Is LASIK Safe? Understanding the Safety, Risks, and Success Rates

LASIK eye surgery has become one of the most popular elective procedures in the United States, with millions of people choosing it to correct their vision. But if you’re considering LASIK, you’re probably asking yourself: “Is LASIK safe?” This comprehensive guide explores the safety profile of LASIK surgery, examining success rates, potential risks, complications, and what the latest research tells us about this widely-performed procedure.

Understanding LASIK Safety: The Track Record

LASIK (Laser-Assisted In Situ Keratomileusis) has been performed in the United States for over 25 years, with an extensive safety record backed by millions of procedures. The Food and Drug Administration (FDA) approved LASIK surgery, and ongoing research continues to validate its safety and effectiveness.

The overall safety profile of LASIK is impressive. More than 99% of patients achieve 20/40 vision or better after the procedure, which is the legal requirement for driving without corrective lenses in most states. Additionally, over 90% of patients achieve 20/20 vision or better, and patient satisfaction rates consistently exceed 95%.

Serious complications from LASIK are rare, occurring in less than 1% of procedures. The vast majority of patients experience minimal side effects that resolve within weeks to months after surgery. This track record has made LASIK one of the most studied and well-documented elective surgical procedures available.

What Makes LASIK a Safe Procedure?

Several factors contribute to the safety of modern LASIK surgery:

Advanced Technology

Today’s LASIK procedures use sophisticated laser systems with wavefront-guided and bladeless technology. These advancements allow surgeons to create highly precise corneal flaps and reshape the cornea with exceptional accuracy, minimizing the risk of complications and improving outcomes.

Improved Screening Protocols

Modern pre-operative screening has become much more rigorous. Surgeons use detailed corneal mapping and comprehensive eye examinations to identify patients who are good candidates for the procedure and screen out those who might be at higher risk for complications.

Surgeon Experience and Training

LASIK surgeons undergo extensive specialized training beyond their ophthalmology residency. Experienced surgeons who have performed thousands of procedures demonstrate consistently better outcomes and lower complication rates.

FDA Oversight and Regulations

The FDA closely monitors LASIK procedures, laser equipment, and outcomes. This oversight ensures that only approved technologies are used and that safety standards are maintained across the industry.

Common Side Effects: What to Expect

While LASIK is generally safe, it’s important to understand that some temporary side effects are common and expected as part of the normal healing process:

Dry Eyes

Dry eyes are the most common side effect of LASIK, affecting up to 95% of patients temporarily. This occurs because the procedure temporarily disrupts the nerves that regulate tear production. Most cases resolve within three to six months, though some patients may experience dry eyes for up to a year. Your eye care professional may recommend artificial tears or other treatments to manage this symptom.

Visual Disturbances

Many patients experience temporary visual disturbances during the healing period, including:

• Halos around lights, especially at night
• Glare or starbursts
• Fluctuating vision throughout the day
• Light sensitivity
• Difficulty with night driving

These symptoms typically diminish significantly within the first few weeks and continue to improve over three to six months. For most patients, these effects completely resolve, though a small percentage may experience persistent mild symptoms.

Discomfort and Foreign Body Sensation

It’s normal to feel some discomfort, scratchiness, or a sensation that something is in your eye for the first 24 to 48 hours after LASIK. This usually subsides quickly as the corneal flap heals.

Potential Risks and Complications

While serious complications are rare, it’s essential to understand the potential risks before deciding on LASIK surgery:

Undercorrection or Overcorrection

In some cases, the laser may remove too little or too much corneal tissue. Undercorrections are more common in patients with high degrees of nearsightedness and may require an enhancement procedure. Overcorrections can be more challenging to fix and may necessitate glasses or contact lenses for certain activities.

Regression

Some patients experience regression, where vision gradually shifts back toward the original prescription over time. This is more common in patients with higher degrees of refractive error and may require an enhancement procedure.

Flap Complications

The creation of the corneal flap carries some risks, including:

• Incomplete or irregular flap creation
• Flap displacement (extremely rare with modern techniques)
• Epithelial ingrowth (cells growing under the flap)
• Inflammation under the flap

These complications occur in less than 1% of procedures and can usually be managed successfully if they do occur.

Induced Astigmatism

Rarely, LASIK can cause or worsen astigmatism due to irregular healing or tissue removal. This may require additional treatment with glasses, contact lenses, or enhancement surgery.

Infection

Post-operative infections are very rare, occurring in approximately 0.1% of cases or less. Following your surgeon’s post-operative care instructions carefully significantly reduces this risk. If you experience signs of infection such as increased pain, redness, or discharge, contact your surgeon immediately.

Ectasia

Corneal ectasia is one of the most serious but rarest complications of LASIK. It occurs when the remaining corneal tissue is too thin or weak, causing the cornea to bulge forward and distort vision. This complication affects fewer than 0.2% of patients and is largely preventable through proper pre-operative screening to ensure adequate corneal thickness.

Vision Loss

Severe vision loss is extremely rare with LASIK. The risk of losing lines of best-corrected vision (vision with glasses or contacts) is less than 1%, and complete blindness from LASIK is exceptionally rare, with only isolated cases reported in medical literature.

Who Is NOT a Good Candidate for LASIK?

Understanding who should not have LASIK is crucial to the procedure’s safety. You may not be a suitable candidate if you have:

• Unstable vision that has changed within the past year
• Thin corneas or corneal irregularities
• Large pupils relative to the treatment zone
• Severe dry eye syndrome
• Autoimmune diseases that affect healing
• Uncontrolled diabetes
• Certain eye conditions such as keratoconus, glaucoma, or cataracts
• A history of herpes simplex or herpes zoster affecting the eye area
• Pregnancy or nursing (due to hormonal vision changes)
• Unrealistic expectations about outcomes

People in certain professions or who participate in contact sports may also want to consider alternative procedures, as trauma to the eye could potentially dislodge the LASIK flap even years after surgery.

