Posted on January 3, 2018
Different Types of Laser Eye Surgeries for Different Ages
Laser-assisted in situ keratomileusis, or LASIK surgery, also known as laser vision correction surgery, is the most popular form of refractive eye surgery. This is particularly because of its safety, efficacy and cost effectiveness. Laser vision correction can correct refractive errors including nearsightedness, farsightedness and astigmatism. In this article LASIK will be used as the generic term for all related procedures, including conventional LASIK and its modifications, as well as advanced surface ablations that use the excimer laser to provide freedom from glasses.
Laser vision correction corrects refractive errors by remoulding the cornea, that is, making it steeper, flatter or more rounded in order to focus any light entering the light sharply on to the cornea.
Whether or not an individual is eligible for the laser vision correction is decided by the treating ophthalmologist by a battery of tests including a comprehensive eye evaluation, ensuring that the chosen surgery is best suited for that patients’ eye heath and visual needs. The age criteria for LASIK were earlier more stringent earlier, but with increasing patient safety data being pooled from across the world, as well as newer emerging variations of LASIK, these are also evolving to incorporate both the extremes of age.
Defined Age Criteria
The US FDA has approved the use of LASIK for those 18 years or older. Many doctors may ask you to wait for an additional couple of years, in order to ensure that your refraction is stable and changing. This is because a person’s prescription does not usually change after eighteen years of age. It is advisable to have a stable prescription for at least one year, before going ahead with LASIK.
The physiology and functioning of the eye undergoes a major change around 40 years of age. Most people need glasses for reading and near work, and this condition is known as presbyopia. LASIK does not correct presbyopia, so conventionally, people around forty years of age were not offered LASIK.
However, in current practice, doctors do not hesitate to discuss LASIK with patients of presbyopia also, offering monovision LASIK. In this, one eye (usually the dominant eye) is corrected for distance, while the other eye is corrected for near vision. Most patients are happy with this outcome, as they are no longer dependent on either near or distance vision glasses.
Similarly, around sixty years of age, the eyes change again, with most people experiencing the beginning of cataract. Those who do not have cataracts are still good candidates for LASIK, despite their age. So a comprehensive dilated exam, again, decides eligibility. Also, patients who have not achieved optimal vision after cataract surgery, despite good eye health, are also good candidates for LASIK. This is just to highlight the changing and evolving paradigms of the eligibility criteria for laser vision correction.
What about particular age groups?
As far as particular age groups are considered, here are the general recommendations, depending on the patient being otherwise fit for laser vision correction.
- Childhood and the Teens: The eye continues to grow until at least eighteen years of age. Therefore, experts recommend that surgery for vision correction not be performed until this age, since the benefit will be temporary and the patient will be saddled with glasses as soon as his or her eye prescription changes, due to the natural process of growth. Also, LASIK is an elective surgery, so it is better if the patient has attained the age of consent. That said, LASIK has been used with success to treat severe refractive errors in patients younger than eighteen, especially those suffering from amblyopia or lazy eye, when conventional treatment with glasses or contact lenses has failed to produce optimal results.
- Early Adulthood: This is considered to be the ideal age for laser vision correction, and most doctors prefer to operate as soon as the prescription for glasses has been stable for a year. This is because it provides almost twenty plus years with no dependence on glasses whatsoever. This is also the age group that has been the traditional age group seeking refractive surgery.
- Middle-Age: After the age of 40, presbyopia begins to set in, and cannot be handled with conventional laser vision procedures. However, your doctor will discuss with you the possibility of monovision, where one eye will be corrected for distance and the other for near. This provides a practical and simple solution for freedom from both distance and near vision glasses in this age group.
- Golden old age: There is no fixed upper age limit, and is dependent on the individuals’ eye health and visual needs. For patients who do not have any organic reasons for the vision loss including cataract, and have no medical contraindications, they can safely undergo LASIK. Having LASIK is not a contraindication for future cataract surgery. The patient also must understand that the development of cataract is inevitable, and that laser vision will not prevent it. Also, in the small subset of patients who have not had the desired vision correction after cataract surgery, laser vision correction surgery may be performed to allow better vision without glasses.
So what is the final verdict on age and laser vision correction surgery?
There is no generic guideline which holds true for the individual patient. In fact, with the changes in laser correction technology and safety, the criteria for eligibility for the surgery are continuously changing. Age, as for anything else that you would want to try and achieve in life, is just a number. The reasons for deciding eligibility and success of the laser vision correction are more dependent on a comprehensive eye evaluation to determine eligibility, and also your visual needs.
In conclusion, do not let your age stop you from seeking a consultation with your eye doctor to discuss laser vision correction.