Should I Get Laser Eye Surgery? A Personalized Guide from Dr. Corsini

Surgery

Do you yearn to wake up and read the clock on the wall without first fumbling for your specs? Perhaps you dream of swimming or skiing without the hassle of contacts. Maybe you have friends or family members who’ve had LASIK or SMILE, and now you’re left really wanting to know: “Should I get laser eye surgery?” This is the most critical question I answer. At the end of the day, you want to know if you qualify for surgery, and if it’s the right moment to leap to a glasses-free life. 

Naturally, that question comes with others: “Will I still need to wear glasses after surgery? What if I get dry eyes? Is there any chance I could lose vision? Could I be better off staying in contacts and glasses?” These are perfectly normal concerns, and I review all of them with every patient before making my final recommendation. 

In this post, we’ll discuss the risks and benefits of laser eye surgery, highlight key differences between SMILE, LASIK, and PRK, and empower you to make an informed decision when you’re ready for your laser eye surgery consultation. 

TL;DR
Short on time? Here’s the Cliff-Notes version of this post:
✓ Laser eye surgery is a modern medical marvel, although it’s not suitable for everyone.
✓ 98.8% of patients are satisfied, and 99.5% can drive glasses-free after laser eye surgery.
✓ The risk of vision loss after laser eye surgery is exceedingly low.
✓ Not recommended for pregnant/nursing patients or those with unstable prescriptions or uncontrolled diabetes/glaucoma. 

Reviewing What The Data Says About Laser Eye Surgery

Every conversation I have with my patients is grounded in rigorous scientific studies. My goal is to ensure you have access to the most relevant clinical data when making a life-changing decision about your eyes. Below is a summary of key statistics I often share with patients when discussing laser vision correction (LVC) outcomes. Please keep in mind that studies measure each eye (right or left) individually, so data is reported per eye instead of per patient.

*Note: These studies reflect modern LVC outcomes (roughly 2016 to today). The modern LVC data shows remarkable improvement since the initial FDA data (1998 to 2005). This progress is driven by technological advances in pupil tracking and iris fixation, topography and wavefront-guided treatments, SMILE, and improved patient selection—especially for those with thin corneas or dry eyes. 

Before we look at the data, I’ll clarify what we mean by visual acuity and other basic terms.

Visual Acuity 

1. Uncorrected Visual Acuity (UCVA): a measure of visual clarity without corrective lenses. UCVA before laser eye surgery varies depending on the magnitude of your refractive error (i.e., the strength of your glasses or contact lens prescription). Pre-operative UCVA is uniformly blurry, which is why patients pursue surgery in the first place. UCVA after laser eye surgery is a key measure of the procedure’s success. 20/20 UCVA means you can read the 20/20 line without glasses or contacts.
   
2. Corrected Distance Visual Acuity (CDVA): a measure of an eye’s best possible distance vision when corrected with glasses or contacts. CDVA is usually 20/20 or better before and after laser eye surgery. However, after LASIK, patients are twice as likely to experience a 2-line improvement in CDVA (1.45%) than a 2-line reduction (0.61%). CDVA is an important measure of surgery’s safety. Check out this American Academy of Ophthalmology reference to learn more about visual acuity.

Putting LASIK Safety Into Perspective 

For analogy’s sake, it can be helpful to think of LASIK as an airplane, highly engineered, precise, guided by experts, and contact lenses like a car, common, but subject to everyday risks and user variability. When commercial air travel was new, many consumers focused on the safety of the plane, asking: “What if my plane crashes?” Those who asked the alternative: “What if my car crashes?” found out that car accidents are a lot more frequent and cause far more injuries and deaths compared to air travel in the United States each year.

Similarly, while LASIK may seem daunting because of its surgery, years of evidence show it’s actually the safer choice. Daily contact lens use leads to significantly more eye health complications, including serious infections, than LASIK does year after year. 

Take-home Point: The risk of injury is never zero, whether in transportation or vision correction. But, just as flying is statistically much safer than driving, LASIK is safer, cleaner, and more predictable than long-term contact lens wear.

