Fortunately, the great majority of patients do not regress after LASIK surgery. The curvature of the cornea should remain reasonably stable shortly after the first few months. Using computerized topography to map the cornea shows us that most LASIK patients achieve a stable refraction within the first three months after surgery. However, some patients with high myopia, may require up to six months or longer to stabilize.

Patients who do experience a drop in the effectiveness of the procedure usually were severely myopic before surgery. Doctors are still puzzled as to why these patients occasionally regress. The best that can be surmised is that the problem is most likely related to the depth of the laser ablation, and the healing process. The more laser treatment necessary, the more remodeling necessary by the stroma or middle layer of the cornea. This remodeling takes place during the first couple of years after surgery. Also, the epithelium may regrow a little thicker over the lasered area, especially in highly myopic patients. In order to overcome large amounts of nearsightedness, the laser must make a deeper ablation. The deeper the laser treatment, the more the body will attempt to fill in the surgical depression, or "divot," with new epithelium. In highly myopic patients, this natural healing response may contribute to slight-to-moderate post-surgical regression.

LASIK surgery will neither slow down, or speed up the normal progression of nearsightedness. As a result of this, some myopic patients naturally continue to get a little more nearsighted throughout their life. Even though the corneal curvature is stable, should the eyeball become slightly longer, or if the crystalline lens begins to develop a cataract, the person will become more myopic . No matter how much the natural progression of near-sightedness progresses over time, patients still should have better vision without glasses after LASIK surgery.

For example, consider a thirty-year-old man with -7 diopters of myopia. With or without surgery, he may naturally develop another diopter of refractive error over a five-year period. Without the surgery, his correction would now be -8 diopters (severe myopia). However, let's say he had LASIK surgery at thirty years old, and his correction was reduced to -1 diopter (mild myopia). The five years pass and his eyeball naturally elongates so that his refractive error increases to -2 diopters. This is much better than the -8 severe myopia that would occur without LASIK surgery.

Scientists have noticed, and it does make obvious sense, that people doing large volumes of close work tend to be more myopic. People who work outdoors, such as construction workers, who must focus in the distance are less likely to be severely myopic. As you may know, when you have to focus on a near object, your eyes will converge. Having been pulled inward during years of reading, there is a good chance your eyeball could become slightly longer. The slightest increase of only 1 millimeter in the length of the eyeball can increase myopia by up to 3 diopters. Think of it like this; when you squeeze a tennis ball and quickly let it go, it will pop right back to its original shape. Should you squeeze the tennis ball sixteen hours a day for ten years, it is not unreasonable to expect that the tennis ball's shape could elongate slightly.

Investigate the benefits of LASIK surgery carefully to fully understand the chances of regression.

Copyright 2006 Carl DiNello