If you’ve had LASIK surgery in the past and are now approaching the age where cataracts become more common, you might be wondering: How will my previous LASIK procedure affect cataract surgery? The good news is that you can still have successful cataract surgery after LASIK—but it does require additional planning and expertise.
Can You Have Cataract Surgery After LASIK?
Yes—patients that have had LASIK will still need cataract surgery in time, and it’s performed frequently. Many patients who had LASIK in their 20s or 30s are now entering their 50s, 60s, or 70s and developing cataracts, which naturally occur with age.
However, because LASIK permanently alters the shape of the cornea, planning cataract surgery requires additional care to ensure accurate lens selection and optimal outcomes.
How LASIK Changes the Eye
To understand why LASIK affects cataract surgery, it helps to know what LASIK does:
- LASIK reshapes the cornea, the clear front part of your eye, to correct nearsightedness, farsightedness, and/or astigmatism.
- This reshaping changes how light enters the eye, reducing the need for glasses or contact lenses.
- However, this change can alter corneal measurements, which are used later in life when planning intraocular lens (IOL) selection for cataract surgery.
Why Accurate Measurements Matter
During cataract surgery, your natural lens is replaced with an artificial intraocular lens (IOL). To achieve the best possible visual outcome, your surgeon must:
- Measure the curvature of the cornea
- Calculate the length of your eye (axial length)
- Choose an IOL power that provides clear distance, intermediate, and/or near vision—depending on your goals
In eyes that have undergone LASIK, standard measurement formulas may be inaccurate, especially if records from the original LASIK procedure are unavailable.
Challenges in Cataract Surgery After LASIK
Here are a few reasons why extra care is needed in post-LASIK cataract patients:
1. Altered Corneal Curvature
LASIK reshapes the cornea, which can make traditional IOL power calculation methods less reliable.
2. Missing Historical Data
Knowing your pre-LASIK prescription and corneal measurements helps improve accuracy—but many patients don’t have these records decades later.
3. Higher Risk of Refractive Surprise
A “refractive surprise” means the outcome doesn’t match the visual goal. This is more likely if the IOL power was calculated without compensating for past LASIK surgery.
4. Higher Expectations
Patients who previously chose LASIK are often motivated to maintain spectacle-free vision, making precise IOL selection especially important.
How Surgeons Plan for Cataract Surgery After LASIK
Fortunately, modern technology and refined techniques allow experienced cataract surgeons to overcome these challenges. Here’s how:
Advanced Diagnostic Tools
Devices like corneal topographers, optical biometers, and wavefront aberrometers help assess your post-LASIK cornea with greater precision.
Special IOL Formulas
Surgeons use modified formulas that are specifically designed for eyes that have had previous refractive surgery.
Using Historical LASIK Data (If Available)
If you have your LASIK records, share them with your cataract surgeon. Information like your original prescription and treatment can improve IOL accuracy.
Custom IOL Recommendations
Post-LASIK patients are often candidates for customized and more sophisticated IOLs, including:
- Light Adjustable Lens (LAL), which can be adjusted to refine and perfect focus after surgery and healing. The LAL can be adjusted to correct any residual nearsightedness, farsightedness, and/or astigmatism that may occur because of inaccuracies caused from your original LASIK. This IOL provides the greatest advantage in reducing the need for glasses after cataract surgery in patients with a history of LASIK, PRK or RK.
- Toric IOLs for correction of higher levels of astigmatism to help provide focus for distance vision
- Monofocal IOLs for patients with lower levels of astigmatism to help provide focus for distance vision
- Multifocal or Extended Depth of Focus (EDOF) IOLs to help provide focus for both distance and near vision. Patients with a history of LASIK may not always be ideal candidates for these IOLs and should be discussed with your surgeon.
Your surgeon will recommend the best lens type based on your current eye health and visual goals.
What Are the Visual Outcomes After Cataract Surgery with Prior LASIK?
When planned carefully by an experienced ophthalmologist, cataract surgery after LASIK often produces excellent results. Because LASIK can impact the accuracy of your preoperative measurements, it’s important to choose appropriate technology with your surgeon if you intend on maintaining independence from glasses.
It’s important to have realistic expectations. In some cases, fine-tuning with glasses, contact lenses, or even a LASIK enhancement may be needed after surgery.
Questions to Ask Your Surgeon
Before moving forward with cataract surgery, ask your eye surgeon the following:
- Do you specialize in cataract surgery for post-LASIK patients?
- Will you be using advanced IOL formulas and diagnostic equipment?
- What type of intraocular lens do you recommend for my eyes and lifestyle?
- What are my options if the visual outcome is not exactly as expected?
Choosing a cataract surgeon experienced in treating post-LASIK eyes is key to achieving the best possible outcome. Surgeons at Twin Cities Eye Consultants commonly treat cataracts in patients with a history of LASIK and have been active in research and publishing on the most advanced technology available to post-LASIK patients needing cataract surgery.
References:
Conclusion: LASIK Doesn’t Prevent Cataract Surgery—But It Does Require Expertise
If you’ve had LASIK in the past, rest assured that you can still have successful cataract surgery. While LASIK permanently alters your cornea, state-of-the-art diagnostics and formulas, in addition to advanced technology IOLs allow surgeons to carefully account and plan for these changes.
With the right preparation and personalized approach, you can enjoy sharp, clear vision after cataract surgery—even decades after LASIK.
