LASIK Eye Surgery: Costs, Risks, and Good Candidates

A Surgery Performed Over 700,000 Times Each Year in the U.S.

In the United States alone, surgeons perform roughly 700,000 to 800,000 LASIK procedures annually, making it one of the most common elective surgeries in the country. Since the FDA approved the first excimer laser for LASIK in 1999, an estimated 19 million Americans have undergone the procedure. The surgery reshapes the cornea using a laser, permanently altering how light focuses on the retina — eliminating or reducing dependence on glasses or contact lenses for patients with nearsightedness, farsightedness, or astigmatism.

The cornea must be reshaped with submicron precision. A microkeratome blade or femtosecond laser creates a thin flap in the corneal tissue, the flap is folded back, and an excimer laser removes calculated amounts of stromal tissue. The whole process takes roughly 15 minutes per eye and is completed entirely as an outpatient procedure under topical anesthetic drops.

Who Makes a Good Candidate

Not everyone qualifies. Ophthalmologists evaluate candidates using a rigorous pre-operative screening that assesses corneal thickness, pupil size, prescription stability, and the presence of conditions that would increase risk.

• Age: Patients must be at least 18 years old; most surgeons prefer 21+, when prescriptions have typically stabilized
• Stable prescription: Refraction should not have changed by more than 0.5 diopters in the preceding 12 months
• Adequate corneal thickness: At least 500 microns pre-operatively, as the procedure removes roughly 10–15 microns per diopter corrected
• No active keratoconus: This degenerative corneal condition is an absolute contraindication
• No severe dry eye disease: LASIK temporarily disrupts corneal nerves, worsening dry eye symptoms
• Prescription range: FDA-approved for up to approximately -12.0 D of myopia, +6.0 D of hyperopia, and up to 6.0 D of astigmatism, though outcomes are best at moderate ranges

Roughly 15–20% of prospective patients are deemed poor candidates during pre-operative screening. For them, alternatives such as PRK (photorefractive keratectomy), LASEK, or SMILE may be appropriate.

Real Costs and What Drives Them

Price transparency in LASIK is notoriously inconsistent. Advertised prices as low as $299 per eye typically represent outdated equipment or the most limited prescriptions. In practice, patients pay considerably more.

Most health insurance plans classify LASIK as elective and do not cover it. However, many FSA (Flexible Spending Account) and HSA (Health Savings Account) plans allow LASIK expenses. Financing through CareCredit or practice-specific plans is common; interest rates vary from 0% promotional to over 20% APR.

Enhancement procedures — touch-up treatments for residual refractive error — are offered free or at reduced cost within a defined window (typically one to three years) by many practices. Ask specifically about enhancement policies before committing.

Documented Risks and Their Frequency

The FDA describes LASIK as generally safe but not risk-free. Published complication rates vary across studies, and the FDA conducted a large patient-reported outcomes study (PROWL-1 and PROWL-2) in 2014, which remains the most rigorous U.S. data set.

The PROWL studies found that 3 months after surgery, approximately 46% of patients reported some visual symptoms that weren't present before — though many of these were mild. Only a small fraction reported symptoms severe enough to impact daily activities.

Outcomes and Patient Satisfaction

The numbers are encouraging. Clinical studies consistently find that 90–95% of patients achieve 20/20 vision or better after LASIK, and over 99% achieve 20/40 or better (the legal standard for driving without correction in most U.S. states). Patient satisfaction surveys routinely report 95–96% satisfaction rates across large samples.

• A 2021 meta-analysis in JAMA Ophthalmology covering 67 studies and 67,893 eyes found a mean postoperative uncorrected visual acuity of 20/20 in 85.1% of eyes
• Presbyopia (age-related near-vision loss) will still occur after LASIK — patients in their mid-40s will likely still require reading glasses even with successful distance correction
• Vision can shift slightly over decades; some patients require glasses for specific tasks years after surgery

Choosing a surgeon with high procedure volume and modern equipment matters significantly. Outcomes at high-volume centers consistently outperform those at lower-volume practices.

This article is for informational purposes only. Consult a qualified healthcare professional before making medical decisions.