Lasik longterm results - good or bad?

The 1.4 million Americans who chose to have Lasik vision correction surgery last year presumably have no doubts about lasik longterm results.

The Food & Drug Administration (FDA) has still not drawn final conclusions about how effective or how safe of enhancement surgery is.  The reason is that laser companies have not yet produced enough evidence to make such conclusions possible.

A paper presented in November 2006 at the annual meeting of the American Academy of Opthalmology did provide encouraging news.  

The paper was based on a follow-up study of people who had undergone lasik and PRK (photorefractive keratotomy)10 years earlier.

The study found that while there had been some regression, on average patients had maintained 20/25 vision.

A recent Irish study of patients who had had lasik surgery in 1998 and 1999 reported the same findings. There had been some regression, but surgeons were able to fix eye defects with a great deal of accuracy.   There was a high level of patient satisfaction even many years after the procedure.

The popularity of the lasik option for people who depend on eyeglasses or contacts therefore appears to be based on fact and the results can be dramatic.

Improved vision

Nearly 95 % of all patients report improved vision almost right after the procedure. Quite often eyesight improved to 20/40 eyesight or better.

Modern Lasik surgery was first used in America at the start of the nineties.  So the experience bank is now about 20 years, and equipment and techniques are  improving all the time.

Nonetheless, the FDA remains cautious. Its website says that “Long-term data is not available. Lasik is a relatively new technology. The first laser was approved for Lasik eye surgery in 1998. Therefore, the long-term safety and effectiveness of Lasik surgery is not known.”

Lasik surgeons agree, and warn that lasik is surgery, and all surgery has some risk.

Possible problems

The FDA lists the following possible problems:

• Some patients lose lines of vision on the eye chart that cannot be corrected with glasses, contact lenses or further surgery.
• Some patients have troubling side effects, such as glare, halos or double-vision. Driving in fog or at night can become a real problem for those who lose some visual acuity (”sharpness”), even if they have 20/20 vision.
• Patients may be over- or under-treated, which may need further surgery to correct.
• Patients may develop severe “dry eye” problems (see the separate item on this site).
• And results are generally not as good in patients with very large refractive errors.  (Normally this is an issue that most surgeons will highlight at the very first examinination).

The FDA is worried that the benefits of improved vision may not be permanent. The recent studies support the view that there may be a gradual regession, but it does appear to be just that - gradual.

Of course, there is always the possibility that even with the surgery, a patient may still need to wear glasses.   This might be either for reading or for long distances, depending on what type of lasik procedure was carried out.

As long as :

• You  investigate the issues properly. 
• You  chose your surgeon carefully.  
• You are a good candidate in the first place. 
• And you understand the potential side effects.

It seems that you can count on achieving good lasik long term results.