Does LASIK Wear Off?
This is a common question we hear from patients who are experiencing blurring of their near vision many years after having laser vision correction (LVC) such PRK, LASIK, or SMILE. An explanation follows below, but the short answer is no, the LASIK did not wear off!
Laser vision procedures alter the shape of the cornea (the clear ocular surface) to change the power of the eye and eliminate the need for glasses. During the procedure, laser energy removes microscopic layers of the corneal stroma, which are incapable of growing back. While vision fluctuations are common for the first few weeks following LVC, once the eye has fully healed it is very rare for the cornea to change in a significant way for the rest of your life. Laser enhancement rates can vary from 1-3%, but if needed are typically done within the first year after the original treatment.
If LASIK isn’t wearing off, then what explains the change in vision?
After the age of 40, everyone starts to experience aging changes in the natural crystalline lens known as presbyopia. With presbyopia, the lens becomes less flexible and is unable to refocus when you change from looking at a distance object to a near one. These changes occur in everyone, not just those who have had LVC in the past. Additionally, once we are in our 50s, we also begin to develop cataracts, a clouding of the lens, which may cause a generalized blurring of vision of the lens and can alter the power of the lens (your prescription) by itself. While the cornea has remained stable since LASIK, the lens does change eventually, resulting in the need for reading glasses.
Can LASIK be repeated to fix the problem?
In some cases, yes, we can re-treat one of your eyes to give you improved near vision (monovision), but this comes at the expense of your distance vision in that eye. In addition, your surgeon will need to check to make sure your corneas are thick enough for re-treatment.
What are other options to correct presbyopia and cataracts?
Other than wearing glasses, there are other options to correct the loss of near vision with age. A new eye drop called Vuity has been shown to help in some patients with the early stages of presbyopia but may come with other side effects such as red eyes or headaches. Contact lenses can be prescribed in one eye for reading (monovision or multifocal contacts). Finally, the dysfunctional lens can be permanently replaced with an advanced-technology lens in a procedure known as refractive lens exchange (RLE). In addition to correcting the near and far vision, RLE also prevents the development of cataracts and the need for cataract surgery later in life. When combined with an advanced lens implant such as the RxLAL light adjustable lens, PanOptix or Vivity IOL, patients can restore their near vision while maintaining good distance vision quality.