Question
Asked 25th Jul, 2015

Do cataracts develop after lasik?

Do colleagues note the development or accelerated progression of cataracts after lasik?

Most recent answer

17th Sep, 2015
Peter Gray
University of Cambridge
Dear Colleagues
Thankyou for your responses - obviously there is the need for a long-term prospective study which will answer the question which I posed

All Answers (21)

26th Jul, 2015
Marianne Levon Shahsuvaryan
Eye care project
To my knowledge I have not read or heard about catractogenetic impact of LASIK
27th Jul, 2015
Jiucheng He
Louisiana State University Health Sciences Center New Orleans
Lasik surgery itself may not induce cataract, but its complication that destroys the intraocular homeostasis can.
27th Jul, 2015
Constantinos H Karabatsas
University of West Attica
I have certainly come across several cases with cataracts after Lasik, but none of these could be directly attributed to the excimer laser. Most of these cases were patients that had laser refractive surgery many years ago and are now within the age group that a cataract can develop anyway. A couple of young patients I have treated that also had developed cataracts after LRS, were taking postoperative topical steroids for a relative long period, so steroids could be blaimed as well. I am not aware of any clinical studies confirming direct correlation of Lasik or PRK  with cataract formation. 
27th Jul, 2015
Ricardo Jaramillo Diaz
Escuela Colombiana de Carreras Industriales
this case may happen by chemical process from the body different of lasik procedures depending on subsequents bacterials grown but this is not cause directly for the corneal operation
28th Jul, 2015
Mark E Wilkinson
University of Iowa
I have never heard of LASIK causing cataracts.
30th Jul, 2015
David Austin
PPD
Very unlikely as the exposure during the LASIK procedure is extremely minimal when compared to accumulative exposure to say solar radiation.
30th Jul, 2015
Luis Emilio Abad
Ballsbridge University
LASIK not cause cataract, because the surgical exposure is minimal. Exposure to radiation, can lead cataract formation.
30th Jul, 2015
Jagat Ram
Postgraduate Institute of Medical Education and Research
In my experience, Uneventful LASIK does not produce cataract.
30th Jul, 2015
John Konkal
University of British Columbia - Vancouver
Think cataracts occur at the same rate as they would without the LASIX as the population gets older.
31st Jul, 2015
Robert Epstein
Centegra Health System
Uncomplicated LASIK does not promote cataracts.  I have a series of people 48 to 68 years old avg 53.3 years old, who had presbyopia correcting LASIK as long as 12 ago, They do not get cataracts at a higher rate than the norm.   Now PRK is a different story since these people get topical steroids.
3rd Aug, 2015
Gaurav Prakash
University of Pittsburgh
The incidence of cataract may be more in high myopes as such. Therefore, there may be a false bias towards LASIK causing cataract.  The modern lasik procedure has a very short course of post operative steroids  which should not cause cataract.  These patients may tend to get earlier cataract because of  the myopia related ocular anatomy rather than lasik itself.
3 Recommendations
11th Aug, 2015
José Ramón Villada
Baviera Clinic, Albacete, Spain
The only energy that can get deeper in the eye are the shock-waves produced by the interference of laser with corneal tissue. The energy is not enough to produce cataracts. regards
11th Aug, 2015
David Austin
PPD
I don't see what shock waves are produced by this surgical approach, surely they would be attenuated
13th Aug, 2015
dr.ajab Dhabarde
Mahatma Gandhi Institute of Medical Sciences
13th Aug, 2015
David Austin
PPD
why would these be produced and what energy would they possess? Yes no answers are not very useful.
15th Aug, 2015
José Ramón Villada
Baviera Clinic, Albacete, Spain
Shock waves produced by excimer laser is a very well known issue for many years (Trokel SL, Srinivasan R. Excimer laser surgery of the cornea. Am J Ophthalmol 96(4):710-715). The fact that they can affect intraocular tissues is controversial but it has been mentioned several times (Tsai Y, Lin JM. Effect of laser-assisted in situ keratomileusis on the retinal nerve fiber layer. Retina 20(4):342-345, April 2000. Vroman DT, Solomon KD, Holzer MP, Peng Q, Apple DJ, Bowie EM. Endothelial decompensation after laser in situ keratomileusis. J Cataract Ref Surg 2002; 28:2045-2049. Here, two examples). It is worthy to read a review done quite long ago by Dr Bansal: Bansal AK, Veenashree MP. Laser refractive surgery: Technological advance and tissue response. Bioscience Reports. Vol 21 No 4 August 2011.
Regards
2 Recommendations
15th Aug, 2015
David Austin
PPD
Thanks for the references and commentd
15th Aug, 2015
José Ramón Villada
Baviera Clinic, Albacete, Spain
Thanks to you :)
15th Aug, 2015
José Ramón Villada
Baviera Clinic, Albacete, Spain
Reviewing the subject these days, I came across this paper. It is also an interesting reading. Abdelkawi S, Taher IM, Ghoneim DF, Ataot WE, Badr YA. 193 ArF excimer laser induced changes in aqueous humor of rabbit´s eyes. JASMR 2010; 5(2):181-189.
It is true that in a couple of occasions patients developed catarats rather soon after laser vision correction and I did not remember to see any trace of cataracts before the treatment. I did not give it much importance, especially because the proportion with the number of patients operated was minimal.
2 Recommendations
16th Sep, 2015
Nurullah Cagil
Ankara Yildirim Beyazit University
Corneal epithelium and stroma block UV A and B radiation. All of the UV-B radiation in the environment is absorbed in the epithelium and superficial layers of stroma. UV- A radiation is absorbed in the corneal epithelium and stroma, but still part of it reaches anterior chamber and lens. Lens absorbs most of the UV-A radiation that comes on it. Reactive oxygen species and many oxidant substances are produced during absorption of UV rays. 
Absorption of UV-A radiation by corneal stroma is thickness-dependent. This means that, if cornea is thin, more UV-A radiation may pass through to reach on lens.
I observed cataract to develop in shorter than expected time in my patients with high myopic ablations, but I am not sure if this is due to thin corneas. I advice my refractive surgery patients to avoid from sun for the lifetime.

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