Most patients enjoy good uncorrected vision in the short-term after LASIK. But what about long-term? In general, LASIK surgeons follow their patients for no more than one year. Anecdotal reports suggest that LASIK results decline over time, and the few long-term studies of LASIK confirm that regression after LASIK is common.
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Myopia of more than 1 diopter was seen in 76.6% of LASIK patients 10 years after surgery in small study.
Source: Lim, at al. Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia. Korean J Ophthalmol. 2016 Apr; 30(2): 92–100.
6/2/2015 - Nine years after LASIK, patient back in glasses.
From the article: "Last summer I finally admitted that my eyesight had changed. By September, I had distance glasses again. Not realizing how much my sight had changed, I assumed I would just need the glasses for driving. The second I put them on, I realized how blind I had been. Now I am adjusting to the new routine of needing my glasses every time I leave the house and needing to remove them when I need to see close up."
November 2014 - Fifteen year followup of LASIK for moderate to high myopia in 40 patients finds significant regression.
Editor's comment: At 15 years, less than half (46.15%) of patients were within +/- 1 diopter of attempted correction. The remainder, OVER HALF, were more than 1 diopter over or under corrected.
Alió et al. Laser in situ keratomileusis for -6.00 to -18.00 diopters of myopia and up to -5.00 diopters of astigmatism: 15-year follow-up. J Cataract Refract Surg. 2014 Nov 20.
PURPOSE: To evaluate the long-term outcomes of laser in situ keratomileusis (LASIK) for high myopia with or without astigmatism.
DESIGN: Retrospective-prospective case series.
METHODS: Laser in situ keratomileusis was performed using the Visx 20/20 excimer laser. The minimum follow-up was 15 years. The main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and corneal topography.
RESULTS: This study included 40 patients (40 eyes) with a mean age of 51.08 years ± 6.67 (SD) (range 41 to 60 years) with high myopia (-6.00 to -18.00 diopters [D]). At 15 years, the safety index was 1.23 and the efficacy index, 0.95. During the follow-up, a significant increase in the dioptric power of all keratometric variables was detected (P≤.028, Friedman test), the most notable increase occurring between 3 months and 1 year (P≤.005). At 15 years, 46.15% of the eyes were within ±1.00 D of the attempted spherical equivalent and 64.10% were within ±2.00 D. The UDVA at 15 years was 20/25 or better in 43.59% of eyes and 20/40 or better in 64.10% of eyes. The postoperative CDVA was significantly better than preoperatively (P<.001). The postoperative complications were minor except in 1 eye in which ectasia occurred.
CONCLUSIONS: Laser in situ keratomileusis for high myopia was safe over the long term. However, significant myopic regression with time was detected. Low preoperative pachymetry and low residual stromal bed were predictors of keratometric regression.
7/9/2014 - Patient files report with FDA: Regression three years after LASIK, adverse effects persist:
Quote: "Had lasik eye surgery in 2007. Since then, I have severe dry eyes always requiring eye drops and also halos around lights at night time. In addition, in only a few years my vision degraded to the point of needed glasses again, completely nullifying the purpose of the surgery. In addition I feel it was not fully explained how the corneal flap never fully heals, and only heals to a few percent of the original strength. I knew the vision may worsen (though they said more like 30 years), but did not know it never fully heals. That alone, as I am into sports etc, would have been enough to skip the procedure. In addition, my night vision is worse, halos over lights, and computer screens always look out of focus for whatever reason as well. I fell I traded 3 years of decent vision for a whole list of other issues in addition to my "old" vision returned in only 3 years."
O'Doherty M, O'Keeffe M, Kelleher C. Five year follow up of laser in situ keratomileusis for all levels of myopia. Br J Ophthalmol. 2006 Jan;90(1):20-3.
Abstract
AIMS: To assess the long term refractive and visual outcome of patients who have laser in situ keratomileusis (LASIK) surgery.
METHODS: This was a retrospective study of visual and refractive outcome of patients who had LASIK surgery performed in 1998 and 1999. All levels of myopia were included in the study. 49 patients attended for follow up. The main outcome measures were safety, predictability, efficacy, and stability. Postoperative complications and aberrations were also recorded. The mean preoperative spherical equivalent was -4.85.
RESULTS: At 2 months postoperatively 67% of eyes were within plus or minus 0.5D of attempted correction with 81% within plus or minus 1.0D. At 5 years postoperatively 60% of eyes were within plus or minus 0.5D of attempted correction with 83% within plus or minus 1.0D. 88% of eyes had a vision of 6/12 or better at 2 months compared to 89% of eyes at 5 years. Best spectacle corrected visual acuity (BSCVA) was unchanged or improved in 51%. No eye lost more than one line of BSCVA. Overall, there was regression towards myopia with a mean change in refraction of -0.5D over the 5 years. As expected, severely myopic patients regressed more with a mean change of -1.06D. However, there was a high level of patient satisfaction with the surgery.
CONCLUSION: LASIK surgery offers predictable results in terms of refractive and visual outcome with mild regression in refraction over time.
Zalentein WN, Tervo TM, Holopainen JM. Seven-year follow-up of LASIK for myopia. J Refract Surg. 2009 Mar;25(3):312-8.
Abstract
PURPOSE: To assess the long-term refractive results, subjective parameters, and late sequelae of LASIK.
METHODS: A retrospective follow-up study was conducted on 38 eyes of 21 patients (17 with bilateral treatment and 4 with unilateral treatment) who had LASIK surgery between 1999 and 2000. Laser ablations were done with an excimer laser (VISX STAR and STAR S2). Follow-up was 2 months, 2 years, and > 7 years postoperatively. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, indirect ophthalmoscopy, and wavefront analysis were measured at the last follow-up and a questionnaire was answered.
RESULTS: Postoperatively, BSCVA < or = 0.0 (logMAR) was obtained in 91%, 100%, and 89% of eyes at 2 months, 2 years, and at last follow-up, respectively. Postoperative spherical equivalent refraction within +/- 0.50 diopters (D) was obtained in 75%, 63%, and 42% of eyes at 2 months, 2 years, and 7 to 8 years, respectively. At 2 months and 2 years, 83% of eyes were within +/- 1.00 D, which decreased to 42% at 7 to 8 years. Mean spherical equivalent refraction at 2 months was -0.41 D, at 2 years -0.57 D, and at 7 to 8 years continued to decrease to -1.38 D. Patient satisfaction was high--100% of patients would have LASIK again.
CONCLUSIONS: LASIK outcomes tend to shift toward undercorrection over time. Postoperative ectasia was not noted 7 to 8 years after LASIK. All patients were satisfied with the postoperative results although emmetropia was not reached.
Disclaimer: The information contained on this web site is presented for the purpose of warning people about LASIK complications prior to surgery. LASIK patients experiencing problems should seek the advice of a physician.