The first U.S. LASIK procedure was performed in 1991, and more than 20 million Americans have had it since. LASIK eye surgery uses an excimer laser to reshape the cornea so light focuses correctly on the retina, eliminating or reducing the need for glasses or contacts. According to the American Academy of Ophthalmology, more than 96% of LASIK patients achieve 20/20 vision or better. The procedure is fast, but the screening that determines whether you are a good candidate is what really drives outcomes.
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 over 18, have a stable glasses prescription for at least 12 months, have healthy eyes free of cataracts or active disease, and have corneas thick enough to safely reshape. The FDA notes that pregnancy, breastfeeding, autoimmune disease, and certain medications can disqualify or delay candidacy. Severe dry eye and unusually thin or steep corneas are also red flags. Roughly 15–20% of people who seek LASIK are turned away after screening, which is a sign of careful gatekeeping rather than scarcity.
How the Procedure Is Performed
Surgery itself takes about 15 minutes for both eyes. After numbing drops, an eyelid speculum holds the lids open and a femtosecond laser creates the corneal flap in 10–20 seconds. The surgeon lifts the flap and the excimer laser delivers programmed pulses lasting 30–60 seconds total per eye. The flap is replaced and seals on its own without stitches.
Patients are awake throughout. You will see flashing lights and feel pressure during the flap creation, but no pain. Modern wavefront-guided and topography-guided platforms map the eye in three dimensions for a customized treatment, which according to peer-reviewed FDA trials reduces night-vision side effects compared with older systems. SMILE (small incision lenticule extraction) is a flapless laser alternative that some surgeons offer for myopia.
Preparation and the Day Of
Soft contact lenses are stopped for one to two weeks before screening, and rigid gas-permeable lenses for three to four weeks, because contacts can temporarily reshape the cornea and skew measurements. Pre-op imaging includes corneal topography, pachymetry (corneal thickness), wavefront analysis, and tear film testing.
On surgery day, eat a light meal, skip eye makeup and perfumes, and arrange a ride home. You’ll spend about 90 minutes at the center for paperwork, drops, and the procedure itself. Most surgeons hand out a sleep aid so you can nap right after, which lets the corneal flap settle.
Recovery Timeline
Vision is usable within hours and most patients see well enough to drive themselves to 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 used for about a week, and preservative-free artificial tears are recommended for one to three months because the laser temporarily reduces corneal nerve sensation that triggers tear production.
Vigorous exercise, contact sports, swimming pools, and hot tubs are off-limits for two to four weeks. Eye rubbing and falls should be avoided for at least a month so the flap remains in place. Vision usually stabilizes by three to six months. Some patients are surprised that LASIK does not prevent age-related reading glasses (presbyopia) or future cataract surgery.
Risks, Complications, and Outcomes
Modern LASIK is remarkably safe. Serious complications occur in well under 1% of cases. Common side effects include temporary dry eye (very common in the first three months), glare and halos at night, and undercorrection or overcorrection requiring an enhancement. Rare but serious complications include flap dislocation, infection, ectasia (progressive corneal weakening), and persistent dry eye, per the Cleveland Clinic overview.
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 preferred for patients with thin corneas, dry eye, or active military and contact-sport lifestyles. SMILE works through a smaller keyhole incision and is gentler on corneal nerves. Implantable collamer lenses (ICLs) are reversible lens implants for patients with very high prescriptions or thin corneas. Some patients are also better served by waiting for refractive lens exchange or future glaucoma surgery planning if intraocular pressure is borderline.
Glasses and contact lenses remain perfectly valid alternatives, especially for people who do well in either. LASIK trades inconvenience now for inconvenience later — many patients find the trade worthwhile, but it is not universally so.
Cost Considerations
LASIK is considered elective and is rarely covered by insurance. Expect $2,000 to $3,500 per eye in 2026 dollars, with most U.S. centers charging $4,000 to $7,000 for both eyes including pre-op evaluation, procedure, and one year of follow-up. Premium platforms (wavefront-guided, topography-guided, SMILE) often cost more. FSA and HSA dollars can be used pre-tax, which effectively reduces the price by 20–35%. Avoid centers advertising prices below $1,000 per eye — those usually exclude technology fees and enhancements. Our healthcare costs guide covers FSA timing and how to compare elective surgery quotes.
Frequently Asked Questions
Does LASIK last forever?
The corneal reshaping itself is permanent. However, your eyes continue to change with age. Most people will eventually need reading glasses for presbyopia in their 40s and may develop cataracts in their 60s or 70s regardless of LASIK.
Is LASIK painful?
No. Numbing drops eliminate pain during surgery. Most patients describe pressure and brief discomfort during the flap creation. Mild burning or scratchiness is common for the first six to eight hours, which usually responds to a nap and artificial tears.
Can I have LASIK if I have astigmatism?
Yes. Modern excimer lasers correct astigmatism up to about 5–6 diopters. Patients with very high astigmatism or irregular astigmatism may be better suited to PRK, SMILE, or ICLs.
What if my prescription changes after LASIK?
Small changes can be corrected with an enhancement procedure, usually included in the original price for the first one to two years. Larger changes from age-related lens shifts are typically managed with reading glasses or, eventually, premium-lens cataract surgery.
The Bottom Line
LASIK is a fast, well-studied procedure with excellent outcomes for the right candidate. The screening matters more than the laser brand. Ask your surgeon about your corneal thickness in microns, your tear film test results, the platform they use, the lifetime enhancement policy, and the realistic chance you will still need reading glasses in your 40s. A surgeon who is willing to tell you no is often the one most worth saying yes to.