April 14, 2010
Question from Clarence, New York, USA:
My son is considering LASIK eye surgery to eliminate the need for glasses and we were wondering if thisweres advisable or not given that he has type 1 diabetes. His diabetes in well controlled at the present time, but could the surgery work against him later in life?
LASIK surgery is only considered for patients who are at least 18 years of age and have had a stable refraction (prescription) for the previous two years. Most often, patients’ prescriptions continue to change significantly past age 18, so most LASIK surgeons recommend that patients wait until they are 21 years of age (again, with a stable prescription for two years prior to treatment).
Studies show that patients with diabetes do equally well with LASIK as patients without diabetes after six months, though the complication rate (dry eye, corneal erosions, infection, epithelial in growth) is slightly higher for those of us with diabetes in the early period after treatment. I would recommend against LASIK for any patient with a glycosylated hemoglobin above 7%, or with diabetes and a history of dry eye or corneal erosion (hyperglycemia weakens the attachments of cells on the surface of the cornea, leading to corneal erosion, as well as dries out the surface of the eye, both of which problems are often aggravated by LASIK).
There are no long term (> 25 years) studies of LASIK in patients with diabetes, so it is impossible to say with certainty what will happen over time – however, I have seen numerous patients both with and without diabetes who have had LASIK more than 10 years ago and have done very well; it is unlikely the surgery will cause problems later in life (other than needing reading glasses or bifocals, as all people do who are not nearsighted).