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The first U.S. LASIK procedure was performed in the early 1990s, and millions of Americans have had it since. LASIK eye surgery uses an excimer laser to reshape the cornea so light focuses more accurately on the retina, reducing or eliminating the need for glasses or contacts. According to the American Academy of Ophthalmology, a large majority of suitable LASIK patients achieve 20/20 vision or better, though outcomes vary from person to person. The procedure itself is fast, but the screening that determines whether you’re a good candidate is what really drives results – and, as the FDA has stressed in recent years, understanding the risks beforehand matters just as much as the technology. Only a qualified eye surgeon can decide whether LASIK is right for you.
What LASIK Is and Who Qualifies
LASIK stands for laser-assisted in situ keratomileusis. The surgeon creates a thin flap on the surface of the cornea, lifts it, and uses an excimer laser to remove a precise amount of corneal tissue beneath. The reshaped cornea bends light onto the retina more accurately, correcting myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.
Good candidates are typically adults (generally over 18) with a stable glasses prescription for at least about a year, healthy eyes free of cataracts or active disease, and corneas thick enough to safely reshape. The FDA notes that conditions such as pregnancy, breastfeeding, certain autoimmune diseases, and some medications can disqualify or delay candidacy. Severe dry eye and unusually thin or steep corneas are also red flags. A meaningful share of people who seek LASIK are turned away after screening – which is a sign of careful gatekeeping, not scarcity. If a surgeon tells you that you’re not a candidate, that’s the screening doing its job.
How the Procedure Is Performed
The surgery itself usually takes around 15 minutes for both eyes. After numbing drops, an eyelid speculum holds the lids open and, on modern platforms, a femtosecond laser creates the corneal flap in a matter of seconds. The surgeon lifts the flap and the excimer laser delivers programmed pulses lasting roughly 30-60 seconds per eye. The flap is then repositioned and seals on its own without stitches.
Patients are awake throughout. You’ll see flashing lights and feel pressure during flap creation, but the procedure is generally not painful. Modern wavefront-guided and topography-guided platforms map the eye in three dimensions for a customized treatment, which peer-reviewed FDA trial data suggest can reduce night-vision side effects compared with older systems. SMILE (small incision lenticule extraction) is a flapless laser alternative that some surgeons offer, mainly for myopia and some astigmatism.
Preparation and the Day Of
Soft contact lenses are generally stopped for one to two weeks before screening, and rigid gas-permeable lenses for longer (often three to four weeks), because contacts can temporarily reshape the cornea and skew measurements. Pre-op imaging typically includes corneal topography, pachymetry (corneal thickness), wavefront analysis, and tear-film testing. This work-up is where candidacy is really decided.
On surgery day, eat a light meal, skip eye makeup and perfumes, and arrange a ride home. You’ll usually spend around 90 minutes at the center for paperwork, drops, and the procedure. Many surgeons suggest a sleep aid so you can nap afterward, which helps the corneal flap settle.
Recovery Timeline
Vision is often usable within hours, and many patients see well enough to attend the next-day follow-up appointment. Some blurriness, halos, dry eye, and light sensitivity are normal in the first one to two weeks. Antibiotic and steroid drops are typically used for about a week, and preservative-free artificial tears are often recommended for one to three months, because the laser temporarily reduces the corneal nerve sensation that triggers tear production.
Vigorous exercise, contact sports, swimming pools, and hot tubs are generally off-limits for two to four weeks. Eye rubbing and falls should be avoided for at least a month so the flap stays in place. Vision usually stabilizes by three to six months, though the timeline varies. Some patients are surprised that LASIK does not prevent age-related reading glasses (presbyopia) or future cataract surgery – it corrects your current refractive error, not the eye’s later changes.
Risks, Complications, and Outcomes
Modern LASIK is generally considered safe, and serious complications are uncommon. But “uncommon” is not “never,” and the risks are real. Common side effects include temporary dry eye (very common in the first few months), glare and halos at night, and under- or overcorrection that may require an enhancement procedure. Less common but more serious complications include flap problems, infection, corneal ectasia (progressive corneal weakening), persistent dry eye, and, rarely, a loss of best-corrected vision or lasting visual symptoms. Some patients experience ongoing glare, starbursts, or double vision, and a minority report persistent dry-eye discomfort – which is part of why informed consent matters so much.
The FDA has focused specifically on this. It maintains patient information and a LASIK Surgery Checklist of questions to ask and issues to consider, and in July 2022 it issued a draft guidance recommending stronger patient labeling for LASIK devices – including a proposed patient decision checklist covering contraindications and warnings – out of concern that some patients weren’t receiving or fully understanding the benefit-and-risk information. FDA officials specifically cited potential adverse effects such as dry eye, pain and discomfort, and visual symptoms. The takeaway for patients: ask directly about these risks, and make sure you understand them before consenting.
