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LASIK Eye Surgery: Pros, Cons, and What to Expect

LASIK permanently reshapes the cornea to correct nearsightedness, farsightedness, and astigmatism. Most good candidates achieve driving-quality vision without glasses. Real trade-offs include temporary dry eye, glare or halos at night, and a small chance of needing a follow-up enhancement procedure. Candidacy requires a thorough pre-operative evaluation.

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How does LASIK work?

LASIK (laser-assisted in situ keratomileusis) uses an excimer laser to permanently reshape the cornea — the clear dome at the front of the eye — so that light focuses directly on the retina instead of in front of or behind it. The surgeon first creates a thin hinged flap in the outer corneal tissue (using a microkeratome blade or, in the all-laser variant, a femtosecond laser), lifts it, applies the laser to the underlying cornea, then repositions the flap. The flap heals without sutures within a few days 1.

For nearsightedness (myopia), the laser flattens the central cornea. For farsightedness (hyperopia), it steepens it. For astigmatism, it corrects uneven curvature. The entire laser treatment typically takes less than a minute per eye.

What are the main benefits of LASIK?

  • Speed of results. Most people notice improved vision within 24 hours and reach stable vision within a few weeks.
  • High patient satisfaction. A 2025 systematic review and meta-analysis of 11 studies (1,753 patients) found that laser vision correction significantly improved quality of life at one, three, and six months after surgery, with more than 90% of patients satisfied overall 3.
  • Long-term stability. For myopia, results are generally durable once the prescription has been stable for at least one to two years. The AAO Refractive Errors Preferred Practice Pattern reflects this track record 1.
  • Convenience. Freedom from glasses and contact lenses for most daily activities — sports, swimming, waking up without reaching for glasses.
  • Reduced lifetime cost. For many people, the upfront cost is offset over years of not buying glasses frames and contact lens supplies.

What are the real risks and downsides?

Dry eye is the most common side effect. LASIK cuts corneal nerves that signal tear production, and dryness lasting weeks to several months is common 1. Pre-existing dry eye can worsen significantly, which is one reason it may influence candidacy.

Visual disturbances — halos, glare, and starbursts — particularly in dim light and around oncoming headlights at night. These are most pronounced in the first few months and often improve, but can persist in some people, especially those with large pupils or higher prescriptions 1.

Undercorrection or overcorrection. A small percentage of people need a second treatment (enhancement) to fine-tune the result.

Flap complications. The corneal flap is a permanent structural change. Trauma to the eye years later can displace it. This is rare but relevant for contact-sport athletes.

Ectasia — a rare but serious weakening and progressive steepening of the cornea — can occur if too much tissue is removed relative to corneal thickness, or in people with an undetected corneal disease such as keratoconus. Rigorous pre-operative screening is designed to identify at-risk corneas 12.

Reading glasses are still likely after 40. LASIK corrects distance vision but does not prevent presbyopia — the age-related loss of near focusing that affects virtually everyone in their 40s.

LASIK, PRK, or SMILE — does the type matter?

LASIK is the most widely performed laser vision correction procedure, but it is not the only option 12:

  • PRK (photorefractive keratectomy) — no flap is created; the laser is applied directly to the corneal surface after removing the epithelium. Recovery takes longer (days to weeks of blurry vision), but there is no flap-related risk and it suits people with thinner corneas or contact-sport athletes.
  • SMILE (small incision lenticule extraction) — a newer all-laser procedure that extracts a disc of tissue through a small incision without a flap. Studies suggest comparable outcomes to LASIK with less post-operative dry eye, because SMILE preserves more corneal nerves 2.

Your refractive surgeon will recommend the approach that best matches your corneal measurements and lifestyle.

What does the pre-operative consultation involve?

A LASIK evaluation is comprehensive and typically requires you to stop wearing contact lenses for one to several weeks beforehand (soft lenses for at least one week; rigid lenses longer) so the cornea returns to its natural shape before measurements are taken.

The surgeon will map the cornea's thickness and curvature, assess pupil size, evaluate for dry eye, check prescription stability, and screen for contraindicated conditions like keratoconus. This pre-operative screening is the step that filters out people who should not have the procedure 12.

