risks can help you make an informed decision and manage expectations during recovery.

LASIK eye surgery side effects – What are the most common issues?

Post-LASIK, some patients may experience side effects, most of which are temporary and resolve as the eyes heal. Common issues include:

• Dry eyes: A significant number of patients report dry eye symptoms following LASIK. This occurs due to a temporary decrease in tear production as the cornea heals. Symptoms typically improve within six months²⁴ https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774 .
• Visual disturbances: Some individuals notice glare, halos, or double vision, especially in low-light conditions. These effects are usually temporary, lasting a few days to weeks²⁵ https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774 .
• Light sensitivity: Increased sensitivity to light is common during the initial recovery period. This typically diminishes as the eyes adjust²⁶ https://my.clevelandclinic.org/health/treatments/21805-lasik-eye-surgery .

Safe recovery – What can go wrong during healing?

While most LASIK recoveries are uneventful, certain complications can arise during the healing process:

• Epithelial ingrowth: This involves the growth of epithelial cells beneath the corneal flap, potentially affecting vision. Incidence is rare, at around 1%²⁷Toda (2008) LASIK and the ocular surface. Cornea. https://pubmed.ncbi.nlm.nih.gov/18813078/ .
• Infection: Although exceedingly rare (0-1.5%)²⁸ https://pmc.ncbi.nlm.nih.gov/articles/PMC7856934/ infections can occur post-surgery. Prompt medical attention is crucial to address any signs of infection, such as increased redness, pain, or vision changes.
• Diffuse lamellar keratitis (DLK): Also known as "sands of Sahara syndrome," DLK is an inflammatory response that can develop beneath the corneal flap. Incidence is around 1 in 50²⁹Moshirfar et al. (2023) Laser In Situ Keratomileusis (LASIK). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-35813/ . Early detection and treatment are essential to prevent vision impairment.

How common are long-term complications?

Long-term complications from LASIK are uncommon, but it's important to be aware of potential issues:

• Chronic dry eyes: While most dry eye symptoms resolve within months, a small percentage of patients may experience persistent dryness requiring ongoing management³⁰ https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774 .
• Visual aberrations: A minority of patients report lasting visual disturbances, such as halos or glare, particularly in low-light conditions. Most patients report a stabilisation of visual disturbances 3 - 6 months post surgery³¹ Moshirfar et al. (2023) Laser In Situ Keratomileusis (LASIK). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-35813/ .
• Regression: In some instances, the eye may gradually return to its pre-surgery refractive state, necessitating enhancement procedures. This can often be corrected with follow-up treatment.

Understanding these potential risks underscores the importance of thorough preoperative evaluation and selecting an experienced surgeon to minimise complications.

Is LASIK surgery safe from infection risks?

LASIK surgery is widely regarded as a safe and effective procedure for correcting refractive vision issues. However, as with any surgical intervention, there is a potential risk of infection. Understanding the likelihood of such infections and the measures to prevent them can help ensure a safe and successful outcome.

How high is the risk of infection after LASIK?

The incidence of infection following LASIK surgery is exceptionally low. Studies have reported infection rates ranging from 0% to 1.5%

³²https://pmc.ncbi.nlm.nih.gov/articles/PMC7856934/ . This makes LASIK one of the safest elective surgical procedures available today. For comparison, contact lens users face a higher risk of eye infections than LASIK patients.

How to reduce the risk of infection and promote safe healing

While the risk of infection is minimal, adhering to proper post-operative care is crucial to further reduce this risk and promote optimal healing. Here are some guidelines to follow:

• Use prescribed medications: Your surgeon will prescribe antibiotic eye drops to prevent infection and anti-inflammatory drops to reduce inflammation. It's essential to use these medications exactly as directed.
• Maintain proper hygiene: Keep your hands clean and avoid touching or rubbing your eyes, especially during the initial healing period.
• Avoid contaminated water: Refrain from swimming in pools, hot tubs, lakes, or the ocean for at least two weeks post-surgery to prevent exposure to bacteria.
• Follow activity restrictions: Avoid activities that may introduce contaminants to the eyes or cause trauma, such as contact sports, until your surgeon advises it's safe to resume them.
• Attend follow-up appointments: Regular check-ups allow your surgeon to monitor your healing process and address any concerns promptly.

Most importantly, you must diligently follow your surgeon's post-operative instructions and maintain good hygiene practices to significantly minimise the already low risk of infection after LASIK surgery.

How does LASIK safety compare to other vision correction options?

When considering vision correction methods, it's essential to evaluate the safety profiles of each option. LASIK surgery, contact lenses, and lens replacement surgery are common choices, each with its own set of risks and benefits.

Is LASIK safer than contact lenses?

