Laser eye surgery for vision correction

Laser eye surgery for vision correction can reshape your cornea. This can restore your vision as an alternative to wearing glasses or prescription contact lenses.

There are many types of laser eye surgery offered for vision correction (also called refractive surgery). Your eye doctor (ophthalmologist) can help you decide which type of surgery may be most suitable for your vision and eye health needs. As with all surgery, laser eye surgery has risks and possible complications, as well as benefits.

Your eye doctor is the best person to help you decide if laser eye surgery is right for you. There are many factors to consider. Your specialist will examine you and ask about your medical history. This helps them decide if laser eye surgery is suitable. Your age and the reason for surgery are important factors.

Most laser eye surgeons will ask you to wait until your glasses prescription has been stable for at least 2 years before considering surgery. Having surgery while your eyes are still growing can increase risks and may not give the best long-term results.

As you age, the lens in your eye becomes more rigid and affects close-up vision. Your surgeon can check your eyes and discuss if laser surgery is right for you.

Your doctor might recommend avoiding or delaying laser eye surgery if you:

• have problems with eye surface health, such as dry eye
• are pregnant or breastfeeding
• have an autoimmune disease
• have other vision problems such as glaucoma or cataracts

Laser eye surgery may not be suitable if you have certain medical conditions, such as:

• an autoimmune disease
• diabetes
• some rheumatic conditions
• keratoconus (a cone-shaped cornea) or other problems with the shape of your cornea
• a history of herpes in the eyes

Laser eye surgery may not be an option for you if your glasses prescription is outside of the treatable range.

You may be suitable for some laser surgery procedures but not others. Not all clinics offer all types of laser surgery. Different types of laser surgery suit different vision problems.

Before having laser eye surgery, your doctor will usually put local anaesthetic eye drops in your eye. These drops numb your eye so that you don’t feel any pain.
The laser will be set specifically to your needs.

There are many types of laser eye surgery offered for vision correction, including:

• LASIK — laser-assisted in situ keratomileusis
• PRK — photorefractive keratectomy
• ASLA — advanced surface laser ablation
• SMILE — small incision lenticule extraction

What happens during the procedure depends on the type of laser surgery you have:

• In LASIK surgery, the surgeon makes a flap on the surface of the cornea. A laser then shapes the corneal layer underneath, before the flap is replaced.
• In SMILE surgery, a laser makes a tiny cut and removes a small disc of tissue from the cornea.
• In PRK (ASLA) surgery, a solution softens and removes the top layer of the cornea. A laser then reshapes the surface.

To learn more about your surgery, ask your eye specialist.

How you prepare for surgery depends on the type of surgery and the clinic you attend.

Your ophthalmologist (specialist eye doctor) or optometrist will give you instructions.

Usually, they will ask you to stop wearing contact lenses before your surgery. You may also need to arrange for someone to drive you to and pick you up from your appointment, because you cannot drive straight after the surgery.

What should I ask my specialist before laser eye surgery?

Ask your eye specialist about the best type of eye surgery for you. They may also provide advice specific to their clinic.

Some things you might like to talk about include:

• the risks and side effects of the procedure
• how long it will take to recover
• the cost of the surgery
• if you will need to use eye drops and for how long
• if you will be able to play contact sports
• if you will need another surgery later and if it is included in the cost
• how to get in touch with your surgeon after your surgery

Your recovery period will depend on the type of laser eye surgery you had. Speak to your doctor about specific restrictions and what to expect during your recovery period.

How can I take care of my eyes after surgery?

After surgery, it is important to follow the instructions from your ophthalmic surgeon or ophthalmologist. They might ask you:

• to take a few days off work
• to take antibiotics or use eye drops
• not to rub your eyes
• not to play contact sports or do activities where your eye could be knocked
• to avoid swimming
• to make a follow-up appointment

My vision following the surgery

Most people will see better after laser eye surgery, but you may still need glasses or contact lenses in the future.

The type of surgery you have will affect how long you need to wait to see improvements in your vision. Here are some examples:

• After LASIK surgery, you should have comfortable vision the next day.
• After SMILE surgery, you should see improvement within a few days.
• After PRK (ASLA) surgery, you will usually need at least a week of rest before you can return to normal activity.

People under 40 years of age usually do not need contact lenses or glasses after surgery. How much your vision improves after surgery will depend on:

• the stability of your prescription
• your age

Some vision changes happen naturally with age, such as presbyopia where your eyes lose the ability to focus. If you have vision problems after the age of 40 years, you may need different treatment. These may include a lens-based surgery to replace your lens with an artificial lens.

To learn more about recovery after your surgery, ask your eye specialist.

Laser eye surgery is regarded as a safe procedure, but all vision correction laser procedures have a risk of complications. Complications are more likely in the first few weeks after surgery, and more common ones include:

• dry eye or not being able to produce enough tears
• eye sensitivity to light
• infection

Most of these problems should only last a few days after surgery. But it might take up to 6 months for your vision to stabilise.

Sometimes you will need a second surgery to manage issues such as:

• overcorrection or undercorrection of the cornea
• scarring
• thinning of the cornea 
• changes that happen to your reshaped eye over time

To learn more about the risks and side effects of your surgery, ask your eye specialist.

If you have strong pain or your symptoms get worse, see your doctor immediately.

Alternatives to laser eye surgery include wearing glasses or contact lenses.

Some vision problems may also be treated or managed with procedures that do not use a laser. These include implantable contact lenses or lens replacement surgery, where your natural lens is replaced with an artificial lens.

Your ophthalmologist can discuss the benefits and risks of different treatment options and help you decide which option is best for you. 

Your doctor will discuss what may happen if you decide not to have laser eye surgery or if your procedure is delayed. In many cases, your vision may stay the same or gradually change over time. Your doctor can also discuss your options, which for some people may include glasses or contact lenses, to help improve your vision.

If you're considering laser eye surgery because you're concerned about your vision, visit an optometrist for an eye exam. Find an optometrist (Opens in new tab) near you.

Information for Aboriginal and/or Torres Strait Islander peoples

Read more on Aboriginal and/or Torres Strait Islander eye health programs at Strong Eyes, Strong Communities (Opens in new tab).

Learn more about Aboriginal and/or Torres Strait Islander Eye Health in Australia Today (Opens in new tab), including resources on eye conditions (Opens in new tab) affecting communities.