Key Findings & Statistics from Clinical Studies 

• Modern LASIK Outcomes
  • 99.5% of eyes with CDVA achieve at least 20/40 (legal driving vision) after LASIK.
  • 1.45% vs. 0.61%: Patients are twice as likely to gain 2 or more lines of visual acuity (for example, improving CDVA from 20/25 to 20/15) after LASIK than to lose 2 or more lines.
  • 98.8% visual satisfaction rate in patients after LASIK.
  • Only 0.18% experienced worsened dry eye symptoms beyond 6 months.
  • Only 0.89% experience increased haloes and glare beyond 6 months.
    
• Refractive Surgery in Refractive Surgeons
  • 62.6% vs. 13.2%: Refractive surgeons are 5x more likely than the general population to undergo laser eye surgery.
    
• Infection Risk in LASIK vs. Contacts
  • 3x less likely: In any given 5-year period, a LASIK patient is 3 times less likely to develop a corneal infection than a contact lens wearer.
    
• LASIK Satisfaction Compared to Contact Lens Wear
  • Improved ease of night driving.
  • No increase in dry eye symptoms.
  • Higher satisfaction at 1, 2, and 3 years of follow-up.
    
• SMILE Outcomes in Young Myopic Patients
  • 95.4% of eyes achieved a UCVA of 20/20 and 20/25 or better in 98.7% of eyes
  • 0.08% lost two or more lines of CDVA, and 100% of these patients restored their pre-surgery CDVA following PRK enhancement.

Presbyopia, LASIK, Modern Solutions

So far, my discussion has centered on distance vision. But some of our senior readers may be wondering about near vision and asking: “Can LASIK help me get rid of my readers?

Whether or not you’ve had laser vision correction, everyone eventually experiences the progressive loss of accommodation called presbyopia. As we age, the natural lens in our eyes stiffens, making it harder to focus clearly on close-up objects. Solutions include: 

• Reading glasses, 
• Bifocals, 
• Progressive lenses, 
• Eye drops, 
• Multifocal contact lenses, 
• Refractive lens exchange with multifocal lens implantation, 
• Blended vision,
• And Monovision.

Laser eye surgery helps by using the blended and monovision options to offset patient frustration with presbyopia. 

Is There a Best Option? 

In life, when there are 8+ solutions for correcting a single problem, it usually means there’s no one best option. My goal as an ophthalmologist is to help you find the presbyopia-management tool or combination that works best for you. Sometimes, this means laser eye surgery, and sometimes a different approach is better. Visit my prior blog post to learn more about how LVC can address presbyopia.

Key Differences Between SMILE, LASIK, and PRK

Not all laser eye surgeries are alike, and I carefully recommend the procedure that will best meet a patient’s goals, eye health, and lifestyle. You can explore our detailed blog post for a deep dive, but here’s a quick summary:

Weighing the Data Against Life Benefits

While the previous data paints a clear picture of how LVC stacks up on paper for patients, it’s just as important to consider the real-life benefits of laser eye surgery. A great place to start is to imagine how your life would improve if you woke up to clear vision every day – what would that look and feel like for you? Many of my patients tell me that laser eye surgery was one of the best decisions they’ve ever made, simply because it gives them the freedom to: 

• Swim without contacts, 
• Wear sunglasses without a prescription, 
• Perform military or first responder duties with clear, unhindered vision. 

Of course, surgery isn’t the right choice for everyone. If you’re not bothered by glasses or contacts, your primary motivation for pursuing LVC may be financial. Visit our LASIK savings calculator to estimate what you could save over a lifetime without glasses or contacts.

Who Should NOT Get Laser Eye Surgery? 

The following conditions are contraindications for laser eye surgery:

• Pregnancy or breastfeeding
• Uncontrolled diabetes
• Unstable refractive error
• Uncontrolled glaucoma
• Severe dry eye
• Active eye infection
• Keratoconus
• Unrealistic expectations

Additional factors will influence your candidacy for laser eye surgery, which you can discuss at your complimentary consultation.

It’s a Personal Journey—Finding Your Answer to Laser Eye Surgery

“Should I get laser eye surgery?” I asked myself that very question seven years ago, and after a detailed discussion with my surgeon, I answered a resounding, “Yes!” I now have excellent vision thanks to my PRK surgery. My wife has had LASIK, and I have performed SMILE on many of my family members. Your answer to that question will be personalized and unique, and I am here to help you sort out the pros and cons when you are ready to discuss. 

—Jonathan Corsini, MD