When is LASIK not for me?
You are probably NOT a good candidate for refractive surgery if:
- You are not a risk taker. Certain complications are unavoidable
in a percentage of patients, and there are no long-term data available
for current procedures.
- It will jeopardize your career. Some jobs prohibit certain
refractive procedures. Be sure to check with your employer/professional
society/military service before undergoing any procedure.
- Cost is an issue. Most medical insurance will not pay for refractive
surgery. Although the cost is coming down, it is still significant.
- You required a change in your contact lens or glasses prescription
in the past year. This is called refractive instability. Patients
who are:
- In their early 20s or younger,
- Whose hormones are fluctuating due to disease such as diabetes,
- Who are pregnant or breastfeeding, or
- Who are taking medications that may cause fluctuations in vision,
are more likely to have refractive instability and should discuss
the possible additional risks with their doctor.
- You have a disease or are on medications that may affect wound
healing. Certain conditions, such as autoimmune diseases (e.g.,
lupus, rheumatoid arthritis), immunodeficiency states (e.g., HIV) and
diabetes, and some medications (e.g., retinoic acid and steroids) may
prevent proper healing after a refractive procedure.
- You actively participate in contact sports. You participate
in boxing, wrestling, martial arts or other activities in which blows
to the face and eyes are a normal occurrence.
- You are not an adult. Currently, no lasers are approved
for LASIK on persons under the age of 18.
Precautions
The safety and effectiveness of refractive procedures has not been determined
in patients with some diseases. Discuss with your doctor if you have a
history of any of the following:
- Herpes simplex or Herpes zoster (shingles) involving the eye
area.
- Glaucoma, glaucoma suspect, or ocular hypertension.
- Eye diseases, such as uveitis/iritis (inflammations of the eye)
- Eye injuries or previous eye surgeries.
Other Risk Factors
Your doctor should screen you for the following conditions or indicators
of risk:
- Blepharitis. Inflammation of the eyelids with crusting
of the eyelashes, that may increase the risk of infection or inflammation
of the cornea after LASIK.
- Large pupils. Make sure this evaluation is done in a dark room.
Younger patients and patients on certain medications may be prone to
having large pupils under dim lighting conditions. This can cause symptoms
such as glare, halos, starbursts, and ghost images (double vision) after
surgery. In some patients these symptoms may be debilitating. For example,
a patient may no longer be able to drive a car at night or in certain
weather conditions, such as fog.
- Thin Corneas. The cornea is the thin clear covering of the
eye that is over the iris, the colored part of the eye. Most refractive
procedures change the eyes focusing power by reshaping the cornea
(for example, by removing tissue). Performing a refractive procedure
on a cornea that is too thin may result in blinding complications.
- Previous refractive surgery (e.g., RK, PRK, LASIK). Additional
refractive surgery may not be recommended. The decision to have
additional refractive surgery must be made in consultation with your
doctor after careful consideration of your unique situation.
- Dry Eyes. LASIK surgery tends to aggravate this condition.
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