LASIK (laser-assisted in situ keratomileusis) is a popular refractive surgery used to correct refractive errors like near-sightedness, far-sightedness and astigmatism. During LASIK, a laser is used to reshape the cornea and change its focusing power to reduce dependency on glasses or contact lenses.
Many people undergo LASIK with the hope that they can kiss their glasses and contact lenses goodbye forever. But is that really the case? Can you get short sighted again after LASIK?
Can LASIK regression happen?
Yes, it is possible for short-sightedness to return after LASIK, a phenomenon known as “LASIK regression”. There are a few reasons why this can happen:
- Natural growth of the eye – As we age, our eyes continue to gradually grow and change shape. For some people, the length of the eye (from cornea to retina) may increase over time, causing the light entering the eye to focus at a point in front of the retina, resulting in short-sightedness again.
- Presbyopia – Most people start losing their ability to focus on near objects clearly, a condition known as presbyopia, around age 40. This natural hardening of the crystalline lens can cause blurry near vision and make short-sightedness recurrence more likely after LASIK.
- Corneal changes – The cornea can become misshapen over time after LASIK. A distortion in the corneal shape, such as corneal ectasia, can contribute towards short-sightedness again.
- Healing responses – During LASIK recovery, cells grow over the area of cornea that was reshaped by laser. Differences in individual healing can affect the cornea’s final shape and curvature, influencing the potential for short-sightedness to return.
- Loss of effect – While LASIK aims to permanently change corneal shape, the effects can slowly diminish over time. This gradual loss of initial treatment efficacy can lead vision regression.
How common is LASIK regression?
LASIK regression is relatively uncommon. According to studies, significant regression occurs in around 5-10% of patients within 10 years after LASIK. Mild regression can occur in up to 20% of patients in the long run.
People under 45 years old have a lower risk of regression. Younger corneas undergo less age-related changes so the effects of LASIK tend to be more stable long-term. Older patients are more prone to regression since their eyes continue to change with advancing age.
When does LASIK regression occur?
Regression can occur any time after LASIK, but is more likely to happen years later. Here’s an overview of when regression tends to occur:
- Within first 6 months – Regressive changes soon after surgery are rare and usually minor. May be due to residual healing effects on cornea shape.
- 6 months to 2 years – Uncommon timeframe for significant regression. Indicates non-age related factors like corneal healing changes are involved.
- 2 to 5 years – Gradual regression may start due to early presbyopia and natural eye growth. Mild changes in prescription may be needed.
- After 5 years – Most common timeframe for regression. Presbyopia, eye growth, and loss of LASIK effect over time often necessitate vision enhancement.
- After 10 years – Over 50% of regression cases occur 10+ years post-LASIK. Advancing age makes recurrence of short-sightedness more likely.
Are you a good candidate for LASIK?
The best candidates for LASIK have:
- Stable vision – Vision should not have changed much in the past 1-2 years, indicating your eyes have stopped growing and changing focus.
- Healthy eyes – No eye diseases, injuries, or dry eye problems.
- Reasonable expectations – Understand that some vision fluctuation is still possible long-term.
- No very high correction – People with low-moderate near-sightedness, far-sightedness or astigmatism get the most stable LASIK results.
- Age between 20-40 years – Younger eyes tend to get more permanent results from LASIK.
Can anything be done for LASIK regression?
If short-sightedness recurs years after your initial LASIK procedure, there are enhancement options to sharpen vision again:
- LASIK re-treatment – A second LASIK procedure can be performed to re-reshape the cornea and further reduce short-sightedness. This is less effective if regression is due to natural eye aging changes.
- Photorefractive keratectomy (PRK) – The surface layer of the cornea is removed and reshaped with laser energy to re-correct short-sightedness. PRK may offer more regression stability than LASIK re-treatment.
- Phakic IOL – This lens implant is placed inside the eye in front of the natural lens to correct short-sightedness, reducing dependency on the cornea.
- Reading glasses or contacts – If regression is mild, you may be able to use glasses or contacts just for reading or driving to sharpen vision as needed.
Can regression after LASIK be prevented?
There are a few things you can do to lower chances of regression:
- Have LASIK done at age 40 or under – Choose the procedure when your eyes and vision are still relatively stable.
- Maintain a healthy lifestyle – Don’t smoke, manage diseases like diabetes, eat well and wear sunglasses to protect your eyes from UV damage.
- Have regular eye exams – Your optometrist can detect subtle vision changes before major regression occurs.
- Use reading glasses as you age – Over-focusing to see up close can worsen short-sighted regression.
- Limit near work – Take frequent breaks when doing prolonged close activities like reading and using devices.
Takeaway points on LASIK regression
- Regression after LASIK is fairly uncommon but can occur, especially years later as the eyes age.
- Younger patients have a lower lifetime risk of LASIK regression.
- Enhancement procedures like LASIK re-treatment or PRK can re-correct regressed vision.
- Choosing LASIK at an appropriate age and maintaining ocular health helps prevent recurrence of short-sightedness.
Conclusion
While LASIK has proven effective for permanently reducing dependence on glasses or contacts, there remains a small risk of short-sightedness recurring years later. This is more likely in patients who undergo LASIK at older ages. Regression risk should be discussed beforehand so expectations are realistic. If short-sightedness does return after LASIK, there are possible enhancement options to re-sharpen vision.