LASIK, Pregnancy, and Breastfeeding

Can pregnant women undergo LASIK?

Because LASIK has a proven record of providing outstanding vision with little to no side-effects, many people have turned to this treatment to enhance their careers, hobbies, and overall quality of life. Pregnant women are often interested in LASIK too, although most patients are advised to wait until after pregnancy and breastfeeding for two important reasons.

First, a pregnant woman undergoes a number of physical and hormonal changes, which can cause adjustments in her vision. LASIK is advised only for patients with stable vision – pregnant or not. Stable vision helps to ensure that your LASIK results will not be compromised by future changes to your vision. This allows patients to enjoy long-term satisfaction with the results of their procedure.

Secondly, eye drops and other medications are administered as part of the LASIK procedure and recovery. Although these therapies are perfectly safe for adults, they should be avoided to protect a developing fetus that may be more sensitive.

Is LASIK safe for women who are breastfeeding?

For similar reasons, LASIK is not recommended for women who are breastfeeding. In the months following childbirth (especially during breastfeeding), a woman will continue to experience hormonal changes that can affect her vision. The best way to enjoy optimal, long-lasting LASIK results is by seeking treatment after your hormonal changes and vision have stabilized. Additionally, the medications that are administered as part of the LASIK process will enter the woman’s body, including her breast milk. To prevent any potential health-related issues to your child, we recommend that women wait until nursing is complete to undergo LASIK.

How soon after pregnancy or breastfeeding can a woman undergo LASIK?

In general, LASIK surgeons recommend that women wait at least two menstrual cycles after they give birth or stop breastfeeding before considering LASIK surgery. At this time, hormones will have largely returned to normal levels and a woman's eyesight should have returned to its pre-pregnancy prescription.

LASIK and Cataract Surgery

Can patients undergo LASIK after cataract surgery?

In the past, patients who had undergone cataract surgery were not candidates for laser eye surgery. As a result, compensating for pre-existing corneal abnormalities like nearsightedness, farsightedness, and astigmatism required corrective eye wear. Today, ophthalmologist Andrew Holzman can provide safe LASIK (laser-assisted in-situ keratomileusis) surgery to correct these conditions in post-cataract patients. TLC Laser Eye Centers feature the latest LASIK technology, with locations in Virginia, Maryland, and Washington, D.C. Dr. Holzman has personally performed more than 70,000 LASIK treatments, many of which were for post-cataract patients.

How soon after cataract surgery can a patient undergo LASIK?

Cataract patients considering LASIK should wait a few months following surgery before undergoing the treatment in order to ensure their eyes have healed without complication. Once a patient's eyes have fully stabilized, Dr. Holzman conducts comprehensive exams with each patient to determine candidacy for the treatment. Patients undergoing LASIK after cataract surgery should be in good overall health, with no ocular health issues beyond aberrations.

LASIK after 40

Is LASIK appropriate for patients older than 40?

Patients in their 40s often begin experiencing presbyopia, a weakening of the crystalline lens, which can make it more difficult to focus and refocus at various distances. LASIK surgery can still benefit patients over 40, but it must be performed in a special way to account for presbyopia. LASIK monovision is a variation on this popular procedure that helps mature patients retain the ability to focus at a range of distances. If you are considering LASIK after 40contact our practice serving Washington DC, Virginia, and Maryland to learn more about how Dr. Andrew Holzman can help you reduce or eliminate your need for prescription eye wear.

What is presbyopia?

Between the ages of 40 and 45, we all begin to experience presbyopia to varying degrees. Presbyopia causes the lens of the eye to weaken, making it more difficult to alternate focus from far away to close up. Close-up vision is increasingly affected until reading glasses are required. In most cases, the condition continues to worsen with age, and eventually intermediate-range correction may be needed as well.

What is LASIK monovision?

Patients in their 20s and 30s can enjoy complete vision correction with traditional LASIK surgery. After age 40, this treatment can address distance vision, but will not eliminate the need for reading glasses. For patients 40 and older who would like to avoid wearing glasses, Dr. Holzman offers laser vision correction with a monovision adjustment.

To administer LASIK monovision, the dominant eye is treated for a full distance vision correction, while the other eye receives a slight under correction that is optimal for reading. Every patient has a dominant eye that is favored for distance vision, usually on the same side as the dominant hand. Because the dominant eye is the one the brain relies on for visual information, your brain easily makes the adjustment when the non-dominant eye takes the role of ‘reader.’ 

Is it difficult to adjust to monovision?

