LASIK vs contact lenses

Winston Chamberlain, M.D., Ph.D.

Until recently, most people – including many eye doctors – assumed laser vision correction surgery was riskier than wearing contacts. This is partly because surgery is very different from wearing contact lenses. Problems caused by contact lenses usually take a long time to develop, while complications from LASIK often appear soon after the procedure.

Casey Eye Institute doctors recently compared the chance of complications from contact lenses with the risks of vision correction surgery. Specifically, we studied how often people who wore contacts lost some vision, compared to people who had LASIK surgery.

We found that the risk of an eye infection called bacterial keratitis was 1 in 100 for people who wore daily wear contacts for 30 years. One (1) in 2000 people lost some vision because of infection. The risk of another disease that sometimes affects contact lens wearers, Acanthamoeba keratitis, was about 1 in 1000 for people who wore daily wear contacts for 30 years. The risk of losing some vision was about the same for both infections. One (1) in 2000 people lost some of their vision.

When Casey Eye Institute doctors studied the risk of vision loss after refractive surgery, we reviewed a recent study of more than 16,000 soldiers and almost 32,000 LASIK procedures. Patients had vision loss in one (1) surgery in approximately every 1,250 people. The vision loss was less than people lost from infections related to contact lenses. We also studied 18,000 procedures done at Casey Eye Institute over a 10-year period. We found that even when there were complications, no patient lost more than a small amount of vision, about 2 lines’ difference on a standard eye chart.

The chances of eye infection or complications will probably change as technology makes contact lenses and LASIK surgery safer. Contacts that let more oxygen reach the eye keep your eyes healthier. New ways of doing LASIK are also safer and better at correcting vision. It is difficult to compare the chance of getting an infection in the next 20 or 30 years with the chance of complications after a procedure. However, our information tells us that contact lenses are not always a safer choice than LASIK surgery. Both contact lenses and LASIK are very safe, although there is a small risk of complications from both of them.