LASIK and Diabetes: Can Diabetics Undergo the Procedure?
Laser in-situ keratomileusis, or LASIK surgery, is one of the most effective procedures for correcting refractive errors like farsightedness, nearsightedness, and astigmatism.
Before suggesting the procedure, your eye doctor should know all the underlying conditions that affect you. Doing so will prevent serious complications from the procedure, including blindness.
Role of Diabetes in Eye Health
Diabetes, a disease caused by high blood sugar levels, can affect many body organs. If not managed properly, your eyes may fall victim to this condition.
According to The Centers for Disease Control and Prevention (CDC), several eye conditions can result from diabetes:1
These conditions are grouped as diabetic eye diseases.2 Considering the seriousness of some diabetic eye diseases, it’s essential to understand how they affect your eligibility for LASIK surgery.
In this article, we’ll discuss:
- Whether LASIK is effective for diabetics
- How LASIK works for diabetics
- Recovery after LASIK
- The cost of LASIK
Can Diabetics Get LASIK Surgery?
You can get LASIK if you have Type 1 or Type 2 diabetes. While having diabetes doesn’t automatically disqualify you from laser vision correction surgery, your surgeon may consider other clinical factors before determining your eligibility.
Type 1 diabetes occurs when you don’t produce enough insulin, a hormone that helps the body manage sugar levels. People with Type 2 diabetes produce less insulin, and the body doesn’t respond properly to the hormone.
Diabetics need regular insulin injections to stabilize their blood glucose levels. According to experts, diabetics with a well-managed condition can have a successful LASIK procedure.
What Factors Influence LASIK Eligibility for Diabetic Patients?
Eligibility for LASIK essentially boils down to the status of your condition, general health status, and how well it’s managed and monitored.
Your eye doctor will examine the following to determine eligibility:
Blood sugar levels
Measuring blood sugar levels is the first step in determining LASIK eligibility for a diabetic patient. Your doctor will review your test results to determine your blood sugar levels.
They may also inquire with your physician how well your condition is controlled. It’s essential that vision is stable and blood sugar is controlled before considering LASIK.
Fluctuating Prescription
LASIK surgery requires a stable prescription so that your doctor can make correct changes to your cornea. Fluctuating sugar levels can affect the stability of your eye prescription, thus disqualifying you from the procedure.
Ocular Health
If your vision prescription is stable and blood sugar levels well managed, your eye doctor will examine your eyes for any underlying conditions affecting LASIK success.
These conditions include:
- Diabetic eye disease (macular edema, diabetic retinopathy, etc)
- Cataracts (clouding of the eye lens)
- Diabetic corneal neuropathy
- Advanced glaucoma (pressure in the eyes)
- Diabetic keratopathy
- Dry eyes
Corneal Thickness
Safe LASIK procedure requires the candidate to have a thick cornea.5 A thick cornea ensures you have enough tissue for your surgeon to create a corneal flap and remove some tissue to reshape the cornea.
Your LASIK surgeon will measure your corneal thickness in a pachymetry procedure to determine your eligibility.
Why Might Some Diabetics Not Be Allowed to Undergo LASIK?
You may not be a good LASIK candidate if diagnosed with diabetic keratopathy. This major corneal complication affects various parts of the eye.
Diabetic keratopathy is characterized by:
- Slow epithelial wound healing
- Edema (bleeding)
- Recurrent corneal erosion (RCE)6
- Neuropathy/loss of corneal sensitivity
- Changes in the tear film
These abnormalities may become exacerbated following LASIK.
How Does Laser Eye Surgery Work for Diabetes?
During laser surgery, laser beams are applied to the eye to correct defects caused by diabetes. An example of these defects is diabetes retinopathy (DR).
DR is when abnormal blood vessels grow in the retina, following damage caused by high blood sugar. The condition is known to cause blindness among people with diabetes.3
Research shows that laser surgery (photocoagulation) can slow down vision loss if the condition is detected early.4 However, it may not reverse the damage that’s already there before the procedure.
