This article is professionally reviewed by Dr. Hoang Thanh Nga, MSc, MD, Department of General Medicine and Internal Medicine, Vinmec Ha Long International Hospital. Dr. Nga has 10 years of experience working in the field of ophthalmology.
LASIK surgery is currently regarded as an effective method to improve vision in individuals with myopia. However, some cases of post-LASIK myopia regression have been reported. Let’s explore the causes of this recurrence and discuss suitable preventive measures.
1. What is LASIK surgery?
Lasik (short for “Laser-Assisted In Situ Keratomileusis”) is a refractive surgery method that uses laser beams to reshape the corneal surface, correcting refractive errors, including myopia.
Benefits of LASIK Surgery for Myopia Treatment:
- The surgery typically takes less than 15 minutes.
- No bleeding or significant pain.
- Most patients recover quickly.
- Positive Outcomes: About 80% of patients who do LASIK experience significant improvement in vision after the procedure. Within a day, most can see clearly without corrective lenses.
- No longer requiring corrective lenses: Patients can see clearly without eyeglasses or contact lenses.
See also: Common symptoms that may occur after LASIK surgery.
2. Causes of Myopia Recurrence After LASIK Surgery
It is a reality that all patients undergoing laser refractive surgery, including LASIK, have a certain probability of myopia recurrence. Depending on the severity of the refractive error, this recurrence rate may range from 1-2% to 12-15%.
The common causes of post-LASIK refractive regression include:
2.1. Residual Refractive Error
If preoperative determination of refractive error is inaccurate, the input parameters for LASIK surgery will be incorrect, potentially leading to incomplete correction of nearsightedness and residual refractive error post-surgery. The extent of residual refractive error will directly impact the patient’s vision, ranging from minimal to significant impairment.
Thus, ensuring precise preoperative refractive measurements is critical. To minimize measurement errors and achieve accurate results before LASIK surgery, patients should adhere to the following preoperative guidelines:
Preventive Measures
- Discontinue the use of soft contact lenses at least three days prior to undergoing an in-depth evaluation before LASIK surgery.
- Cease the use of rigid corneal reshaping lenses, such as orthokeratology (Ortho-K) lenses, at least three weeks before the preoperative assessment to allow the eyes to return to their natural refractive state.
- Opt for a high-quality examination and diagnostic process to ensure accurate and reliable refractive measurements.
2.2. Performing LASIK on Unstable Refractive Error
Refractive error is considered stable when it has not increased by more than 1 diopter within the past 6 months. Individuals under 18 years of age, pregnant women, or those breastfeeding within the last 6 months may experience fluctuating refractive errors. If LASIK is performed during such periods, the progression of myopia may continue, leading to recurrence.
See also: Preventing refractive regression after LASIK surgery: Key considerations.
2.3. Changes in the Lens’s Refractive Index
Over time, the natural lens of the eye tends to undergo changes due to aging, losing its elasticity and transparency as metabolic processes alter. In patients with high myopia, these changes occur earlier, influencing refractive indices and potentially causing recurrence of myopia.
2.4. Surgery on Eyes That Do Not Meet Required Conditions
In some cases, patients may have eye structures that are unfavorable for surgery, such as small eye size, narrow orbital sockets, or a corneal curvature radius that is excessively steep or flat.
The effectiveness of LASIK surgery in correcting refractive errors can only be maximized if the patient’s eyes meet the necessary safety and suitability criteria for the procedure, such as:
- Stable refractive error over time.
- Normal corneal structure, with adequate thickness and curvature, free from abnormalities like keratoconus or overly flat corneas.
- Absence of strabismus, amblyopia, infections, or other ocular pathologies affecting the retina or lens.
2.5. Choosing an Inappropriate Surgical Method
The essence of LASIK surgery involves using a laser to reshape the cornea by ablating its tissue, thereby altering its curvature and eliminating refractive errors. The higher the degree of myopia, the more corneal tissue is removed. In cases of severe myopia, performing LASIK may result in an excessively thin residual cornea, which may struggle to withstand intraocular pressure, leading to corneal ectasia and subsequent regression of myopia. Thus, selecting the appropriate surgical method is crucial.
2.6. Overuse of the Eyes Post-Surgery
After LASIK surgery, the most critical aspect of recovery is allowing the eyes to rest and relax. However, some patients neglect proper eye care and continue harmful habits, such as staying up late, insufficient sleep, prolonged close-up screen use, using dim phone screens, exposing the eyes to intense light in dark environments, or focusing on overly bright objects. These behaviors can contribute to regression of myopia post-surgery.
3. Conclusion
The causes of myopia recurrence mentioned above are entirely preventable and manageable if appropriate measures are taken:
- Undergo thorough preoperative examinations at reputable facilities to ensure accurate eye measurements.
- Proceed with LASIK only if the eyes meet all conditions and refractive errors have stabilized.
- Eliminate harmful habits and provide proper postoperative care for the eyes.
- Choose a surgical method tailored to the condition of the eyes.
- Regularly monitor and care for the eyes through follow-up examinations.
Doctor’s advice: Patients experiencing myopia recurrence after LASIK should seek medical evaluation promptly to identify the underlying cause and implement suitable interventions. Delayed management may result in rapid progression of myopia and complicate subsequent treatments.
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