In this blog post, we’ll discuss one of the most frequently asked questions (by women) about LASIK. The question is some form of: “What if I have LASIK then become pregnant,” or “What about LASIK and nursing my baby?” or “What about LASIK and pregnancy?”
My 25 Year Experience
My thoughts on pregnancy and PRK, pregnancy and LASIK, and pregnancy and EVO ICL are all about the same. The EVO ICL is referring to the Implantable contact lens. In my practice, we have been doing ICL procedures since 2015. The number of the ICL procedures are much smaller than LASIK and PRK, so my thinking on the ICL is just grouped into my thoughts on LASIK, PRK and pregnancy. I am carefully observant, but would not assume any differences with regards to the EVO ICL versus LASIK and PRK with regards to pregnancy.
Keep in mind, much of what I will discuss with regard to LASIK and pregnancy is anecdotal. That means that a lot of this is just my opinion based on performing LASIK and PRK for 25 years and with over 80,000 procedures performed. A significant percentage of my patients are women of childbearing age, and they often have questions about LASIK and pregnancy. I have included some references to this topic at the end of this blog post. However, the research and studies are few and far between. One of my colleagues said there was an excellent study on pregnancy and refractive error, but you had to go back to 1965. The pubmed database of medical literature does not include studies back to 1965, as far as I can tell.
I’ll lay out my basic theory/thoughts on LASIK and pregnancy. When I ask women if they think their vision changed during their pregnancies, I’d estimate that maybe 20%, or 1 out of 5, say that they do think that their vision was blurry during pregnancy. Around 80%, or 4 out of 5, say they didn’t notice their eyes changing or blurry vision during pregnancy. This is just a rough estimate based on my practice and recollection.
Some of our patients have regression of myopia after LASIK or PRK (laser vision correction) regardless of sex or pregnancy. The percentage of people who have myopic regression needing an enhancement (additional laser touch up) after LASIK or PRK is about 1% per year, or 10% over a ten-year period after their LASIK or PRK. Of that 10% needing an enhancement, a very small percentage became pregnant in that time period. The number of women who have said their vision regressed and stayed blurry after pregnancy is (to my best recollection) about 3 over a 20+ year period and 40,000-50,000 patients. My theory is that the regression of myopia in pregnancy that persists after pregnancy is so small as to be due to chance rather than causative.
My basic advice to women contemplating becoming pregnant after LASIK is to have your LASIK when you want to have LASIK, and have your children when you want to have your children. As long as you’re not pregnant at the time of LASIK, we can do LASIK. My advice is based on the paragraph above, that as far as I can tell, the risk of regression is no greater for having been pregnant than if you have not been pregnant.
The studies referenced below support my theory and my observations that there are no significant changes in refractive error during pregnancy whether or not you’ve had LASIK or PRK. The only one I could find is the first one listed below that was performed on 128 eyes of 64 women who had undergone LASIK and then became pregnant. It was published in 2020. There are no other studies, as far as I could tell, based on my research that specifically reference LASIK and pregnancy. There are studies on the changes in the eyeballs of pregnant women. Generally speaking they also are consistent in that the corneal thickness increased, but there was no change in refractive error (that is the prescription for glasses).
LASIK and Nursing
At SharpeVision, we have performed LASIK on a significant number of women who were breast-feeding and there have not been any issues whatsoever. The theoretical issue that I would consider: is your prescription stable? We have checked previous records and previous glasses and found that there is no significant change in refractive error/glasses prescription for women who are nursing and. The prescription of anyone regardless of age or pregnancy status can vary slightly from measurement to measurement. This is why we measure your prescription at SharpeVision about six different ways. We measure your glasses for a historical data point, we measure your corneal shape, thickness, astigmatism; we measure your prescription automatically with two different devices; we measure your prescription with dilating drops and then again on the day of the procedure without dilating drops. This gives us extremely accurate measurement of your prescription.
For our patients who are nursing and want LASIK, we do discuss the fact that we will ask you to use combination antibiotic/steroid eyedrops for one week. These drops do get absorbed to a very small degree into your bloodstream, and therefore theoretically to an even smaller amount in your breast milk. Because of the extremely small amount and that the medications are safe for your baby, I don’t think any special precautions are necessary. We also offer Valium for our patients preoperatively to lessen any anxiety. This is totally optional, but if you want to take the Valium, we recommend that you discard your breastmilk for the 24 hours following your LASIK procedure, so that the Valium will be metabolized and cleared from your bloodstream before breast-feeding your baby. If your baby did get even a tiny amount of Valium in his or her breastmilk, it is not known to be harmful to infants.
Can LASIK Make You a Better Mother?
Many years ago, I had a young mother say, “After my LASIK, I felt safer.“ I asked her to elaborate on that because I had no idea what she meant, but it was a beautiful sentiment. She said that if her baby were to cry out in the middle of the night, before she had LASIK, she would not have been able to go to her immediately. She would have had to grab her glasses because she was helpless without them. After her LASIK, she said she could go directly to her baby if she heard something at night. I love this thought, and I have heard several other women say this same thing over the years. It’s wonderful to be a young mom and not have to worry about glasses or contacts. Whether you are attending to your baby in the middle of the night or swimming with them, you will be able to see them without the glasses or contacts getting in the way.
I hope this blog post on pregnancy and LASIK has been helpful. There’s very little information in the literature about LASIK and pregnancy, so this blog post consists, in large part, of my expert opinion. I believe the ideal time to have laser vision correction is when you are young, which obviously is also the time when you may be considering starting a family. Having both LASIK and a baby in the same year makes it an incredibly amazing year for you and your family. If you are considering having LASIK or PRK, give us a call at 425-451-2020 or book online to schedule your free comprehensive LASIK evaluation.
2020 study on 128 eyes of 64 women who had had prior LASIK: No significant changes in pregnancy
1987 optometric study on refractive error and pregnancy found no significant changes
2014 study of 54 women found corneal thickness increased, but refractive error stable in 3rd trimester
1997 12 of 18 PRK eyes regressed during 12 months following treatment had haze and got better after pregnancy. Poor study, no comparison to non pregnant patients, didn’t use MMC.