When to seek emergency care: Call your LASIK surgeon immediately or go to an eye emergency room if you experience sudden vision loss, severe eye pain, increasing redness with discharge, or the sensation that something has shifted under the eyelid in the first month. These can signal flap displacement or infection that needs prompt attention.
Alternatives to LASIK
PRK (photorefractive keratectomy) skips the flap by laser-treating the corneal surface directly. Recovery is slower and more uncomfortable, but PRK is often preferred for patients with thin corneas, dry eye, or contact-sport and certain occupational lifestyles. SMILE works through a smaller keyhole incision and may be gentler on corneal nerves. Implantable collamer lenses (ICLs) are lens implants, reversible in principle, for patients with very high prescriptions or thin corneas. For some patients, waiting for refractive lens exchange, or coordinating with future glaucoma care if intraocular pressure is borderline, is the better path. Which alternative fits – if any – is a decision for your eye surgeon.
Glasses and contact lenses remain perfectly valid alternatives, especially for people who do well with either. LASIK trades one kind of inconvenience now for a different set of trade-offs later – many patients find it worthwhile, but not everyone does, and that’s a personal calculation.
Cost Considerations
LASIK is considered elective and is rarely covered by insurance. Cost is almost always quoted per eye, and it varies widely by surgeon, technology, and region. In 2026, per-eye prices commonly fall in the range of roughly $1,500 to $5,000, with many all-inclusive quotes clustering around $2,000-$3,500 per eye; that means both eyes together often run somewhere in the mid four figures. Premium platforms (wavefront-guided, topography-guided, SMILE) tend to cost more. FSA and HSA dollars can typically be used pre-tax, which can effectively reduce the price by roughly your marginal tax rate. Be cautious about centers advertising unusually low per-eye prices – those figures sometimes exclude technology fees, the pre-op evaluation, or enhancements, so ask exactly what’s bundled. Our healthcare costs guide covers FSA timing and how to compare elective-surgery quotes. Treat all prices here as estimates and get a written quote.
Frequently Asked Questions
Does LASIK last forever?
The corneal reshaping itself is permanent. However, your eyes keep changing with age. Most people will eventually need reading glasses for presbyopia in their 40s and may develop cataracts later in life regardless of having had LASIK.
Is LASIK painful?
Generally, no. Numbing drops prevent pain during surgery, and most patients describe pressure and brief discomfort during flap creation. Mild burning or scratchiness is common for the first several hours and usually eases with a nap and artificial tears.
Can I have LASIK if I have astigmatism?
Often, yes. Modern excimer lasers can correct astigmatism within a certain range. Patients with very high or irregular astigmatism may be better suited to PRK, SMILE, or ICLs – your surgeon will advise based on your measurements.
What if my prescription changes after LASIK?
Small changes can sometimes be corrected with an enhancement procedure, which many practices include for a limited period after the original surgery. Larger changes from age-related lens shifts are typically managed with reading glasses or, eventually, cataract surgery.
Am I definitely a candidate for LASIK?
You can’t know without screening. Candidacy depends on your corneal thickness, prescription stability, eye health, tear film, and more – and a meaningful share of people are turned away. Only an ophthalmologist who examines your eyes can decide.
The Bottom Line
LASIK is a fast, well-studied procedure with strong outcomes for the right candidate – but it is not right for everyone, and the screening matters more than the laser brand. The FDA’s 2022 draft guidance underscored that patients deserve clear, upfront information about risks like dry eye and visual symptoms. Ask your surgeon about your corneal thickness in microns, your tear-film results, the platform they use, the enhancement policy, the specific risks in your case, and the realistic chance you’ll still need reading glasses in your 40s. A surgeon willing to tell you “no” is often the one most worth saying “yes” to. Before deciding, see an ophthalmologist for a full evaluation.
TL;DR & medical disclaimer: LASIK reshapes the cornea with a laser to reduce dependence on glasses or contacts, and most suitable candidates do well – but not everyone qualifies, and only an eye surgeon can decide. Real risks include dry eye, night glare/halos, the possible need for an enhancement, and rarely more serious complications; the FDA’s July 2022 draft guidance emphasized clearer risk disclosure. LASIK doesn’t prevent presbyopia or future cataracts. Costs are usually per eye, vary widely (roughly $1,500-$5,000+ in 2026), and are typically not covered by insurance. This article is general educational information, not medical advice – consult a qualified ophthalmologist before making any decision.
Sources
- U.S. Food and Drug Administration – “LASIK” patient information and LASIK Surgery Checklist (fda.gov)
- U.S. FDA – Draft Guidance, “Laser-Assisted In Situ Keratomileusis Lasers – Patient Labeling Recommendations” (July 2022; Federal Register)
- American Academy of Ophthalmology – “LASIK” (aao.org)
- All About Vision – “LASIK Eye Surgery Cost in 2026” (allaboutvision.com)