Laser Eye Surgery for Diabetics

21 December 2023

By Author: Amir Hamid

Laser eye surgery, particularly in the context of diabetic patients, offers a range of benefits, but its success heavily depends on individual patient factors. Here we discuss all issues surrounding diabetic laser eye surgery.

If you have diabetes and are considering laser eye surgery, our expert surgeons at Optegra are always on hand to answer any questions or queries you may have about the procedure.


Can A Diabetic Get Laser Eye Surgery?

Patients with diabetes, whether Type 1 or Type 2, can potentially have laser eye surgeries like LASIK, SMILE  or LASEK to improve their eyesight. However, there are several important considerations and potential restrictions:

Stable Vision: Diabetic patients need to have stable vision before considering laser eye surgery. Fluctuations in blood sugar levels can affect the refractive index of the lens in the eye, leading to changes in vision. Stability is essential to ensuring accurate measurements and successful surgery outcomes.

Diabetic Retinopathy: One of the complications of diabetes is diabetic retinopathy, a condition where high blood sugar levels cause damage to the blood vessels in the retina. If a patient has this condition, it may disqualify them from undergoing laser eye surgery, as the procedure could exacerbate retinal problems.

Control of Diabetes: The level of control over diabetes is crucial. Well-controlled blood sugar levels reduce the risk of complications during and after surgery. Patients with poorly controlled diabetes are more prone to infections and slower healing, which can affect the success of the surgery.

Type 1 vs. Type 2 Diabetes: Both types of diabetes need careful evaluation, but the considerations might differ slightly. Type 1 diabetes, often diagnosed in younger patients, may involve a longer history of the disease and complications. Type 2 diabetes patients, typically older, might have other age-related eye issues like cataracts, which could affect the decision to have laser eye surgery.

Regular Eye Examinations: Diabetic patients should undergo thorough and regular eye examinations prior to considering laser eye surgery. This is to ensure there are no underlying diabetic eye conditions that could be worsened by the surgery.

So, while having diabetes doesn’t automatically disqualify someone from having laser eye surgeries like LASIK or LASEK, the condition does necessitate a more cautious and thorough approach to ensure the safety and effectiveness of the procedure.

Diabetes finger prick test

Is Laser Eye Surgery Safe for Diabetics?

Laser eye surgery, including procedures like LASIK and LASEK, has become increasingly safe and accessible for individuals with diabetes, reflecting a significant shift from past practices. This evolution in approach can be attributed to advancements in technology, a deeper understanding of diabetes management, and improved laser eye surgical techniques.

Today, it is safe and effective for patients with diabetes to undergo laser eye surgery due to the following evolutions:

Advancements in Diabetes Management: Improved methods for managing and monitoring diabetes have made it easier to maintain stable blood sugar levels, reducing the risk of vision fluctuations and complications from surgery.

Enhanced Surgical Techniques and Technology: Modern laser eye surgeries are more precise and less invasive. The use of cutting-edge technology reduces the risk of complications and improves the accuracy of the procedures.

Pre-Surgical Assessment: There is now a greater emphasis on comprehensive pre-surgical assessments. These evaluations ensure that the patient’s diabetes is well-controlled and there are no underlying eye conditions, like advanced diabetic retinopathy, which could contraindicate the surgery.

Individualised Approach: Doctors now adopt a more personalised approach, considering the patient’s overall health, the type and control of diabetes, and the health of their eyes before recommending surgery. This careful consideration has made laser eye surgery a viable option for many diabetic patients.

Post-Surgical Care: Improved post-operative care and monitoring have also contributed to the safety of laser eye surgery for diabetic patients. Close follow-up ensures any complications are caught and treated early.