Some patients fear that it may be difficult to adjust to monovision, but most find that this is not the case. Dr. Holzman always suggests patients use contact lenses to try monovision before having LASIK surgery. Wearing these contacts day and night for a period of a few days allows you to determine whether the monovision adjustment is for you.

Patients who choose monovision enjoy a full range of vision without depending on glasses, and for many, this is an optimal solution. However, not everyone is a candidate for this treatment. Dr. Holzman always explains that monovision patients must be willing to compromise a small amount of visual acuity for distance, since they will be using one eye instead of two.  

"Many of our patients are in their 40s and 50s."

It is a common misconception that patients over 40 are over the LASIK age limit. These patients can undergo LASIK and achieve vast improvement of nearsightedness but may still need to rely on reading glasses. Dr. Holzman frequently helps patients over the age of 40, even into their 60's.

When to Avoid LASIK

What eye conditions can preclude a patient from LASIK?

There are a number of eye conditions that can preclude a patient from LASIK. Patients suffering from persistent dry eyes may not be candidates for LASIK because the procedure could exacerbate the condition. Patients who have thin corneas are often better candidates for photorefractive keratectomy (PRK).  If your vision is fluctuating - that is, if you have had to change your glasses prescription in the last year - LASIK surgery would not be recommended until your vision stabilizes. Because vision fluctuates during pregnancy and breast feeding, laser vision correction surgery would have much less predictable results for these patients, and probably would not be recommended until vision has stabilized. 

There are a number of other eye conditions that can preclude you from LASIK:

  • Cataracts: This gradual clouding of the crystalline lens obstructs vision, and should be addressed before undergoing LASIK.
  • Glaucoma: Glaucoma involves high intraocular pressure (IOP) that can damage the retina and optic nerve. IOP increases during LASIK, so glaucoma sufferers may not be suitable candidates.
  • Fuchs' Dystrophy - This condition involves the deterioration of the inner surface of the cornea, causing it to become unstable.
  • Overly Large Pupils: Patients with overly large pupils may carry an increased risk of developing compromised night vision following LASIK.
  • Severe Nearsightedness: Patients with severe nearsightedness are not usually considered good LASIK candidates.
  • Keratoconus - Keratoconus involves the breakdown of collagen in the cornea, causing it to adopt a conical shape instead of a normal dome shape. Patients with keratoconus may not be candidates for LASIK because of corneal instability.
  • Autoimmune Conditions: LASIK may not be advisable for those who suffer from diseases that affect their immune system because there is an increased risk of incomplete healing and other complications. 

LASIK Side Effects

What are the possible side effects of LASIK?

LASIK surgery can cause side effects, but most are temporary. We pride ourselves on minimizing risks as much as possible. However, it is important for patients to be aware of the possible side effects, including:

  • Vision disturbances - After undergoing LASIK surgery, you may experience disturbances to your normal vision. During the first few weeks or months, you may experience halos, hazy vision, and glare or starbursts in dimmer settings. These side effects should wear off gradually, and usually disappear within three to six months. In rare cases, patients continue to experience long-term vision disturbances. 
  • Red spot on eye - Some patients develop a red spot on the white of their eye following LASIK surgery. This red spot, called a subconjunctival hemorrhage, results when a blood vessel in the outermost protective coating of the eyeball breaks. These red spots rarely occur, but if they do, they are harmless. Any spots will disappear within a few days to a couple of weeks after surgery. Prior to transporting you to the surgical suite, we prep your eyes with a series of eye drops meant to minimize this risk.
  • Flap complications - During LASIK surgery, Dr. Holzman uses a femtosecond laser to create a flap in the cornea of your eye. After reshaping your corneal tissue, Dr. Holzman closes the flap to heal on its own. Sometimes complications effect the healing of the flap, though this is rare. If the flap does not adhere properly, this can create tiny wrinkles in the surface of the cornea, which may affect your vision. 
  • Dry eyes - Some patients develop dry eyes following surgery, but this side effect usually goes away within six months. The LASIK procedure can cause a decrease in your tear production, resulting in dry eyes. Patients who have severe dry eyes may not be candidates for the procedure. 
  • Infection - Infection rarely occurs following LASIK surgery. Dr. Holzman will give you detailed post-operative instructions, including directions on using medicated eye drops, to help minimize the risk of infection. 

By choosing a highly-trained surgeon like Dr. Holzman, you are taking the first step to minimize the chance of side effects. By conducting a comprehensive exam and obtaining precise data prior to surgery, Dr. Holzman can create a custom surgical plan intended to minimize risk and enhance your vision.

