Should the Minimum Age for LASIK Surgery be Lowered?

Minimum Age for LASIK Surgery

Contrary to the popular belief and despite its high success rate, LASIK surgery is not approved or recommended for everyone. Instead, strict age and eye condition criteria need to be followed while considering LASIK for any reason whatsoever.

FDA's age restriction on LASIK
To many, it seems that the FDA (Food & Drug Administration, USA) has some of the strict regulations especially when it comes to the products related with the eye and vision therapy. LASIK surgery, for example, is only approved by FDA for patients who are 18 years or older with stable eyesight. FDA also advises to avoid this procedure during pregnancy and in those having eye diseases in the past.

In extremely rare cases, however, FDA does allow a doctor to perform a LASIK on the patients of younger age if the doctor seriously thinks that the vision of the child or a teenager is severely threatened and LASIK could potentially save the vision. In other words, LASIK could be done in the underage patients only when there is a strong “medical (not cosmetic)” reason to do so and benefits overweigh the risk in the eyes of your doctor.

What is the approved, recommended age for LASIK?
While FDA has approved LASIK in people older than 18, the ideal LASIK patient is over 21 years of age, since the refractive error is more likely to be changing below this age. Some patients over the age of 21 are still experiencing change in refractive error making them unsuitable for LASIK.

Conditions when the use of LASIK can be considered in children and teenagers
As stated above, there could be conditions when your doctor can actually recommend LASIK as a therapy to address some major problem such as:

  • In children even under the age of 7 years who have a condition called “anisometropic amblyopia” and who are intolerant of spectacles or contact lenses.
  • In older children to allow them to participate more fully in sport and other activities of daily living.

Why is LASIK not approved before the age of 18?
Underdeveloped eyes: Ophthalmologists and clinical researchers generally believe that the eyes do not fully develop prior to the age of 18 years. In fact, in some cases, they may not be fully developed until the age of 21. Once your eyes are fully developed, there is virtually no risk of the LASIK failing in correcting the vision of the eye, as there is not likely to be any additional changes to the eye tissues. In addition, this is also why LASIK is considered to be a permanent procedure, likely to last for the rest of your life.

Temporary vision improvement: Several studies have shown that, in both children and teenagers, the vision improvement achieved after the performance of LASIK is usually only temporary and short-term. Therefore, in almost all cases, LASIK will need to be re-performed in the future.

High risk of complications: Some researchers believe that during the early years (such as the child age or teenage), the human growth and development is still in premature phase and one’s immune system may not be able to fully address various complications that may arise during and after any surgery including LASIK. Some studies have even shown that LASIK has been associated with a slower recovery time and higher risk of post-operative (after surgery) pain, refractive regression, and corneal haze. Potential long-term complications associated with LASIK include dislocation or loss causing a permanent decrease in vision, corneal thinning, halos, and glare.

High risk of recurrence of refractive disorders: Some studies also show that one of the major drawbacks of LASIK in children is refractive regression (return of the refractive error) following surgery. This could be due to continued eye growth and changes in the cornea as it heals after surgery.

Reduced quality of vision: Some researchers also believe that the aggressive healing response in children may cause corneal haze and a decrease in the quality of vision.

Studies supporting successful LASIK in children
On the other hand, however, there are quite a number of studies and trials that have shown significantly better outcomes and safe results when LASIK was performed in children to “correct a some medical problem” such as to treat anisometropia and improve visual acuity. However, in the event that a child is approved for LASIK eye surgery, he or she will need to be heavily sedated in order to stay completely still for the procedure.

All in all, based on the above discussion, it can be concluded that while LASIK results are promising in children and other underage groups, evidence is still limited for the use of LASIK in children. Several other issues like clinical effectiveness, safety, and logistic issues also need to be addressed. Therefore, more research and large long-term clinical trials are needed to support the generalized benefit of LASIK in patients who are below the recommended / minimum age.

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