[Health Tip] LASIK and LASEK, the Main Causes of Presbyopia?..."No Correlation"

Although vision correction surgeries such as LASIK and LASEK have been introduced in Korea for 30 years, some people still hesitate due to concerns about the possibility of developing eye diseases like presbyopia. However, experts explain that vision correction surgeries involve either reshaping the cornea using a laser or implanting intraocular lenses to correct myopia, and thus have little relation to presbyopia, which occurs due to the loss of elasticity caused by aging of the lens.

A teenager is receiving a consultation before vision correction surgery.
[Photo by Kim Eye Hospital]

Commonly known vision correction surgeries include LASIK, LASEK, SMILE LASIK, and intraocular lens implantation surgery. LASIK and LASEK are surgeries that correct refractive errors such as myopia, astigmatism, and hyperopia by applying a laser to the cornea. When the degree of myopia or astigmatism is high relative to corneal thickness, correction can be done through intraocular lens implantation surgery. LASIK involves making a thin flap in the corneal layer like a lid, applying a laser inside, and then covering it back. LASEK removes only the corneal epithelium, applies a laser to sculpt the corneal stroma, and then covers it with a protective contact lens. SMILE LASIK is performed without creating a flap; it uses a femtosecond laser to cut the necessary portion of the corneal stroma, separates it, and removes it through a small incision.

On the other hand, presbyopia is a condition where the lens, an ocular tissue, ages and loses its accommodative ability. Therefore, it has little correlation with surgeries like LASIK and LASEK that target the cornea, and the perception that vision correction surgery accelerates presbyopia is weakly supported. Conversely, many mistakenly believe that intraocular lens implantation surgery for correcting myopia and astigmatism also corrects presbyopia. Since intraocular lens implantation surgery inserts lenses to correct myopia and astigmatism while leaving the natural lens intact, it is difficult to improve the weakening of lens accommodation caused by aging. Additionally, LASIK, LASEK, and SMILE LASIK surgeries are performed on the cornea and do not directly affect the lens or retina, so they are not strongly associated with the development of retinal diseases, glaucoma, cataracts, or other eye diseases.

However, if the remaining corneal thickness after cutting is too thin, there is a possibility of developing corneal ectasia (keratoconus), where the thinned cornea protrudes in a cone shape. Also, if there are peripheral retinal abnormalities or tears, it is better to perform laser treatment before surgery. Therefore, thorough evaluation of corneal shape and thickness, as well as the presence of eye diseases, should be conducted through corneal topography, corneal shape, and pupil size tests before surgery.

Ham Minji, a corneal specialist at Kim Eye Hospital, said, “With winter vacation and year-end holidays approaching, inquiries about LASIK and LASEK are increasing. Although the safety of vision correction surgeries has been somewhat verified, since there are many surgical options, it is important to accurately understand one’s eye condition through consultation and detailed examinations with an experienced specialist before making a decision.”