Posted on December 18, 2017
For ladies who are interested in having LASIK or ICL surgery, and are expecting a baby (or hoping to be pregnant soon), deciding for or against surgery presents a major dilemma. Is the surgery safe during pregnancy and while breastfeeding? The professional opinion in response to this question is almost unanimous. Refractive surgeries, that is, surgeries to get rid of glasses are elective surgeries, and best planned after having the baby, and preferably six months after stopping breastfeeding. That said, there have been several cases where LASIK or ICL surgery has been performed, not knowing that the lady having the surgery was pregnant, with no harmful effect to either the baby or the mother.
So, let’s discuss why your doctor will still recommend you wait until after you’ve stopped breast feeding the newborn before going ahead with surgery.
Your body undergoes tremendous hormonal changes during pregnancy. Let’s look at how those changes affect your eyes.
Pregnancy is a major life changing event, in more ways than one. The changes in the body and its hormonal milieu are drastic. HCG (human chorionic gonadotropin), progesterone, oestrogen, oxytocin, prolactin and relaxin are all hormones which suddenly acquire increased importance. These hormones send signals to all parts of your body to help nurture the baby growing inside the mother’s womb, and ensure an easy and safe childbirth by preparing it for labour, delivery and breastfeeding.
As a part of the pregnancy induced changes in the mother’s body, these hormones can cause decreased tear production, leading to dry eyes. This manifests as irritation and redness, especially in patients who wear contact lenses. The water retention in the body caused by the hormonal changes also affects the eyes. The curvature of the cornea changes, and consequently, the power of your glasses. This results in the fluctuation of vision that is often reported during pregnancy normally. The fluctuation of vision is much more in diabetics.
In case you were to have the ICL surgery for removal of glasses during pregnancy, and the eyes were to return to the pre-pregnancy state, you would need glasses again. Also, since there is no algorithm to determine how much of the change in power will actually come back, the doctor cannot rely on your pre pregnancy glasses either to determine the exact power of the ICL. Which is why doctors advise that it is better to wait until the refractive power of the eye has stabilised before considering ICL surgery.
Another consideration to avoid elective surgery during pregnancy is that the eye drops used during and after ICL surgery may be absorbed into your blood stream and reach the growing baby. This quantity is extremely small, and there is no evidence that it can potentially harm the foetus, but doctors generally feel that it is best to defer surgery unless absolutely necessary.
Which brings us to a million dollar question: what if you have had ICL surgery, and then discover you were pregnant?
The answer to this is simple. Do not panic. You are not the only one. There are several young women who have had ICL surgeries, only to find out that they were pregnant at that time. There have been no reported harmful effects to their eyes, or to the growing babies. In fact, some people actually use this as an argument to allow the surgery during pregnancy.
Understandably, there is very little data on the refractive changes in the eye during pregnancy and lactation. Which is why your doctor will always prefer to err on the side of caution, and advise you to wait for your ICL surgery. The guidelines for this are not precise, and recommendations differ from practice to pratice, but most eye surgeons will ask you to wait at least until after you have had one menstrual period, either after the baby is born (if you are not breast feeding) or until after you have stopped breast feeding, preferably after six months of the same. This will ensure that your eyes have sufficient time to revert to the pre-pregnancy state, thereby allowing your ophthalmologist to ensure the best possible short-term and long-term success of any refractive surgery, including ICL.