What is laser eye surgery?

Laser eye surgery is most often used to correct vision.

People with poor vision often have a misshaped cornea.

The cornea is the clear layer at the front of your eye. It helps to focus light coming into your eye to help you see. A misshaped cornea can cause distorted or blurred vision, and conditions such as:

• short-sightedness (myopia)
• long-sightedness (hyperopia)
• astigmatism

As with all surgery, laser eye surgery has risks and possible complications, together with important benefits.

What are the benefits of laser eye surgery?

The benefits of laser eye surgery depend on the type of surgery and your health needs.

Laser eye surgery can reshape your cornea and 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 known as refractive or vision correction surgeries) including:

• LASIK
• LASEK
• PRK
• ASLA
• SMILE

Laser eye surgery is also used to treat a range of other conditions, including:

• diabetic eye disease
• some cases of glaucoma
• retinopathy in premature babies

Different sight conditions need different types of surgery.

Who can get laser eye surgery?

Your eye doctor (ophthalmologist) is the best person to guide you on whether 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 will help them decide if laser eye surgery is right for you. Your age and the reason for surgery are key 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. Getting surgery while your eyes are still growing can increase risks and may not give you 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 cataracts
• have problems eye surface health (such as dry eye, despite treatment)
• 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, and not others. Not all clinics offer all types of laser surgeries. Different types of laser surgery are better suited to different vision problems.

What does laser eye surgery involve?

Before having laser eye surgery, your doctor will usually place 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.

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

• In LASIK surgery, a flap is made on the top 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 disc of tissue from the cornea.
• In PRK (ASLA) surgery, the top layer of the cornea is softened by a solution and is then removed. A laser reshapes the surface.

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

What should I ask my specialist before laser eye surgery?

It is important to ask your eye specialist about the best type of eye surgery for you. They may have advice unique to their clinic.

Some things you might like to talk about are:

• 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 long term
• if you will be able to play contact sports
• if you will need a second surgery later on, and if it is included in the cost
• how to get in touch with your surgeon after your surgery

How can I prepare myself for laser eye surgery?

How you prepare for your 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 organise for someone to drive you to and pick you up from your appointment, because you cannot drive straight after the surgery.

How soon will I recover?

Your recovery period will depend on the type of laser eye surgery you had. You should speak to your doctor about specific restrictions and expectations 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 participate in 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 that doesn't mean that you won't 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 fairly comfortable vision the next day after surgery.
• After SMILE surgery, you should see improvement within a few days.
• After PRK/ASLA surgeries, you will usually need at least a week of rest before you can return to normal activity.

People aged under 40 years of age should not need to wear contact lenses or glasses after surgery, but the extent of your vision improvement after surgery will depend on:

• the stability of your prescription
• your age

Some vision problems, such as presbyopia, come on naturally with age. If you have vision problems after the age of 40 years of age, you may need different treatment. These may include a lens-based surgery that involves replacing your lens with an artificial lens.

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

What complications can happen?

While laser eye surgery is regarded as a safe procedure, 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 concerns 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 over correction or under correction of the cornea, scarring, thinning of the cornea or 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.

Resources and support

If you're considering laser eye surgery because you're concerned about your vision, visit an optometrist for an eye exam. Find an optometrist near you.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Read more on Aboriginal and/or Torres Strait Islander eye health programs at Strong Eyes, Strong Communities – a five year vision for the Indigenous community.

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