Is laser eye surgery permanent? For those who have given any thought to surgical vision correction, this question is probably one of the more important ones on your mind, given that you’re about to entrust your sight to an eye surgeon. Laser eye surgery has several advantages. The major ones are that it means you’re no longer dependent on your glasses or contact lenses, with all the inconveniences that come with them.
Conversely, any form of surgical vision correction also comes with some drawbacks, such as the upfront costs, or the possibility of an unsatisfactory outcome or complication, even in the hands of the most experienced eye surgeon. To learn what you need to know about is laser eye surgery permanent, keep reading.
Is Laser Eye Surgery Permanent?
The short answer is – it’s designed to be. Laser eye surgery involves reshaping the cornea at the front of the eye. By adjusting its curvature, your eye surgeon can change the way that light passes through this surface so that it can come to a clear focus on the retina. Modifying your corneal curvature during laser eye surgery is achieved by removing precisely selected areas of tissue. During the PRK and LASIK vision correction procedures, this process is known as photoablation. It is performed using an excimer laser to vaporise parts of the cornea to reshape it. For SMILE vision correction, your eye surgeon uses a femtosecond laser instead to create a disc-like sliver of tissue out of the deeper corneal layers, which is then removed through a keyhole incision.
Because corneal tissue that is removed during laser eye surgery cannot be replaced, in this sense, laser eye surgery is permanent. However, you may already be aware of friends or family who have ended back up in glasses or contact lenses after having undergone successful surgical vision correction. So, why do some people experience this? Is laser eye surgery permanent?
Age as a Factor
It probably doesn’t come as a surprise to you to hear that age causes changes to your sight. This includes impacting the longevity of laser eye surgery.
One of the first effects of age on an eye that’s had successful laser vision correction is presbyopia. Presbyopia is a normal part of ageing and usually starts to become noticeable around the mid-40s. At this age, you’ll start to find that your near sight is not as easy or as comfortable as it used to be. You’ll start to need to hold text or objects slightly further away in order to see them clearly or, if you’re naturally short-sighted, remove your distance glasses in order to read clearly up close. As you continue to age, the effects of presbyopia will only become more pronounced. Having laser eye surgery does not influence the onset or development of presbyopia. The majority of such procedures aim for distance vision correction, with the exception of Presbyond. Presbyond is a modification of LASIK, which provides a bit of reading sight in each eye in addition to long distance; it is offered only by select surgeons. While you may enjoy excellent long-distance sight for decades, you will find that your near sight begins to deteriorate around the mid-40s, as anticipated.
As you get older, you’ll also realise that age is a risk factor for a variety of medical conditions, including those that can affect your sight. The most likely condition that will begin to undo the clear sight provided by your laser eye surgery is cataract. In addition to cataracts, other eye diseases that are more prevalent with age include glaucoma and age-related macular degeneration.
Regression as a Factor
The possibility of regression may come up during your pre-operative consultations with your surgeon. It refers to the slow return of refractive error – also known as your prescription – months or years after having had successful laser vision correction. Your script may not regress completely to your pre-operation degree, but it may be enough that you feel you need to return to wearing glasses or contact lenses to function properly for some or all tasks.
Surgeons don’t fully understand why regression occurs. One possible explanation is that as the cornea heals, this process brings back some degree of myopia (short-sightedness) or hyperopia (long sightedness).
No one can guarantee that you will not encounter regression after your surgical vision correction. However, research has uncovered several factors that seem to be associated with an increased risk of regression. These risk factors include:
- The severity of the refractive error (prescription)
- Patient age at the time of surgery
- Ambient temperature of the operating room
- Thickness of the cornea prior to surgery
- Residual corneal thickness after surgery
Even after all of this, your eye surgeon will still not be able to give you an accurate prediction of whether you’re expected to experience regression or when it might happen. Some people find things begin to become blurry within a year or two after their laser eye surgery, while others may enjoy much longer before regression sets in.
There is some suggestion that not all techniques are equal when it comes to the risk of regression. One study noted that SMILE was associated with a lower risk of short-sighted regression compared to LASIK and PRK.
The good news is that a touch-up procedure is often available if you do experience regression. This is another quick laser operation, whether LASIK or PRK, to correct your sight back to perfect. Though not everyone may be suitable for a second round of laser surgery, your surgeon will be able to perform an assessment and explain your options.
Call us on 03 9000 0389 for an eye assessment today.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
Factors predicting the need for retreatment after laser refractive surgery.
https://journals.lww.com/corneajrnl/Abstract/2016/05000/Factors_Predicting_the_Need_for_Retreatment_After.5.aspx
SMILE offers low enhancement rate after nomogram adjustment.
https://www.ophthalmologytimes.com/view/smile-offers-low-enhancement-rate-after-nomogram-adjustment
How long does LASIK last?
https://www.healthline.com/health/eye-health/how-long-does-lasik-last
LASIK and PRK in hyperopic astigmatic eyes: is early retreatment advisable?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820209/
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