There are several important components for a successful LASIK treatment, and the technology used is clearly a critical part.

The technology has improved significantly since the earliest days of laser vision correction. Even with the older technology, excellent results were obtained. But the newer technology helps us to treat a wider range of patients with fewer side effects.

Wavefront (also known as custom) treatment is probably the biggest improvement in LASIK technology, and I would recommend that you only consider having a treatment using wavefront technology. Wavefront is a method of measuring irregularities in the vision cannot be corrected using glasses or contact lenses. By adjusting for these irregularities, vision can be obtained that surpasses the vision with glasses or contact lenses.

Wavefront technology is more important in situations with higher levels of vision abnormalities, so some doctors say that it is not worth the extra expense in patients with lower levels of vision impairment. I take a different view: I would like the best outcome possible for all of my patients, so I only perform laser eye surgery using the custom, wavefront technology.

Newer testing technology has also contributed to better LASIK. Approximately one in 2,000 people have a genetically weak cornea, a condition known as keratoconus. Patients with this tendency can have unusual results from LASIK treatment, so we want to identify these people before we perform the treatment. There are several newer technologies that enable us to detect those people who might have early stages of this condition.

Of course, no technology is useful without its proper application. Here is where the doctor cannot be replaced. I cannot stress enough the importance of the training, experience, and judgment of the doctor. It is the doctor who selects the technology, the doctor who decides which technology to use for which patient, and the doctor who is responsible for programming the equipment with the specific treatment for each individual patient. Judgment is critical if the technology is to be used to obtain the best possible results.

Andrew Caster, MD

The short answer is: yes, you can have laser vision correction, but it might be better to wait a few years.

One of the key points to understand about laser eye surgery is that it will not stop the eyes from undergoing naturally occurring, age-related changes. So LASIK can completely correct the vision, but if the eyes are still changing, then they will change whether or not you have LASIK. Obviously, the vision will not be very bad if the eyes undergo a small change after they have been corrected, but in such a case they will no longer be perfect, and a repeat LASIK treatment might then be a good idea.

In cases of nearsightedness, which is the most common vision problem, the vision typically worsens for 5-10 years, and then stabilizes. The age at which it starts to get bad, and the age at which it stabilizes, varies from person to person. For some people, the vision will stabilize at age 16, but for others it is not until the early or even mid-twenties.

If we know that your vision has stopped changing for a year or two, then it has most likely stopped changing for good. If this is the case at age 17, then you can have LASIK and most likely will not need further treatment in the future. But it might be better to wait a few more years, at least until after age 18, just to be sure.

The other negative to having laser vision correction below the age of 18 involves the issue of keratoconus, which is a genetic condition in which the cornea is weak. This condition typically begins to appear in the teenage years or early twenties. The younger we perform the LASIK treatment, the more likely that a person might have the genetic component and develop this rare condition after we have performed the LASIK treatment, and we would prefer to know beforehand whether the person has this weak cornea condition. Typically, there are subtle signs of this condition by the age of 18 or so. Approximately 1 in 2,000 people have this condition. Although it runs in families, there are many cases without a family history.

Some sports, such as waterpolo, really cannot be performed with glasses or contact lenses, so some athletes less than 18 will have laser eye surgery for this reason.

Of course, if the vision changes after the LASIK treatment, then a touchup can be performed if desired (unless you have the weak cornea, keratoconus condition).

Andrew Caster, MD

LASIK / FAQs

Text FAQ