Red Spot after LASIK

Boy with Red Spot on Eye

What is the red spot that can develop on the eye after LASIK?

The red spot that some patients develop after their LASIK procedure is called a subconjunctival hemorrhage (bleeding under the conjunctiva). This condition does not pose any health risk, and will have no effect on the results of your LASIK procedure. In fact, a subconjunctival hemorrhage is a superficial issue, and it does not last for long.

The conjunctiva is the thin, moist, clear membrane that covers the white part of the eye and the inside of the eyelids. This protective layer of the eye has a network of nerves and very small blood vessels. These blood vessels are delicate and prone to breaking, which can result in a subconjunctival hemorrhage. In addition to LASIK, the conjunctival blood vessels may rupture due to:

  • Heavy sneezing
  • Heavy coughing
  • Vomiting
  • Heavy lifting
  • Rubbing the eye
  • Trauma to the eye
  • Severe eye infection

How do I know if I have it?

Most patients realize they have this condition when they look in the mirror. They may find that the white part of their eye carries a bright red spot.

How long does it last?

A subconjunctival hemorrhage is like a bruise on the skin; it will resolve on its own when the body absorbs the blood. Compared to the skin and other parts of the body, it takes the conjunctiva a little longer to absorb the blood. Generally, the blood will remain trapped under the transparent conjunctiva for a week or two before the red spot goes away.

How do I treat it?

Since the body will absorb the blood, no treatment is necessary. It is simply a matter of waiting. If you are having other side effects from your LASIK procedure, such as dry or itchy eyes, you may want to use eyedrops and other therapies approved by your doctor to improve your comfort level.

How can the risk be reduced?

Before you enter the surgical suite, Dr. Holzman has his team will prepare your eye for surgery. During this preparation, you will be given a series of three drops of Naphcon A. This medication helps to reduce the risk of developing subconjunctival hemorrhage. With this precautionary step and our years of experience in performing LASIK, we are proud to say that the incidence of subconjunctival hemorrhage among our patients is very low.

Dry Eye after LASIK

Can LASIK result in dry eyes?

LASIK surgery has been safely performed on millions of patients, however, one potential side effect is dry eyes. This condition occurs when the eyes do not receive sufficient lubrication. Most patients will experience some degree of dryness immediately following their LASIK procedure, but symptoms typically dissipate as time passes. Since dry eye is also commonly seen in patients prior to LASIK surgery, often because of contact lens use, Dr. Holzman will review your medical history to determine if you are at-risk for this condition.

How is dry eye treated?

If we find that you have any pre-existing dry eye symptoms, we can provide you with treatment before undergoing LASIK surgery. After LASIK, Dr. Holzman will provide medicated eye drops to help relieve initial dry eye symptoms and promote proper healing. Although rare, dry eyes symptoms can sometimes persist. In these cases, we can provide additional treatments, including tear supplementation, punctal occlusion, and anti-inflammatory therapies.

Life after LASIK

How Long Do LASIK Results Last?

LASIK is a type of refractive surgery that uses a specialized laser to reshape the cornea, correcting irregularities in its curvature that can lead to nearsightedness, farsightedness, and astigmatism. After surgery, LASIK patients can often enjoy reduced dependency upon glasses and contacts, or eliminate their dependency altogether. Because the cornea itself is altered during LASIK, many people believe they will have 20/20 vision, or even better, for the rest of their life. In an ideal world, the eyes would defy the inevitable effects of aging. But the natural aging process takes a toll on the eyes, whether they have undergone LASIK or not.

In short, a number of factors will determine how long the effects of LASIK will last. Many of our patients enjoy the maximized benefits of their procedure for years and even decades. As presbyopia, or trouble seeing close up, develops, some patients will need to supplement their vision with reading glasses or bifocals. This condition usually becomes apparent after age 40. Additional age-related eye conditions and diseases, like cataracts and glaucoma, can also compromise the effects of LASIK.

About 5% of LASIK patient will require a "touch-up" procedure at some point, restoring their 20/20 vision. If you choose to undergo LASIK again, Dr. Holzman can use the same corneal flap created during your initial surgery. 

How can I maximize the benefits of LASIK?

Choosing a reputable, technologically advanced practice is the best way to maximize your LASIK results. Our practice combines unparalleled experience - Dr. Holzman has successfully performed more than 70,000 surgeries - with the most innovative techniques and equipment to provide patients with their best possible results. We use advanced tools like Wavefront diagnostic technology for highly customized corneal reshaping, and the ALLEGRETTO WAVE™ laser system to provide unparalleled control and accuracy during surgery. 

