Laser eye surgery corrects corneal optics.
It does not treat retinal disease.
If the macula is unstable, refractive precision cannot restore lost retinal function.
Professional guidelines caution against elective refractive surgery in patients with uncontrolled diabetic retinopathy or macular pathology. ¹
Clinical reports describe progression of diabetic retinopathy in some patients after LASIK when disease was not fully stabilised. ²
Red flags include:
- Active diabetic macular oedema
- Recent anti-VEGF injections
- Neovascular age-related macular degeneration
- Unexplained reduced best-corrected vision
- Abnormal OCT findings
The issue is not that laser directly damages the retina. It is that elective corneal surgery should not proceed while underlying pathology is active.
Visual rehabilitation begins with retinal stability.
Only once disease is controlled and prognosis clear should refractive discussions resume.
Long-term vision depends on prioritising the posterior segment first.
References
- American Academy of Ophthalmology Refractive Surgery PPP Panel. Refractive Surgery Preferred Practice Pattern®. Ophthalmology. 2017;124(1):P1-P104.
- Choi JA, Han K, Kim T. Progression of diabetic retinopathy after LASIK. Retina. 2011;31(3):493-499.
- Schallhorn SC, et al. Complications of refractive surgery. Int Ophthalmol Clin. 2003;43(3):89-100.
Related Topics
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- Pregnancy, Breastfeeding and Laser Eye Surgery: Why We Defer
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