Certain medical conditions, eye health issues, and lifestyle factors can disqualify someone from being a suitable candidate for LASIK eye surgery.
These contraindications must be carefully assessed by an eye specialist to prevent complications and ensure patient safety.
LASIK (Laser-Assisted in Situ Keratomileusis) eye surgery is one of the most popular procedures for correcting vision problems like nearsightedness, farsightedness, and astigmatism. While it has transformed the lives of millions by reducing or eliminating the need for glasses or contact lenses, it’s not suitable for everyone.
This blog explores the specific contraindications for LASIK, providing a comprehensive guide for those considering this life-changing procedure.
1. Age-Related Factors
Not Suitable for Individuals Under 18
One of the most basic criteria for LASIK surgery is that the patient must be at least 18 years old. Vision continues to change during adolescence, and performing LASIK on a patient whose eyes are not fully developed may lead to unsatisfactory outcomes or regression of vision correction.
Caution for Patients Over 40
While LASIK is generally safe for older adults, those over 40 may experience age-related conditions such as presbyopia (difficulty focusing on near objects). LASIK cannot treat presbyopia directly, making other procedures or corrective solutions more suitable for this group.
2. Unstable Vision
Patients with unstable vision are not ideal candidates for LASIK surgery. If your prescription has changed significantly in the last 1–2 years, it may indicate that your eyes are still stabilising. LASIK requires a stable prescription to achieve long-lasting results, and performing the surgery on someone with fluctuating vision can lead to the need for additional corrective procedures.
Common Causes of Unstable Vision Include:
- Hormonal changes (e.g., during pregnancy or breastfeeding)
- Certain medications like corticosteroids
- Ongoing or untreated eye conditions
3. Corneal Thickness and Shape
The cornea must meet specific thickness and shape criteria for LASIK surgery to be successful. Here’s why:
Thin Corneas
LASIK involves reshaping the cornea by removing a small amount of corneal tissue. If your cornea is too thin, it may not leave enough tissue to maintain the structural integrity of the eye. This increases the risk of complications such as ectasia—a condition where the cornea bulges outward.
Irregular Corneal Shape
Certain corneal conditions, like keratoconus (a condition that causes corneal thinning and bulging), make LASIK unsafe. Irregular corneas are more prone to complications and may not respond well to the reshaping process.
Alternative procedures like PRK (Photorefractive Keratectomy) or other vision correction options may be recommended for patients with thin or irregular corneas.
4. Current or Past Eye Conditions
Certain eye diseases and conditions can rule out LASIK surgery entirely. These include:
- Dry Eye Syndrome
Severe dry eye can worsen after LASIK surgery, leading to discomfort and impaired healing. Patients with existing dry eye syndrome are often advised to treat the condition before considering LASIK.
- Active Eye Infections
Any infection, whether bacterial, viral, or fungal, must be resolved before surgery. Performing LASIK on an infected eye significantly increases the risk of complications.
- Glaucoma
LASIK reshapes the cornea, which can affect intraocular pressure readings—a critical measure for managing glaucoma. For individuals with advanced glaucoma, LASIK can worsen the condition or interfere with its management.
- Cataracts
LASIK does not treat cataracts. If a candidate has cataracts that impair vision, they are typically advised to undergo cataract surgery instead of LASIK.
- Retinal Disorders
Patients with retinal diseases like retinal detachment or diabetic retinopathy should avoid LASIK surgery, as these conditions can severely affect visual outcomes and pose risks during the procedure.
5. Autoimmune and Systemic Diseases
Autoimmune and systemic conditions can interfere with healing and increase the risk of complications. These include:
- Rheumatoid Arthritis and Lupus
Healing can be significantly delayed for patients with autoimmune diseases, increasing the likelihood of post-surgery complications, like infections or scarring.
- Diabetes (Poorly Controlled)
Uncontrolled diabetes can impair wound healing and make the cornea more susceptible to infections. For some diabetics, fluctuating blood sugar levels can also lead to unstable vision, further complicating the surgery’s success.
- HIV/AIDS
Patients with suppressed immune systems are at a higher risk of infection and delayed recovery post-surgery. While LASIK isn’t automatically contraindicated for all HIV-positive individuals, it requires careful evaluation.
6. Pregnancy and Breastfeeding
Hormonal fluctuations during pregnancy and breastfeeding can temporarily alter vision, making it inadvisable to undergo LASIK during these periods. Additionally, some medications prescribed during the LASIK recovery process may not be safe for pregnant or breastfeeding individuals.
Experts generally recommend waiting at least several months postpartum and after weaning before considering LASIK.
7. Lifestyle and Occupational Restrictions
Your lifestyle and occupation can also play a role in determining LASIK eligibility. Consider the following:
- Athletes or Individuals in High-Impact Sports
Activities like boxing, martial arts, or similar high-contact sports increase the risk of trauma to the eye. Certain alternative procedures, like PRK, may be better suited for these individuals.
- Military Personnel and First Responders
Those in professions such as military service or firefighting should consult with their employer regarding LASIK eligibility. Some organisations may have specific guidelines due to the demands of these roles.
8. Unrealistic Expectations
LASIK does not guarantee perfect vision, nor does it prevent the natural ageing of the eyes. Patients with unrealistically high expectations may feel dissatisfied with their results. For instance, LASIK cannot eliminate the need for reading glasses in older adults with presbyopia.
Doctors generally ensure candidates are well-informed about what LASIK can and cannot achieve before moving forward with the procedure.
9. Psychological Factors
LASIK requires a cooperative and calm patient during the procedure, alongside successful postoperative care compliance. For individuals with extreme anxiety, phobias related to medical procedures, or certain untreated mental health conditions, LASIK may not be ideal.
Consulting a specialist to address these psychological concerns or pre-procedure sedation may mitigate these issues, making LASIK more viable for these patients.
10. Previous Refractive Surgery
Individuals who have already undergone a refractive procedure, such as PRK or a prior LASIK surgery, may not be good candidates for a second LASIK procedure. It depends on the remaining corneal thickness and overall eye health. Alternative options may require exploration in such cases.
The Bottom Line
Understanding the contraindications of LASIK surgery is essential to make an informed decision about your vision correction. While LASIK can provide life-changing benefits, it’s not a one-size-fits-all solution. Factors like eye health, medical history, and lifestyle are critical to assessing whether LASIK is safe and appropriate for you.
Are you unsure if LASIK is the right choice for your eyes? Speak with a trusted ophthalmologist who can perform a detailed eye examination and recommend the safest options tailored to your specific needs.
Whether or not LASIK is suitable for you, you can still achieve remarkable visual results with alternative treatments. Remember, safeguarding your eye health should always be your top priority.
