Does Lasik Last Forever?

If you talk to someone who had lasik a long time ago, you may have heard them mentioning their lasik “wearing off”. What happened?! I thought lasik was permanent!

Some people think lasik has a shelf life. After a certain amount of time has passed, the lasik wears off and must be repeated. This isn’t necessarily true. For most people, (and especially with today’s modern ways of doing lasik), lasik provides good distance vision for as long as the eyes stay healthy.

Lasik is still designed to be permanent. Lasik works to correct vision by reshaping the cornea. Specifically it works on the very solid structural part of the cornea called the stroma. By being nice and strong and solid, the stroma doesn’t change for the vast majority of people — Reshaping the cornea is a permanent process. The answer as to how some people can have some prescription return or regression exists in other parts of the eye.

But, there are still times when lasik “wears off”.

Natural Shape of the Cornea

_{Trying to maintain shape; Image by Lucario298, CC BY-SA 4.0, via Wikimedia Commons}

With lasik, we are intentionally changing the shape of the cornea. But the cornea likes to stay in the same shape. So what does it want to do after lasik? Re-create it’s old shape. How is this even possible? On the surface of the cornea is a flexible layer of cells called epithelium.

For most people, if they get changes in their prescription after lasik, the changes are typically due to the very surface part of the cornea called epithelium. The eye likes to have a certain uniform shape. Lasik reshapes the cornea. Because of this, the epithelium on the surface of the eye may want to try return the eye back to the original uniform shape.

After near-sighted lasik, the cornea becomes more flat. In response, the epithelium tries to steepen back up again. Parts of the epithelium thicken which changes the curvature of the cornea. The epithelium can only get so far but if this response occurs, the prescription CAN wear off a little. But fortunately, NOT back to square one! Annoying, but not anything a lasik enhancement can't handle.

Fortunately, technology learns. Modern lasers for lasik intentionally try to preserve the natural shape of the eye. Because of this, it is much more uncommon for lasik to wear off. The most likely outcome now is that after lasik, your distance vision remains good as long as your eyes stay healthy!

Natural Change in Prescription

But not everything is the epithelium’s fault. Rarely our prescriptions can just unexpectedly change. For almost everyone, the prescription of their eye stabilizes by the time they hit adulthood. However, sometimes, even after stabilizing, the prescription can change again for some unknown reasons. Of course, if lasik treated one prescription and the prescription changes on you, it looks like the lasik wore off.

So while lasik does an exceptional job for almost everyone, some people can be unlucky and have some prescription return later down the road. But, the good news for those unlucky people is that doing another treatment to get rid of that extra prescription is typically not any issue at all. Bringing back that nice crystal clear vision!

Eyes Getting Older

But there are other ways that lasik can “wear off”. But this isn’t lasik wearing off, it’s actually instead the perception that it’s worn off!

What causes this perception that the lasik has stopped working? Some people think that lasik will keep them out of glasses entirely forever. Although miraculous, unfortunately lasik does have limits. After your prescription stabilizes, there are actually a few more events during life which cause your vision to change.

The first happens around the midpoint of life: the loss of reading vision. Gradually, your own natural lens inside your eye becomes inflexible leading to something called presbyopia. As the lens becomes inflexible, it can no longer focus up close. So while your distance vision may remain perfect from the lasik, you start to need reading glasses. The lasik is still good but since glasses are required, there is the perception that lasik stopped working.

The second time when vision changes also happens to involve your own natural lens. After becoming inflexible, the lens starts to become cloudy and transform into a cataract. But even before the cataract causes measurable vision problems, the cataract can change your prescription. For many people, this causes the vision to become more nearsighted (blurry in the distance but sharper up close). So even if the lasik treated prescription remained perfect, the cataract can shift the prescription out of focus.

_{Inflexible structure; Image by MrsEllacott, CC BY-SA 3.0, via Wikimedia Commons}

So what to do? Well, both of these things can be treated. To restore reading vision, a laser re-treatment focusing on mini-monovision can bring that up close vision back into focus. For the second cause, cataract surgery is probably the solution. So as your lens changes within your eye, rest assured that there are ways to still keep your vision corrected!

Also check out The FACTS on How Long Does Lasik Last on EyeMountain.com to learn more

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