Who is not a candidate for LASIK?

Not everyone with a glasses prescription is eligible. Relative or absolute contraindications include 12:

  • Unstable prescription — if your glasses prescription has changed in the past year, surgeons typically ask you to wait for stability
  • Very thin corneas — the procedure removes tissue, so there must be adequate thickness remaining
  • Keratoconus or forme fruste keratoconus — a corneal shape irregularity that worsens with tissue removal
  • Moderate-to-severe pre-existing dry eye
  • Certain autoimmune conditions that affect wound healing
  • Age under 18 — prescriptions are not stable enough in most younger patients

If LASIK is not suitable, PRK or SMILE may still be options depending on the reason for disqualification.

Common questions

How long does LASIK last?

For most people, the correction is permanent. However, some myopia can gradually return (regression) over many years — more common in people who started with a very high prescription. And after age 40, presbyopia (the need for reading glasses) develops independently of LASIK.

Does LASIK hurt?

Numbing drops are used, so the procedure itself is not painful. Many people feel pressure during the brief suction phase. Afterward, for several hours, there is typically a burning or scratching sensation and light sensitivity; most people are comfortable by the next morning.

Can LASIK fix astigmatism?

Yes. Modern LASIK is highly effective for most degrees of astigmatism, correcting the uneven corneal curvature that causes blurred or distorted vision.

What if I am not a candidate?

If you are screened out — due to thin corneas, unstable prescription, dry eye, or corneal disease — PRK may still be an option, or your surgeon may recommend simply continuing with optimized glasses or contact lenses. Intraocular lenses (implantable collamer lenses or refractive lens exchange) exist for people outside the LASIK range.

Is one eye done at a time or both?

Both eyes are typically treated in the same session (bilateral same-day LASIK), which is standard practice. Some surgeons and patients prefer sequential treatment by a week or two, but this is less common.

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Things worth discussing with your surgeon

  • —Pre-existing moderate to severe dry eye — LASIK can significantly worsen this
  • —Corneal disease such as keratoconus or pellucid marginal degeneration — these are contraindications
  • —Unstable prescription that has been changing year over year — wait until stable for at least a year
  • —Certain autoimmune or connective tissue disorders may affect healing
  • —Pregnancy or breastfeeding — wait until your prescription has stabilized post-delivery

This article is educational and does not replace a consultation with a refractive surgeon. Only a qualified ophthalmologist can determine whether you are a candidate for LASIK after a full in-person evaluation. Gale can help you prepare for that visit.

References

  1. 1.Jacobs DS, Afshari NA, Bishop RJ, Keenan JD, Lee J, Shen TT, Vitale S; American Academy of Ophthalmology Preferred Practice Pattern Refractive Management/Intervention Panel (2023). Refractive Errors Preferred Practice Pattern. Ophthalmology. doi:10.1016/j.ophtha.2022.10.031 ✓LASIK mechanism (flap creation, excimer laser reshaping); candidacy criteria including prescription stability, corneal thickness, keratoconus screening, and dry eye evaluation; contraindications; comparison with PRK and SMILE
  2. 2.Wallace DK, Flaxel CJ, Gedde SJ, Jacobs DS, Kopplin LJ, Lee BS, Mah FS, Oetting TA, Varu DM, Musch DC (2026). Comprehensive Adult Medical Eye Evaluation Preferred Practice Pattern® 2025. Ophthalmology (American Academy of Ophthalmology). link ✓Refractive surgery pre-assessment standards; SMILE outcomes compared to LASIK; ectasia risk and screening
  3. 3.Peyman A, Irajpour M, Yazdi M, Dehghanian F, Noorshargh P, Broumand Y, Fatemi F, Pourazizi M (2025). Quality of Life After Laser Vision Correction: A Systematic Review and Meta-Analysis. Journal of Ophthalmology. doi:10.1155/joph/8833830 ✓Laser vision correction significantly improved quality of life at 1, 3, and 6 months post-surgery in 11 studies (1,753 patients); patient satisfaction consistently above 90%

3 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.