Types of Laser Treatments For Diabetic Retinopathy
There are three types of laser surgeries for DR. Each treatment is recommended based on the extent and location of the damage.
- Grid photocoagulation. Treats swelling in the macula (area at the retina’s center that helps with sharp vision)
- Focal photocoagulation. Seals small areas of leakage in the retina and reduce macular edema (bleeding)
- Pan-retinal photocoagulation (scatter laser surgery). Shrinks the abnormal vessels using light laser beams (for severe cases)
Can LASIK Help Diabetic Retinopathy?
LASIK can help people with DR if they have additional vision problems unrelated to their condition. For example, if you wear contact lenses or glasses, your doctor may recommend a refractive surgery like LASIK.
LASIK’s laser technology targets the cornea, the clear front layer of the eye. It doesn’t target the retina, so it can’t treat diabetic retinopathy.
Due to complications of DR, healing issues, and fluctuating prescriptions, LASIK can be more complex for diabetic patients. Eye doctors will only recommend this procedure on a case-by-case basis.
What is the Recovery Process for Diabetics After LASIK Surgery?
Diabetic people will experience a longer healing period after LASIK because of the slowed wound healing associated with their condition. They are at risk of infections which may further complicate the healing process.
Although steroid eye drops can help prevent infections, they should be taken in moderation due to their potential to elevate blood sugar levels.7
Dry eyes may also be a concern for diabetics after surgery. Although dry eye is common even in non-diabetic LASIK patients, it can be more severe for diabetic patients. Diabetics will require frequent application of eye drops (recommended every 15 to 30 minutes).
Time Frame of LASIK Surgery Recovery
Most LASIK patients achieve better vision a few hours to a day after surgery. However, some may take up to several days.
Full recovery after LASIK may take about 3 to 6 months. Generally, you’ll have excellent results if you only have mild refractive errors. Research shows that 99% of LASIK patients achieve clear vision.
Complications may also affect the recovery time. These include:
- Dry eyes
- Infections
- Flap dislocation
You can prevent these by attending follow-up visits for close monitoring.
What to Expect After Laser Treatment for Diabetic Retinopathy
After LASIK, here’s what you can expect:
- Your doctor will provide you with post-op care instructions
- Your doctor may recommend a few hours of sleep to avoid the initial pain and discomfort
- You’ll be provided with eye shields to prevent unconscious touching or accidental injury
- You may experience mild eye pain or discomfort
- Your doctor will provide you with antibiotic eye drops and ointments
You’ll be advised to avoid the following during recovery:
- Rubbing your eyes
- Swimming (for about a week)
- High-impact activities (e.g. contact sports)
- Eye-straining activities (e.g. excessive reading)
It’s advisable to make your first follow-up visit at least 24 hours after surgery and plan regular visits.
The Cost of LASIK Surgery for Diabetics
On average, LASIK costs about $1,500 to $2,000 per eye. There is no documented difference between standard LASIK and diabetic LASIK.
However, the cost can be higher if additional treatment is required to manage your diabetes. The cost may also vary depending on various factors.
These factors include:
- Your location
- Available facilities
- Correction extent
- Surgeon experience
Many insurance providers consider LASIK surgery an elective or cosmetic surgery and may not cover it unless it’s medically necessary.
Summary
- LASIK surgery is one of the most effective procedures for correcting refractive errors.
- People with diabetes can benefit from LASIK, although a doctor must assess eligibility.
- Diabetic retinopathy is one of the diabetes complications that may affect LASIK’s long term success. However, it can be managed, and patients can benefit from LASIK.
- Although LASIK is possible for diabetic patients, it cannot reverse damage caused to your vision.
- Experts recommend proper management and control of diabetes and improvement of overall health before seeking the LASIK procedure.
- Seek advice from your primary care physician before deciding to undergo surgery.
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