Laser eye surgery procedures have come a long way since their first approval in the 1980s. Patients find the appeal in experiencing freedom from constant spectacle or contact lens wear and all the inconvenience that may come with these optical aids – glasses fogging up in the kitchen, dryness and irritation from contacts, frames slipping down your nose during exercise, or all the extra cleaning and maintenance of reusable contact lens modalities. However, laser eye surgery procedures are not typically considered a small upfront cost, although in the long run it often works out cheaper than continually updating your glasses and contact lens supplies. You still want to get the most out of your operation – so, how long does laser eye surgery last for?
How Long Does Laser Eye Surgery Last?
There are a couple of aspects to this question. One largely relates to normal age-related changes to the eye that change how your vision works, namely, near focus.
Presbyopia is the natural decline of near focusing ability that comes with age, usually manifesting around 45 years old. Many laser eye surgery procedures performed prior to this age will simply be targeting the long-distance prescription; that is, correcting a person’s nearsightedness (myopia), farsightedness (hyperopia), or astigmatism so as to provide them clear vision mainly for distance activities. However, prior to the onset of presbyopia, correcting this prescription should also still allow clear and comfortable near vision as a young patient’s near focusing ability is still active. Although the laser eye surgery procedure has still been successful, patients who have not been informed of the effects of presbyopia may be disappointed to find that around their mid-40s they start needing glasses again – this time specifically for reading and other near activities. For patients already presbyopic who are looking for refractive surgery options that address both long- and near-distance vision, there are procedures available such as Presbyond blended LASIK, monovision, or multifocal intraocular lens implants.
The other aspect to the longevity of laser eye surgery is what’s known as regression, which refers to the re-development of a prescription that compromises the distance vision. Regression after refractive eye operations, including PRK, LASIK, and SMILE® is not yet fully understood. In most cases, these procedures are considered permanent – a laser tool is used to surgically reshape the front surface of your eye, the cornea, in order to alter the way light passes through this structure such that it focuses to a sharp point on your retina for clear vision.
While many patients are fully satisfied with their vision for years and even decades after their refractive procedure, some patients may find their vision slowly begins to blur with time.
One theory is simply that the eye is an organic structure and like all living things, it changes with time. There are some patients whose eyes are not yet fully stabilised and so their prescriptions still progress with time; undergoing laser eye surgery is not a treatment to halt progression.
Another theory supported by research is that the healing process that takes place in the superficial epithelial layers of the cornea and the deeper stromal layers after surgery results in an alteration of the biomechanics and biometrics of this anatomical structure. Refractive surgery techniques such as PRK, LASIK, and SMILE® involve the removal of certain sections of the cornea in a process called photoablation, in order to reshape this surface. Although the operation is controlled and very safe, it is still considered a type of trauma to the eye, which therefore sparks a healing response. In the years following laser eye surgery, the epithelium and stroma of the cornea are known to change in their structure, including thickness and shape, which may result in a change to the prescription of the eye and subsequent regression of vision.
Factors affecting regression after refractive surgery may include high hyperopia, the surgical technique used, female gender, and younger age at the time of treatment.
Many ophthalmologists will offer a touch-up laser treatment for patients whose prescriptions regress to an unsatisfactory level, known as enhancement. For modern LASIK procedures, this rate of enhancement within the first 12 months after initial treatment is somewhere around 1-2%. However, many patients may experience some slight change to their vision with time post-operatively but never be bothered enough to seek an enhancement procedure, either remaining content with their existing vision or being satisfied to wear glasses for occasional activities such as long-distance driving at night-time.
If you have any questions about laser eye surgery treatment, please contact us on 1300 297 583.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.