Factors That Influence LASIK Safety

Age Considerations

The FDA has approved LASIK for people 18 years and older, but most surgeons prefer patients to be at least 21 to ensure vision stability. Younger patients may experience continued vision changes, while older patients may need to consider how presbyopia (age-related near vision loss) will affect their outcomes.

Degree of Refractive Error

Patients with mild to moderate refractive errors generally have the best outcomes and lowest complication rates. Those with extreme prescriptions may face higher risks of complications, regression, or unsatisfactory results.

Overall Health Status

Your general health significantly impacts surgical outcomes. Conditions that affect immune function or healing can increase complication risks. Always disclose your complete medical history to your surgeon during the consultation.

Adherence to Post-Operative Care

Following your surgeon’s instructions after LASIK is critical for safety and optimal outcomes. This includes using prescribed medications as directed, attending all follow-up appointments, avoiding eye rubbing, and protecting your eyes from injury during the healing period.

Comparing LASIK Safety to Other Vision Correction Options

LASIK vs. PRK

Photorefractive keratectomy (PRK) is an alternative to LASIK that doesn’t involve creating a corneal flap. While PRK has a longer recovery time and more initial discomfort, it eliminates flap-related complications and may be safer for people with thinner corneas or those at risk of eye trauma.

LASIK vs. SMILE

Small Incision Lenticule Extraction (SMILE) is a newer procedure that uses a smaller incision than LASIK. Early research suggests SMILE may result in less dry eye and potentially greater corneal stability, though long-term data is still being collected.

LASIK vs. Contact Lenses

Interestingly, some studies suggest that LASIK may actually be safer than wearing contact lenses long-term. Contact lens wear carries risks of infection, corneal ulcers, and other complications, particularly with improper hygiene or extended wear. The lifetime risk of serious complications from contact lenses may exceed the risk from LASIK.

Long-Term Safety Data

Long-term studies following LASIK patients for 10 to 20 years have shown that the procedure remains safe and effective over time. Most patients maintain stable vision, and serious late complications are rare. However, it’s important to understand that LASIK doesn’t prevent age-related eye changes such as cataracts or presbyopia.

Some patients may experience gradual vision changes over the years due to natural aging processes rather than problems with the LASIK procedure itself. Regular eye examinations remain important after LASIK to monitor overall eye health.

How to Maximize Your LASIK Safety

Choose an Experienced, Reputable Surgeon

The skill and experience of your surgeon is perhaps the most important factor in LASIK safety. Look for:

• Board-certified ophthalmologists with specialized LASIK training
• Surgeons who have performed thousands of procedures
• Practices with modern, FDA-approved equipment
• Transparent reporting of complication rates and outcomes
• Good communication and willingness to answer all your questions

Be Honest During Your Consultation

Provide complete and accurate information about your medical history, medications, lifestyle, and vision goals. This helps your surgeon determine whether you’re a good candidate and identify any potential risk factors.

Have Realistic Expectations

Understanding what LASIK can and cannot do helps ensure satisfaction and reduces the likelihood of disappointment. Most patients achieve excellent vision, but perfect 20/20 vision without any visual symptoms isn’t guaranteed for everyone.

Follow All Pre- and Post-Operative Instructions

Your surgeon will provide specific guidelines for before and after surgery. Following these instructions carefully minimizes complications and optimizes your results.

Warning Signs: When to Contact Your Surgeon

While most LASIK recoveries are uneventful, contact your surgeon immediately if you experience:

• Severe or worsening pain
• Significant vision loss
• Increasing redness or discharge
• Flashing lights or new floaters
• Signs of infection
• Any concerns about your healing

Early intervention can prevent minor issues from becoming serious problems.

The Bottom Line: Is LASIK Safe?

Based on decades of research and millions of procedures performed, LASIK is considered a safe and effective vision correction option for appropriate candidates. The procedure has one of the highest patient satisfaction rates of any elective surgery, with the vast majority of patients achieving their vision goals without serious complications.

However, “safe” doesn’t mean “risk-free.” Like any surgical procedure, LASIK carries some risks, and outcomes can vary between individuals. The key to safety is:

• Thorough pre-operative screening to ensure you’re a good candidate
• Choosing an experienced, qualified surgeon
• Having realistic expectations about outcomes
• Following all pre- and post-operative care instructions
• Being aware of potential risks and complications

If you’re considering LASIK, schedule consultations with one or more experienced LASIK surgeons. Ask detailed questions about their experience, technology, complication rates, and what results you can realistically expect. A reputable surgeon will provide honest answers and help you determine whether LASIK is the right choice for your individual situation.

Remember that while the statistics are reassuring, you are an individual, not a statistic. Your personal health, eye anatomy, lifestyle, and vision goals all factor into whether LASIK is safe and appropriate for you. Take the time to gather information, weigh the benefits and risks, and make an informed decision that feels right for your circumstances.

For most people who are good candidates, LASIK offers an excellent safety profile with life-changing benefits. The freedom from glasses and contact lenses, combined with the procedure’s track record of safety and success, makes LASIK a trusted choice for vision correction that has helped millions of people see the world more clearly.

Sources:

• FDA – LASIK Information for Patients
• American Academy of Ophthalmology – LASIK Eye Surgery
• Mayo Clinic – LASIK Eye Surgery
• National Eye Institute – Refractive Errors
• National Center for Biotechnology Information – LASIK Safety Studies