Risk Factors

The main risk factors that might affect whether LASIK would be appropriate for you are:

  • Dry Eye Syndrome. If dry eye is left untreated prior to surgery, patients may be disappointed with their LASIK results. If dry eye is diagnosed and adequately treated before surgery, you will have the same chance of a successful outcome as a patient without pre-existing dry eye. If you have very severe dry eye, however, it might disqualify you as a candidate for the surgery. You are more likely to have dry eye if you are older, especially if you are a woman after menopause. You are also more likely to have dry eye if you have an immune system disorder, or if you are taking hormone replacement therapy or other medications with dry eye as a side effect, such as anti-depressants or certain blood pressure-lowering medications. You should be screened for dry eye before you have LASIK or other refractive surgery.
  • Large Pupil Size, as evaluated in the pre-LASIK exam, has been thought to be a factor in undesirable side effects such as “glare” and “halos,” but there are conflicting reports about the relationship between pupil size in low light and these disturbing visual symptoms. There is a risk of night vision problems after LASIK, irrespective of pupil size. 
  • Keratoconus, a degenerative corneal condition, or a family history of this disorder. Your Eye M.D. should check you for this condition before surgery. 
  • Thin Corneas. Patients with thin corneas may not be good candidates for LASIK but may be considered for other forms of refractive surgery. Your Eye M.D. should check the thickness of your cornea before surgery. 
  • Degree of Refractive Error. Very high levels of refractive error (nearsightedness, farsightedness, astigmatism, or certain combinations of these errors) may not be compatible with LASIK. In addition, if your correction prescription has not remained the same for about a year, your vision may not be stable enough to make you a good LASIK candidate. 
  • Age. The ideal LASIK patient is over 21 years of age, since the refractive error is more likely to be changing below this age. Some patients over the age of 21 are still experiencing change in refractive error making them unsuitable for LASIK. Your Eye M.D. should confirm stability of your refractive error before considering LASIK. 
  • Pregnancy. If you are pregnant or nursing, you are not a good candidate for LASIK, because your refractive error may fluctuate. 
  • Other Conditions. A number of other general health conditions and less- common eye conditions or injuries may affect whether a person is a good candidate for LASIK. Be certain you and your surgeon review your medical and eye health history, current health status and medications during the pre-LASIK exam. 

For information from the FDA about risk factors for LASIK, see the “When is LASIK not for me?” section of FDA’s LASIK Web site

Source:  American Academy of Ophthalmology and the International Society of Refractive Surgery. Is LASIK for Me? A Patient’s Guide to Refractive Surgery. San Francisco, CA: American Academy of Ophthalmology and the International Society of Refractive Surgery, 2008. Print.