Laser eye surgery, which some people call LASIK surgery, can correct several eyesight conditions. However, there are potential risks or side effects, and not everyone can have the procedure.

The eye has an outer layer called the cornea. Some people’s corneas can undergo changes in their shape, leading to vision issues, such as astigmatism and myopia. Laser eye surgery is a medical procedure that reshapes this layer.

Precisely how laser eye surgery reshapes the cornea depends on the vision condition that the treatment aims to correct. Laser eye surgery can fix vision issues, such as nearsightedness and farsightedness.

The surgery is quick, and people remain awake throughout the procedure. It is also usually painless — if a person experiences pain, it usually indicates there have been complications.

This article discusses what laser eye surgery is, who it can help, costs, duration of the surgery, recovery time, and any associated short- and long-term risks.

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LASIK stands for laser-assisted in situ keratomileusis and is the most common type of refractive eye surgery. LASIK was first patented in 1989 and has become the most common treatment for refractive eye errors. The procedure involves lasers to reshape the cornea.

According to the American Academy of Ophthalmology, over 150 million Americans use corrective eyewear, such as glasses or contact lenses, to compensate for refractive errors.

Refractive errors occur when the eye does not bend — or refract — the light to properly focus on the retina in the back of the eye. This is usually due to the shape of the cornea.

Farsightedness

The clinical name for farsightedness is hyperopia. People with this condition can see objects in the distance clearly, but other things can appear blurry at close distance. Farsightedness is due to the curvature of the cornea being too flat. Laser eye surgery can correct this by reshaping the cornea to have a steeper curve.

Nearsightedness

Nearsightedness, known as myopia or short-sightedness, is where a person can see objects close to them clearly. However, distant objects can appear blurred. This is due to the curvature of the cornea being too steep. Healthcare professionals can correct this through laser eye surgery by reshaping the cornea.

Astigmatism

People with astigmatism have a differently-shaped eye that characterizes this condition. The eye of someone without the condition is round, like a soccer ball, while with astigmatism, the eye may have more of a football-like shape. It is possible to correct this irregular curvature of the cornea with laser eye surgery in some cases.

People who are not suitable candidates for laser eye surgery include those who:

  • have had a change in their eye prescription in the last 12 months
  • take medications that may cause changes in vision
  • are in their 20s or younger, although some experts recommend not being under 18 years
  • have thin corneas, which may not be stable following laser surgery
  • are pregnant or nursing

The main benefit of laser eye surgery is that most people no longer have to wear corrective eyewear to see clearly. Individuals may choose to undergo the procedure for several reasons, including:

  • being unable to wear contact lenses but preferring not to wear glasses, perhaps for cosmetic reasons
  • wishing to undertake activities, such as sports, that require a person not to wear glasses or contact lenses
  • having the convenience of not having to wear corrective eyewear

A person is more at risk of developing complications if they have the following eye conditions:

  • eye infections, such as keratitis or ocular herpes
  • significant cataracts — people with this condition will not have corrected vision after laser surgery
  • glaucoma
  • large pupils
  • keratoconus, a disease that makes the cornea thinner and unstable over time

As with all surgeries, a person may experience complications, including:

  • Dry eyes: Up to 95% of people who have laser eye surgery may experience dry eyes after the procedure, where the eyes produce fewer tears. Lubricating eye drops can help with this symptom.
  • Glare or halo: 20% of people undergoing laser eye surgery may experience visual changes such as glare, halo, or sensitivity to light.
  • Double or blurry vision: As many as 1 in 50 people may report blurriness and feel there is something in their eyes. Diffuse lamellar keratitis — also called “sands of Sahara” syndrome — may be the cause.

Other complications a person may experience include:

  • eye infection
  • corneal flap complications
  • red or bloodshot whites of the eye

Most symptoms should resolve after the first few days, so an individual experiencing any symptoms after this time should consult with a medical professional.

The Food & Drug Administration (FDA) suggests laser eye surgery usually takes less than 30 minutes. Others estimate the procedure will take around 5 minutes per eye.

People undergoing laser eye surgery should expect the following:

  • They will sit in a chair and recline, so they are flat on their back underneath a laser device and computer screen.
  • The surgical team will clean the area around the eye and place numbing drops in the eye.
  • Surgeons will use a lid speculum, a medical instrument, to hold the eyelids open.
  • A laser will cut a flap in the cornea, and the surgeon will then lift this open.
  • People will need to stare at a light to keep their eyes still while the laser works.
  • The laser will then reshape the surface of the cornea.
  • The surgeon will then place the flap back into position and apply a shield to protect the eye.

The FDA notes that after surgery, a person may feel as though their eye is burning, itchy, or that there is a foreign object present. The surgeon may recommend a mild pain reliever, such as acetaminophen, to help with these sensations.

Surgeons will provide people with an eye shield to protect their eyes, as there will be no stitches holding the flap in place. The guard helps prevent rubbing the eye or accidentally applying pressure, such as during sleep.

Individuals will usually take a few days off from work so they can recover. They should schedule an appointment to see their eye doctor within the first 24–48 hours after surgery to undergo an eye examination. The doctor will make sure the eyes are healing as they should. After this, a person will need several additional appointments over the first 6 months.

It may take up to 6 months for a person’s vision to stabilize after laser eye surgery. They may notice their vision fluctuates for a while after the procedure, but this should not be a cause for concern.

However, it is common for vision to vary for the initial few months following surgery.

Additionally, sometimes laser eye surgery may accidentally over- or under-correct a person’s sight. This might require further surgery to rectify, which healthcare professionals usually called enhancement.

It is also important to remember that corrected vision can regress years after the procedure.

The cost of LASIK surgery will be different depending on where the person lives. Other surgeons may use various equipment or techniques, which the price may reflect.

Health insurance companies usually categorize LASIK as an elective or cosmetic procedure and do not typically cover these treatments.

In 2020, the American Refractive Surgery Council estimated that LASIK surgery might cost around $4,200 per eye, on average.

Although laser eye surgery can be expensive, it is crucial that people thoroughly do their research before undergoing treatment at reduced prices. There may be a reason the price is so low, which may increase the risk of complications.

Laser eye surgery may be beneficial for some people to remedy issues with their sight. However, while these improvements can last for a few years, they are not usually permanent.

It is a quick but often expensive procedure that health insurance does not usually cover.

It is also important to remember that this procedure may not correct presbyopia — the need for reading glasses as people age.

People should discuss whether laser eye surgery may be suitable for their circumstances with their eye doctor.