LASIK does not “undo itself.” The changes made during LASIK surgery are permanent; however, your eyes can naturally change over time, which may affect your vision.
These changes are not because the procedure reverses but due to age or evolving eye conditions.
Understanding How LASIK Works
To fully grasp the idea of whether LASIK can “undo itself,” you first need to understand the procedure. LASIK (Laser-Assisted in Situ Keratomileusis) is a laser eye surgery designed to correct refractive errors, including nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. By reshaping the cornea, LASIK ensures that light entering the eye focuses correctly on the retina, enabling clear vision.
During the procedure:
- A precise, thin flap is created on the cornea.
- A laser is used to precisely reshape the underlying corneal tissue.
- The flap is repositioned to heal naturally without stitches.
The surgical adjustments are permanent because the corneal tissue removed does not regenerate or “grow back.” LASIK provides immediate and long-lasting results for vision correction, often eliminating the need for glasses or contact lenses.
Why Do Vision Changes Occur After LASIK?
While LASIK itself is permanent, your eyes are not immune to natural changes or further vision issues after the procedure. These changes can lead to the misconception that LASIK “undoes itself.” Below are the primary reasons why vision may change post-LASIK:
1. Age-Related Vision Changes (Presbyopia)
One of the most common reasons for vision changes after LASIK is presbyopia. This is an age-related condition that typically begins in your 40s. It affects near vision as the lens in your eye loses flexibility, making it harder to focus on close objects.
Important to note: LASIK does not prevent presbyopia because it only reshapes the cornea—it does not address the internal lens of the eye.
2. Progression of the Original Vision Problem
For some individuals, their refractive error may continue to develop after LASIK. For example:
- People with high myopia before surgery may still experience progression in nearsightedness over time.
- Similarly, changes to hyperopia or astigmatism could occur due to natural ageing or other factors.
While LASIK corrects your vision at the time of surgery, it cannot stop your eyes from continuing to change as part of the natural ageing process. These changes might lead to reduced clarity over the years.
3. Regression
Regression occurs in a small percentage of LASIK patients—typically within the first year after surgery. This happens when the cornea begins to shift slightly back toward its previous shape, leading to a partial return of the refractive error that LASIK was meant to correct.
Regression is not common, but it is more likely in the following cases:
- Patients with very high levels of refractive error before LASIK.
- Individuals with naturally thin corneas.
Touch-up procedures, also known as LASIK enhancements, can often address and correct regression.
4. Ectasia (Corneal Instability)
Ectasia is a rare complication where the cornea becomes unstable and starts to bulge forward, distorting vision. This can resemble a condition called keratoconus. Risk factors for ectasia include:
- Pre-existing thin corneas.
- Being an unsuitable candidate for LASIK.
Though uncommon, this condition may require further treatment, such as corneal collagen cross-linking or special contact lenses, to stabilise the corneal shape.
5. Cataracts or Other Eye Conditions
Developing eye conditions like cataracts, glaucoma, or diabetic retinopathy can also affect vision post-LASIK. These conditions are unrelated to the laser procedure itself but can lead to diminished visual performance.
Key takeaway: LASIK does not protect against or exacerbate these conditions—they are simply part of normal eye health considerations as one ages.
Preventing Vision Changes After LASIK
While some vision changes are inevitable due to age and other factors, there are proactive steps LASIK patients can take to maintain optimal visual health:
- Adhere to the post-operative care instructions provided by your surgeon.
- Arrange routine eye examinations to assess your vision and maintain optimal eye health.
- Protect your eyes from UV exposure by wearing sunglasses with 100% UV protection.
- Manage chronic health conditions (like diabetes) to minimise their impact on vision.
- Consider enhancements if regression occurs and additional correction is recommended by your ophthalmologist.
Can LASIK Be Re-Done?
If vision issues emerge years after your LASIK procedure due to changes unrelated to the surgery itself, enhancements or additional laser correction may be an option. LASIK enhancement involves re-lifting the original corneal flap to make further adjustments. However, not all patients are candidates for enhancement, as factors such as corneal thickness and overall eye health will determine suitability.
- Enhancements are typically minor and can correct mild regression or residual refractive errors.
- They carry similar risks as the initial LASIK surgery but are generally regarded as safe and effective.
Before considering a second procedure, consult a qualified ophthalmologist to evaluate your suitability.
What This Means for You as a LASIK Candidate?
For those considering LASIK, it’s essential to manage expectations. LASIK delivers life-changing results for many people, but like any medical procedure, it has limitations. The surgery permanently alters your cornea, but it cannot prevent every possible factor that might impact your vision in the future.
Tips for Prospective LASIK Patients:
- Ensure you undergo a thorough pre-surgery evaluation to confirm you’re a suitable candidate.
- Discuss both the benefits and limitations with your surgeon to get a comprehensive understanding.
- Understand that while LASIK can dramatically reduce dependence on corrective eyewear, it may not provide “perfect vision” for every individual, especially long-term.
Conclusion
LASIK does not undo itself. The changes made to your cornea are permanent, yet your eyes may naturally evolve over time, leading to vision changes. These shifts are mostly attributed to age-related conditions, progression of refractive errors, regression, or new eye health issues.
The key to maximising the benefits of LASIK is proactive eye care and clear communication with your eye surgeon. While LASIK is not a cure-all, it remains a highly effective tool for achieving long-term vision correction and vastly improving quality of life.
If you’ve had LASIK or are considering it, but still have concerns about its longevity, don’t hesitate to consult a trusted ophthalmologist. Being informed about the potential for post-surgery changes ensures you can make confident decisions about your vision care.