What to Check Before Your Laser Eye Surgery

Before proceeding with laser eye surgery, diabetic patients should undergo a series of thorough checks to ensure they are suitable candidates for the procedure. These checks are crucial to minimise risks and optimise outcomes. Here are the key factors that should be assessed:

  • Stable blood sugar levels (Hba1c)
  • Assessment for Diabetic Retinopathy. It’s essential to screen for this condition, as it can affect the safety and effectiveness of laser eye surgery.
  • General Ocular Health Evaluation. Check for other eye conditions like cataracts, glaucoma, or corneal abnormalities, which could impact the decision or approach to laser eye surgery.
  • Corneal Thickness and Topography. The cornea’s thickness and shape are crucial factors in determining its suitability for laser eye surgery. Conditions like keratoconus or a cornea that is too thin might rule out certain types of laser eye procedures.

Read more about diabetes-related eye conditions on our blog.


Can a Patient with Uncontrolled Diabetes Have Laser Eye Surgery?

Patients with uncontrolled diabetes are generally considered unsuitable for laser eye surgery due to several significant risks and complications associated with both the condition itself and the surgery. Understanding these risks is crucial to appreciating why strict control of diabetes is a prerequisite for such procedures.


Fluctuating Blood Sugar Levels and Vision Stability

In diabetes, fluctuating blood sugar levels can cause temporary changes in vision. This occurs because high glucose levels can alter the refractive index of the lens in the eye. For laser eye surgery, stable vision is crucial to accurately measuring and correcting refractive errors.

Unpredictable vision changes make it difficult to determine the correct amount of correction needed during surgery, potentially leading to suboptimal outcomes.


Increased Risk of Infection

Uncontrolled diabetes can impair the body’s natural healing process and immune response. This can lead to an increased risk of infection following surgery, a critical concern given the delicate nature of laser eye procedures.


Delayed Wound Healing

High blood sugar levels can slow down the healing process. After laser eye surgery, this can mean prolonged recovery times and increased chances of complications, such as poor wound healing or corneal healing issues.


Increased Risk of Macular Oedema

Laser eye surgery can lead to macular oedema, particularly in diabetic patients. This condition, characterised by swelling in the central part of the retina, can result in vision impairment. The risk is markedly higher for those with uncontrolled diabetes.


How Can Diabetes Affect Your Recovery?

Diabetes can significantly impact a patient’s recovery and aftercare from various medical procedures, including laser eye surgery. The condition, especially when not well controlled, poses unique challenges during the healing process. Here are key aspects of how diabetes may affect a patient’s recovery:

Longer Healing Times

High blood sugar levels can impair the body’s natural healing processes. In diabetic patients, this often translates to longer recovery times following surgery.

Diabetes can also affect collagen synthesis, a crucial component of tissue repair. This altered collagen formation can slow down the healing of surgical wounds.

Increased Risk of Infection

Diabetes, particularly when uncontrolled, can weaken the immune system. This diminished immune response increases the risk of infections post-surgery, which can complicate and prolong the healing process.

Risk of Postoperative Complications

Diabetic patients are more susceptible to post-surgical complications, like poor wound healing. In the context of eye surgery, this might include issues such as delayed epithelial healing or corneal healing problems.


How Successful is Laser Treatment in Diabetic Eye Treatment?

Despite the challenges posed by diabetes, patients can still achieve freedom from glasses through laser eye surgery, provided their condition is well-managed. Advances in medical technology and surgical techniques have enhanced the safety and effectiveness of procedures like LASIK and LASEK for diabetic individuals.

This progress represents a significant step in offering diabetic patients the same quality of life enhancements that others enjoy, bridging a gap that once seemed insurmountable due to the complexities of their condition.


What Next? Contact us to discuss your laser eye surgery requirements

If you would like to know how laser eye surgery can benefit you, set up your free virtual consultation with one of our experts, and we can guide you further.

Amir Hamid Headshot

By Author: Amir Hamid

Mr. Amir Hamid is a Clinical Lead for Vision Correction and an expert refractive surgeon, based in London.

Medically Reviewed Date: 21st December 2023


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