Introduction:
Over the years, laser eye surgery, referred to as refractive surgery, has become incredibly popular as a game-changing technique to treat vision issues and lessen the need for glasses or contact lenses. Though there are many advantages to laser eye surgery, not all are good candidates for laser eye surgery. Individuals who have certain health conditions or characteristics that could heighten their likelihood of experiencing a complication are those who should not undergo laser surgery. This article provides a comprehensive guide on who should avoid refractive eye surgery and the reasons behind it.
What Is LASIK/Laser Eye Surgery?
LASIK stands for laser-assisted in situ keratomileusis, a kind of refractive surgery. Since its initial patent in 1989, it has emerged as the most widely used therapy for refractive eye problems. This procedure can correct several eyesight conditions by using lasers to reshape the outer layer of the eye, called the cornea layer. Only some people are eligible for the surgery, and risks or adverse consequences may exist.
Who Should Not Undergo Laser Eye Surgery?
Individuals Under 18:
Throughout life, a person's eyes can physically change. This holds particularly true during adolescence when the eyes will grow to 21 to 27 millimeters by early adulthood. Because LASIK (Laser-assisted in situ keratomileusis) and related operations are permanent and the patient's eyes are still developing and changing, it is generally not advised for anyone under the age of 18 to have them done. So, holding off on making irreversible eye modifications until they are fully developed is essential. Anyone under 18 is not advised to get laser eye surgery for this reason alone.
However, in some individuals, the eye power is not stable even after 18 years of age. In such a case, waiting for at least a year is ideal until there is a change in the last power. Diabetes, certain disorders that result in hormone imbalances, or some cases, no identifiable reasons, can occasionally induce changes in ocular power for no apparent reason. A thorough examination may be required if there is a reason for concern regarding ongoing power changes.
Pregnant or Breastfeeding Women:
Women who are nursing or pregnant should not have laser eye surgery. This is a challenging period to establish the most appropriate surgical prescription because of the high amounts of hormones in the female body, which also cause a relaxation of tissues and an increase in spectacle power. Although pregnancy or breastfeeding is not a contraindication for laser eye surgical procedures, most ophthalmologists advise waiting until after the woman has finished breastfeeding or at least had her first period following giving birth.
Severe Dry Eye:
Individuals with severe dry eyes, also called keratoconjunctivitis sicca, and conditions characterized by insufficient or low-quality tear production are also advised against laser surgery. An increased risk of postoperative pain and aggravation of dry eye symptoms is present in those with dry eyes. Additionally, because dry eyes produce less lubricant to support the reshaped cornea, healing may be slowed down. Future laser eye surgery procedures are possible if the disease improves and the underlying cause of the extreme dryness is unrelated.
Taking Certain Medications:
Certain prescription medications can make eye variations that can lead to side effects from laser eye surgery. For example:
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Isotretinoin is a drug that is frequently administered to treat acne on the skin. However, in individuals undergoing laser eye surgery, it is also linked to the occurrence of postoperative dry eye.
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Prednisone and other steroid medications inhibit the immune system, which can cause a major delay in healing. Long-term steroid users may also have visual alterations that reduce the success of LASIK.
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Amiodarone is a drug used for the management of heart arrhythmias. Research has indicated that after laser eye surgery, this medication may cause visual abnormalities, including flashing lights or colored rings.
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Other drugs such as Cyclosporine, Bimatoprost, Olopatadine Latanoprost, Travoprost, Brimonidine, and Moxifloxacin can cause dryness of the eyes, which can affect postoperative healing and cause corneal scarring.
Vision Problems:
Laser surgery might not be the best option for people with severe eyesight or eye issues. Sometimes, it can cause more harm than benefit.
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Glaucoma: Patients with glaucoma experience elevated intraocular pressure, which may be exacerbated by laser eye surgery. Before thinking about undergoing a laser treatment, glaucoma must be properly managed.
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Cataracts: Cataracts cannot be efficiently treated with laser eye surgery. Instead, cataract surgery will be beneficial.
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Blepharitis: Until the underlying cause of blepharitis is treated, patients with blepharitis should postpone laser eye surgery. Otherwise, the illness may result in inflammation or infection of the eyes and irreversible corneal scarring.
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Squint or Abnormalities of the Eye Muscles: It may be recommended to postpone laser surgery for individuals who, according to their preoperative evaluation, are at risk of developing squint.
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Corneal Diseases: Individuals with conditions like corneal dystrophies, corneal thinning, or corneal scarring may not be ideal candidates for laser eye surgery.
Systemic Health Issues:
Certain systemic health issues may affect eligibility for laser eye surgery.
Among them are:
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Autoimmune Diseases: Disorders such as rheumatoid arthritis, lupus, and Sjogren's disease might interfere with recovery and raise the possibility of complications.
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Diabetes: Diabetes raises the risk of problems following surgery and can slow healing.
Fluctuating Vision:
Patients are not a good candidate for laser surgery if their glasses or contact lens prescription changes frequently. Most ophthalmologists prefer a stable prescription for at least a year before considering laser eye surgery, which is a permanent procedure.
Conclusion:
Although laser eye surgery can greatly improve eyesight, not every patient will have perfect vision or no longer require glasses or contacts. Furthermore, only some are perfect candidates for laser eye surgery, as it can exacerbate existing conditions or lead to new ones. Before undergoing the surgery, a detailed discussion with the eye surgeon is important.