While both LASIK and contact lenses are generally safe, studies have shown that long-term contact lens wearers may face a higher risk of complications compared to those who undergo LASIK surgery. Research indicates that contact lens users are more likely to experience significant vision loss or blindness from infections than LASIK patients

³³ https://www.dfweyes.com/files/2018/01/LASIK-VS-Contact-Safety.pdf .

Contact lenses require diligent hygiene and proper handling to minimise infection risks. Daily routines of inserting, removing, and cleaning lenses can introduce bacteria, can increase the potential for eye infections over time. In contrast, LASIK is a one-time surgical procedure with a low incidence of post-operative infections, provided proper care is taken during the recovery period.

Glasses vs LASIK – Is there a safety consideration?

Glasses are a non-invasive and straightforward way to correct vision, carrying no direct medical risks. However, relying solely on glasses can pose safety concerns in certain situations. For example, if your glasses are lost or damaged, it may be unsafe to drive, especially if you have a strong prescription. Driving without adequate vision correction can result in accidents, points on your driving licence, or even legal penalties. Similarly, navigating unfamiliar environments, crossing busy streets, or performing essential tasks at work can become hazardous without clear vision.

For those with active lifestyles, glasses can also present physical risks. Playing sports while wearing glasses increases the chance of injury from broken frames or lenses. In contrast, LASIK offers a permanent vision correction solution without the need for daily maintenance.

The decision between glasses and LASIK should consider not only medical factors but also personal safety, lifestyle needs, and an individual's comfort with potential surgical risks.

Lens replacement surgery vs LASIK – Comparing the risks

Lens replacement surgery, also known as refractive lens exchange (RLE), involves replacing the eye's natural lens with an artificial intraocular lens to correct vision. This procedure is more invasive than LASIK, as it requires entering the eye's interior, leading to a slightly higher risk profile. Potential complications include retinal detachment, with studies suggesting a risk rate of 1% to 2% per year

³⁴ https://shapirolaser.com/lasik-vs-lens-exchange-rle-no-rush/ .

LASIK, on the other hand, reshapes the cornea's surface and is less invasive as it does not involve intraocular manipulation. However, RLE may be more suitable for individuals with severe refractive errors or age-related vision changes not adequately addressed by LASIK

³⁵Alio et al. (undefined) Refractive lens exchange. Survey of ophthalmology. https://pubmed.ncbi.nlm.nih.gov/25127929/ .

In summary, while all vision correction methods have associated risks, LASIK offers a favourable safety profile compared to long-term contact lens use and lens replacement surgery. It's crucial to consult with an eye care professional to determine the most appropriate option based on individual vision needs and health considerations.

Final considerations – Is LASIK the right choice for you?

Deciding to undergo LASIK surgery is a significant decision that requires careful evaluation of various factors to ensure it's the best fit for your vision needs and lifestyle.

Key safety factors to discuss with your surgeon

Before proceeding with LASIK, it's essential to have an in-depth discussion with your ophthalmologist about the following safety considerations:

• Refractive error range: Confirm whether your specific refractive error falls within the approved range for LASIK.
• Stability of vision: Ensure that your prescription has remained stable over the past year, as fluctuations can affect surgical outcomes.
• Corneal thickness and health: Adequate corneal thickness is necessary for creating the corneal flap during LASIK. Conditions like thin corneas or irregularities may disqualify you from the procedure.
• Medical history: Disclose any existing medical conditions, such as autoimmune diseases, diabetes, or a history of eye infections, as these can influence healing and increase the risk of complications.
• Age and vision changes: Discuss how age-related changes, like presbyopia, might impact the long-term benefits of LASIK. Individuals over 40 may still require reading glasses post-surgery.
• Lifestyle factors: Consider how your daily activities and occupation might be affected during the recovery period and whether LASIK aligns with your lifestyle.

Conclusion

LASIK surgery is a well-established and effective vision correction procedure with a strong safety record. However, like any medical procedure, it comes with potential risks and is not suitable for everyone. Understanding the safety considerations, possible complications, and alternative options is crucial in making an informed decision about your eye health.

If you are considering LASIK, discussing key safety factors with an experienced ophthalmologist can help determine whether it’s the right choice for you. Factors such as corneal thickness, refractive stability, pre-existing eye conditions, and lifestyle needs should all be taken into account before proceeding with surgery.

For residents in Adelaide considering vision correction options, iVISION Laser offers consultations to determine the most suitable procedure tailored to your individual needs and the best course of action for your eye health.

Ultimately, whether you choose LASIK, an alternative surgical procedure, or another vision correction method, ensuring you make the safest and most informed decision is essential for achieving the best possible long-term outcome.