Can People with Diabetes Get LASIK Eye Surgery?


 

As a person with diabetes, annual visits to your eye doctor are critical to catching the earliest stages of diabetes-related eye conditions. Learn more:


Yes, people with diabetes are potential candidates for LASIK eye surgery! While certain aspects of your diabetes health could mean LASIK surgery isn’t safe or appropriate for you, your diabetes diagnosis alone does not exclude you from getting this surgery.

Here’s what you need to know about getting LASIK as a person with diabetes.

Eligibility requirements for LASIK—regardless of diabetes

“Even a person without diabetes may not be a candidate for LASIK,” explains Julie Larson, M.D. is an ophthalmologist and eye surgeon at Vermont Eye Laser in South Burlington, V.T. As one of the top refractive surgeons in the country, Larson has performed LASIK surgery for more than 15,000 patients—many of whom live with type 1 and type 2 diabetes.

There are a variety of basic requirements—many of which you cannot control—that determine if this type of surgery is safe, effective, and appropriate for you.

Some of these requirements include:

  • At least 21 years old
  • Have nearsightedness, farsightedness and/or astigmatism
  • Glasses or contact lens prescription has been stable for the past 1-2 years
  • Generally health eyes
  • Not pregnant or nursing
  • Your glasses or contact lens prescription is within a treatable range
  • Measurements of your corneas meet basic surgery requirements
  • Learn more about the basics of LASIK with these helpful FAQs.

This last detail—the measurements of the cornea in your eye—is the most considerable detail you cannot control. The thickness and curvature of your cornea hugely determine your eligibility for LASIK surgery.

To determine if your eyes meet these requirements, schedule a LASIK surgery consult with a qualified surgeon. During this consult, they will take detailed measurements of your eyes to determine your eligibility and map out the precise details of your future surgery.

Qualifying for LASIK eye surgery as a person with diabetes

“I perform LASIK surgery on people with diabetes all the time,” explains Larson.

LASIK eye surgery began in the early 90s—and people with diabetes weren’t considered candidates in those early years, but that has since changed.

“We weren’t as aggressive with who could receive LASIK because we didn’t know enough about how well people with diabetes would heal from the surgery,” explains Larson. With time, the eye care industry learned that people with well-managed diabetes can successfully undergo and heal from LASIK surgery.

Today, Larson says the diabetes-related factors that affect your eligibility for LASIK include:

  • Your blood sugars are well-managed
  • Your A1c is in your goal range
  • You have no signs of retinopathy
  • You have no history of retinopathy
  • You do not have cataracts
  • You do not have advanced glaucoma
  • Your diabetes healthcare team considers your blood sugars to be well-managed
  • You are not experiencing chronically high blood sugar levels
  • You’ve been living with diabetes for at least a year or two
  • Learn more about diabetes and eye health

While Larson doesn’t specifically ask a potential patient to provide proof of their most recent A1c, she says some surgeons might.

“I interview the patient during the exam, and I believe what they tell me,” says Larson.

Being honest about your blood sugar management is critical

Being honest during your initial exam is vital. Lying about your blood sugar levels can severely affect the effectiveness of your surgery and your ability to heal.

“Your blood sugar levels play a very important role in LASIK,” explains Larson, “because high blood sugar levels will change your vision, which would affect the measurements we take for your treatment. If your blood sugars improve or worsen after surgery, your surgery won’t be as effective.”

High blood sugar levels also affect your eyes’ healing ability from the surgery.

Remember, if your overall A1c increases significantly after surgery, your vision can change, too—affecting the long-term success of LASIK surgery. Just because you aren’t aware of changes in your vision due to chronically high blood sugars doesn’t mean it’s not happening. These changes can be gradual and go easily unnoticed until they reach a certain severity—which is also why routine eye exams are critical to monitor the health of your eyes. When it comes to surgery, though, small changes are significant.

“Retinopathy of any kind is a big dealbreaker for LASIK,” explains Larson.

“Any history of retinopathy means the eyes have endured some degree of damage, making them more fragile and not a candidate for LASIK.”

Even if your retinopathy is now stable after treatments and changes in your diabetes management, Larson says LASIK is too risky.

What does LASIK eye surgery cost?

In short, it depends. Many health insurance companies consider it elective surgery. A significant number of people pay out-of-pocket for their surgery, with or without health insurance.

If you have health insurance: You should look closely at the vision plan portion of your healthcare coverage. According to the American Refractive Surgery Council, some healthcare plans will:

  • Offer discounts on laser vision correction surgeries
  • Offer even higher discounts if your surgery is performed by in-network surgeons
  • Use HSA/FSA funds towards the cost of LASIK

If you’re paying out-of-pocket: LASIK surgery generally costs somewhere between $2,000 to $3,000 per eye. This means you’re looking at a maximum cost of about $6,000. Most clinics also offer payment plans to help make this hefty cost more manageable.

What to Expect: Before, During, and After surgery

Once you’ve been approved and scheduled for surgery, you’ll probably be a little nervous as surgery day approaches. You’ll also be given a variety of pre-surgery instructions that you should follow very closely—like how many days or weeks to stop wearing contacts before surgery.

Commonly, your LASIK surgeon will give you a tiny dose of valium immediately before surgery to help you stay relaxed during the procedure. They also completely numb your eyes with drops.

The surgery itself is relatively quick and certainly painless. The actual laser part of the surgery is only about 10 minutes long—but you should expect to spend about two hours at the clinic that day from start to finish.

Immediately after surgery, you’ll protect your eyes from the light with a heavy-duty pair of not-so-sexy sunglasses. You will need a friend to help you leave the building and drive you home. You’ll notice a significant improvement in your vision within 24 hours after surgery (especially after a bit of recommended napping). It can take up to six months for your vision to fully stabilize after surgery.

In addition to the basic expectations of LASIK surgery with diabetes, there are a few other things to keep in mind:

  • Well-managed blood sugar levels promote healthy healing!
  • You may experience varying levels of insulin resistance due to steroid eye drops and inflammation while healing.
  • With any surgery, there are risks. If you are experiencing any concerning symptoms in the weeks after your surgery, contact your surgeon immediately.
  • Show up for any follow-up appointments with your surgeon so they can confirm that your eyes are healing well post-surgery.

You’ll be taking steroid eye drops for several weeks after surgery. Steroids of any kind can lead to varying degrees of insulin resistance.

Therefore, some people may need to increase their insulin doses during the weeks after surgery. Keep a close eye on your blood sugar levels and communicate regularly with your diabetes healthcare team if your blood sugar levels are trending higher days or weeks after surgery.

The inflammation that results from any surgery and the healing process can also call for a slight increase in insulin doses. Again, talk to your healthcare team and make any necessary adjustments with their support.

Remember, the healthier your blood sugar levels are before, during, and after surgery, the more successful your surgery will be.

WRITTEN BY Ginger Vieira, POSTED 05/03/22, UPDATED 05/03/22

Ginger Vieira is the Senior Content Manager at Beyond Type 1. She is also an author and writer living with type 1 diabetes, Celiac disease, fibromyalgia, and hypothyroidism. She’s authored a variety of books, including “When I Go Low” (for kids), “Pregnancy with Type 1 Diabetes,” and “Dealing with Diabetes Burnout.” Before joining Beyond Type 1, Ginger spent the last 15 years writing for Diabetes Mine, Healthline, T1D Exchange, Diabetes Strong, and more! In her free time, she is jumping rope, scootering with her daughters, or walking with her handsome fella and their dog.