Tuesday, July 16, 2024

Keep Your Eye on the Prize: You’re Not Too Old for Laser Vision Correction Surgery

Every year, thousands of Canadians who want to forgo glasses look to laser vision correction surgery. However, there’s a common belief that it’s something you should do before age 40 (give or take a few years) to get the best results. But what about those of us with aging eyes? Are we candidates for this life-changing procedure?

YouAreUNLTD turned to Dr. Raymond Stein, a cornea and refractive surgery specialist, medical director of Bochner Eye Institute and Associate Professor of Ophthalmology and Vision Sciences, University of Toronto, to separate fact from fiction.

Question: Is there an age limit on laser vision correction surgery?

Laser vision correction is considered the most successful and safest procedure in all of medicine and surgery today. There is no specific age limit for laser vision correction. Millions of satisfied patients have undergone the breakthrough procedures of LASIK and PRK. People of all ages enjoy the freedom from glasses and contact lenses for driving, walking, hiking, watching TV and theatre, as well as playing sports, such as tennis and golf.

How does it work?

LASIK and PRK change the shape of the cornea to direct light toward the back of the eye to allow clear vision. Advances in topographically guided or wavefront-guided customized treatments allow for the correction of nearsightedness, farsightedness and astigmatism, as well as optical aberrations of the eye. This approach enhances the quality of day and night vision and may result in better than 20/20 sight. Usually less than the thickness of a hair is removed to correct vision.


LASIK is performed with a femtosecond laser (or a blade, but I highly recommend the laser approach) to create a thin flap of corneal tissue. The flap is then folded back and a computer-guided excimer laser is used to gently reshape the underlying corneal tissue. The flap is then repositioned, conforming to a new curvature to correct sight.

In PRK, the superficial cells of the cornea, called the epithelium, are gently removed in a central location. An excimer laser is then used to reshape the cornea. A bandage soft contact lens is then inserted and removed in four to five days when the epithelial cells have regrown to cover the surface of the cornea. Overall, complications are extremely rare and can usually be managed by drops or additional laser surgery. Two points to keep in mind:

  • Although LASIK and PRK provide similar final outcomes, LASIK allows a quicker return of vision.
  • Patients with thin or irregular corneas, or who require high prescription lenses, are usually best suited for PRK.

How can consumers decide whether laser vision correction is right for them?

Expect to undergo a complete eye examination, including 3-D corneal imaging, to determine the shape and thickness of your corneas. While most people are suitable candidates, you may not be ideal if you have significantly dry eyes, an irregular-shaped or thin cornea, cataracts, an extremely high prescription, or if you desire an improvement in both distance and reading vision with each eye.

Patients over 45 years of age have the normal aging condition referred to as presbyopia (the inability to focus up close). This condition is caused by natural stiffening of the crystalline lens, which interferes with the ability to change shape and see up close.

However, there is a corrective surgery solution: Presbyopic patients that prefer enhanced distance and near vision with each eye can have a refractive lens exchange. This procedure is similar to a cataract operation in which the lens is removed and replaced with a custom multifocal implant.


This article originally appeared in Issue 4 of YouAreUNLTD magazine




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