How Female Hormones Affect LASIK Eligibility and Recovery

The “windshield” of the eye, the cornea is the primary tissue of the human eye that is modified with laser eye surgery. Research in the field of refractive surgery has demonstrated that female hormones play a major role in the anatomy and physiology of the cornea. For this reason, changes in the levels of certain hormones during pregnancy or menopause can impact your eligibility for Laser Assisted in situ Keratomileusis (a.k.a. LASIK).

Do women have different eligibility criteria for LASIK?

A woman’s age or pregnancy status may have an impact on her eligibility for LASIK. In ophthalmology, much like in other fields of medicine, the unique female hormones (such as estrogen and progesterone) that are associated with pregnancy can alter human physiology. For this reason prospective female patients may not be good candidates for LASIK while male candidates may not have these same eligibility restrictions.

Can I have LASIK while I’m pregnant?

You should not have any laser vision correction procedures while you are pregnant. These restrictions apply to excimer laser procedures such as LASIK and Photorefractive Keratectomy (a.k.a. PRK), as well as Small Incision Lenticule Extraction (SMILE). Fluctuations in pregnancy hormones can impact the shape and function of the cornea, which in turn can impact a woman’s glasses or contact lens prescription. Refractive errors such as myopia, hyperopia, and astigmatism need to be accurately measured and they need to be stable in order to obtain an excellent LASIK outcome. If a woman is pregnant or nursing, her pre-operative measurements may not be accurate, and there is a risk that her LASIK procedure may not deliver a successful outcome of clear vision.

How does menopause affect LASIK eligibility or recovery?

Menopause may impact tear production, which can lead to dry eye syndrome. For women in this age group, dry eye syndrome can restrict LASIK eligibility and can also delay recovery after LASIK eye surgery. The health of your tears plays a major role in visual clarity. Perimenopausal and postmenopausal women experience changes in their sex hormones (i.e. estrogen and progesterone) which can negatively impact baseline tear production, leading to dry eye disease. Patients with uncontrolled dry eye disease are not good candidates for LASIK. In addition, the signs and symptoms of dry eye disease may lead to a much slower recovery after LASIK.

Do hormones affect vision and LASIK recovery?

By impacting the shape and function of the cornea and natural lens of the eye, female sex hormones can impact visual acuity. Changes in hormone levels can lead to fluctuations in your visual acuity. Ultimately, this may cause blurry vision and can even contribute to a slower recovery after LASIK. Women may experience large changes in the balance of their sex hormones throughout the course of their pregnancy. Similarly, women you are undergoing menopause may have large shifts in these hormones as well.

FAQ’s About How Female Hormones Affect LASIK Eligibility and Recovery

Can hormonal changes affect my eligibility for LASIK?

Most importantly, hormonal changes (such as during pregnancy) can impact your corneal thickness and curvature. In turn this can lead to an inaccurate assessment of your refraction, which is a measure of the degree of nearsightedness, farsightedness, or astigmatism that you have. Without an accurate refraction, there would be no way to assure that your LASIK treatment is accurate. An assessment of the shape of your cornea, also known as a corneal topography, will be performed on the day of your consultation.

How do pregnancy and breastfeeding impact LASIK eligibility?

Our surgeon does not recommend any type of laser vision correction during pregnancy. Furthermore, we recommend waiting at least 3 months from the cessation of nursing before considering a laser eye surgery. Pregnancy and breastfeeding impact corneal anatomy and physiology, which in turn play a major role in your glasses or contact lens prescription. If an accurate assessment of refractive error (i.e. myopia, hyperopia, astigmatism) cannot be made during your consultation, then there is a risk of having an inaccurate post-operative LASIK outcome. It is for this reason that we limit the eligibility of LASIK for pregnant women or breastfeeding women.

Can birth control pills affect the outcome of LASIK surgery?

The use of birth control pills is not likely to affect the outcome of LASIK surgery. In a 2006 article in the Journal of Refractive Surgery, women who were on oral contraceptive medications did not have any different outcomes than women who were not taking these medications. In other words, you do not need to discontinue oral contraceptive pills if you are seeking LASIK for vision correction.

Does the menstrual cycle influence LASIK surgery or recovery?

In general, a woman’s normal monthly menstrual cycle will not influence her LASIK procedure nor her recovery from the LASIK procedure. As such, women do not need to plan around their cycle if they are considering LASIK.

Is it safe to get LASIK during menopause or perimenopause?

It is safe to get LASIK during menopause or perimenopause, but your surgeon may need to pay particular attention to the health of your tear film after the procedure. Imbalances in estrogens and progesterone may have a negative impact on the components of the tear film that are important for maintenance of a healthy ocular surface. Women in this group tend to be at a particularly high risk of dry eye disease, an inflammatory condition that can lead to symptoms such as dryness, pain, tearing, and vision fluctuation. Any existing dry eye symptoms may be exacerbated in the recovery phase after LASIK eye surgery. Your surgeon may need to use medications to reduce the ocular inflammation that is associated with dry eye disease.

How do hormone replacement therapies affect LASIK recovery?

Hormone replacement therapies (or HRT) may complicate the post-operative course of LASIK. In a retrospective review found in the Journal of Refractive Surgery, women who are on HRT are at an increased risk of regression after LASIK. Regression is the term used to describe a phenomenon where patients lose some of the effect of their LASIK procedure. When regression occurs, patients who have an excellent outcome after LASIK may notice that over the course of several months or years their vision seems to lose some of its sharpness. These patients may choose to return to wearing glasses or contact lenses, or they may choose a touch-up procedure to sharpen up their vision.

Can hormonal fluctuations cause dry eyes after LASIK?

Hormonal fluctuations may promote dry eyes after LASIK. We know that hormones play a role in stimulating the cells and glands on the ocular surface that are important for a healthy tear film. If there are changes in hormone balance then this may cause a tear film that is not healthy. The end result may be dry eye disease. Once hormonal balance is re-established, there may be a concurrent improvement in the symptoms of dry eyes.

Will LASIK results be affected if I undergo hormone therapy in the future?

LASIK results may be affected if you undergo hormone replacement therapy, or HRT, in the future. Previous studies have shown that HRT may carry a higher risk of regression. This term is used to describe some loss of the LASIK effect over time.

Should I delay LASIK if I’m planning a pregnancy?

If you are planning a pregnancy, it may be prudent to delay your LASIK surgery. After you have delivered your baby and completed breastfeeding, you will have corneal stability and you will be ready for a more accurate assessment of your visual impairments during a LASIK consultation.

How long after pregnancy or breastfeeding should I wait to get LASIK?

At Lucent Vision we recommend waiting 3 months from the time you stop breastfeeding before considering LASIK surgery. The female sex hormones tend to return to their baseline at this checkpoint. Once you have reached this timeframe, it would be safe to get a LASIK consultation.

source https://lucentvision2020.com/lasik/how-female-hormones-affect-lasik-eligibility-and-recovery/