Is LASIK Safe?

If you suffer with nearsightedness, farsightedness, or astigmatism, and wish to reduce or eliminate your need for glasses, you may be wondering: Is LASIK safe? The fact is that LASIK performed at our Washington, DC-area practice is very safe. Dr. Andrew Holzman has performed more than 70,000 vision correction surgeries. His experience and technologically sophisticated approach to refractive surgery minimizes risks and can ensure that you experience the best possible results of LASIK surgery. To determine if the procedure is right for you, Dr. Holzman will conduct a thorough review of your ocular health and overall health history.

The American Academy of Ophthalmology reports that between 0.2 and 2 percent of patients overall experience complications as a result of LASIK.

Studies Confirm the Safety of LASIK

The American Academy of Ophthalmology reports that between 0.2 and two percent of patients overall experience complications as a result of laser vision correction. Meanwhile, the U.S. Department of Defense has conducted 45 studies on the effectiveness and safety of LASIK. The complication rate among military personnel is 0.009 percent.

Dry eye is the most common side effect of LASIK, and it usually subsides after the recovery period. According to a large study, 35% of patients suffered from dry eye after LASIK, but 32% had a previous history of dry eye.

Patient Satisfaction

A 2009 study found that worldwide, 94 percent of patients surveyed reported satisfaction with their LASIK results. In the United States alone, the American Society of Cataract and Refractive Surgery reports that LASIK has a 96 percent satisfaction rate.

Recently, the Food and Drug Administration released the results of the LASIK Quality of Life Collaboration Project, which showed that patients surveyed in the U.S. had a 96.2% satisfaction rate after three months and a 98% satisfaction rate after six months.

Your Choice of Surgeon

Many patients do not realize that when it comes to any form of refractive surgery, they have the power to influence the safety of their procedure. In short, choosing an experienced surgeon using advanced technology can significantly improve the likelihood of a successful procedure involving minimal side-effects and long-term benefits.

Dr. Holzman is a leader in refractive surgery who lectures and teaches regularly, sharing his expertise with colleagues and medical students alike. Meanwhile, he performs bladeless LASIK involving the use of a laser instead of a blade to create the corneal flap, a technique that significantly reduces the risk of infection and flap complications. In fact, a study of more than 3,000 patients found that less than .05 percent of those who underwent bladeless LASIK between 2002 and 2009 experienced any kind of flap complication. Many patients have experienced life-changing LASIK benefits under his care.

Second LASIK Surgery

Will I require a second LASIK procedure?

We are so confident in a great outcome, we provide a Lifetime Commitment for qualified patients. Ninety-nine percent of our patients have no need for a second surgery, but if you do require a touch-up within the first year, you will receive a second enhancement procedure with the same technology at no additional charge.

Who is a candidate for a second surgery?

The best way to avoid the need for a second surgery is to first ensure that you are a good candidate for the procedure. For example, women who are pregnant or nursing are advised to delay LASIK because of hormonal changes that can effect vision. At TLC Laser Centers, we apply strict candidacy standards to achieve the best possible outcome for our patients. Second LASIK surgery candidates are most often farsighted with a high degree of refractive error, or are over the age of 50. 

What is enhancement surgery?

If your vision is blurred within a few months of LASIK surgery, you may need a corrective enhancement. Additional testing must be done to determine candidacy for a second LASIK surgery. During the enhancement procedure, the flap created during the first surgery is lifted, and the laser is used to further reshape and refine the cornea. For this reason, the cornea must be healthy and have a sufficient amount of tissue remaining. 

What happens if I develop presbyopia?

LASIK surgery is considered to be a permanent correction of your vision. However, aging changes our eyesight over the years. Patients over 40 may begin to develop presbyopia and require reading glasses to see objects up close. A small percentage of people may experience a slight decline in distance vision, and in these cases, a second LASIK surgery can be performed.

Dr. Andrew Holzman

Andrew E. Holzman, MD, FACS

Andrew E. Holzman, MD, FACS, is one of the most well-respected ophthalmologists in the greater Washington D.C. area. He is regularly sought out by professional athletes, media personalities, and other doctors for laser eye surgery. Dr. Holzman is a member of several prestigious organizations, including:

  • The American Academy of Ophthalmology
  • The American College of Surgeons
  • The American Society of Cataract and Refractive Surgery
  • The American Medical Association
  • The International Society of Refractive Surgery

To schedule a consultation at one of our five locations, please fill out our online form or give us a call at (703) 556-9155.

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Dr. Holzman is the best - very honest, very professional yet very friendly and personable. Ben E.

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