Can I Have Laser Eye Surgery If I Have Diabetes?
Source: Tim Harwood/Blog –

The quickest and easiest answer to this question is ‘it depends’ and during this blog post I will try and give you are more complete explanation! I am not going to use this blog to go into lots of detail about diabetes, but I will try and explain the main points in a simple and easy to understand way. The 2 main types of diabetes are type 1 and type 2 and their main features are as follows:

Type 1 is the condition you generally get when you are young (below the age of 20) and people with this type of diabetes will typically need to use Insulin to control their blood sugar levels.
Type 2 normally affects people as they get older and can sometimes (not always) be associated with obesity. People with type 2 diabetes can be diet controlled diabetics (e.g. control their blood sugar levels by watching what they eat), medication controlled (e.g. metformin) or if they are struggling to control their blood sugar levels they may need Insulin.

People with diabetes are normally assessed annually to check that they do not have any diabetic retinopathy. This is the test when you have your pupils dilated (made bigger) and then have a photograph taken of the back of your eyes. If you are found to have significant retinopathy you will be referred to an ophthalmologist who may consider treating your retinopathy with laser. This is not the same type of laser that is used in laser eye surgery. It is completely different and this diabetic laser treatment is used to treat the damage to the blood vessels on your retina at the back of your eyes. Laser eye surgery is carried out on your cornea at the front of your eyes. Having laser for diabetic retinopathy will not mean you will no longer have to wear glasses or contact lenses, which is the aim of laser eye surgery.

I will now return back to the original question of whether or not diabetics are suitable for laser eye surgery. The following lists the problems associated with performing laser eye surgery on diabetics:

Fluctuating prescription (strength of glasses/contact lenses) as a result of poorly controlled blood sugar levels. The reason this is a problem is that the optician/surgeon needs to be able to get an accurate measurement of your prescription as this is what the laser will be programmed to correct. If your blood sugars were high on the day of your laser eye surgery consultation then the readings may not be accurate. This could mean that the laser would not correct the prescription accurately as your eyes may be different once your blood sugar levels have returned to their normal level.

Slower healing: Diabetics generally have slower and less efficient healing of the cornea following laser eye surgery. Some surgeons will insist that you have Intralase as opposed to standard Lasik as healing time is generally quicker with this procedure.

Pre-existing diabetic retinopathy. If you already have diabetic retinopathy your vision may well be slightly impaired. Laser eye surgery will not improve your diabetic retinopathy.

Every clinic and every surgeon will have slightly different guidelines on who they will consider to be suitable for laser eye surgery. The following lists what is generally required for diabetics to be safe for surgery:

Well controlled blood sugar levels: This is to ensure an accurate and long lasting laser vision correction. Most surgeons will insist on a letter from your general practitioner stating that your blood sugar levels are stable.

Minimal diabetic retinopathy: What constitutes minimal will vary from one surgeon to the next. Most surgeons will be happy to carry out laser eye surgery if you have mild background retinopathy which is not affecting the central part of your vision.

In summary, laser eye surgery has been carried out successfully on thousands of diabetics and most surgeons are happy to carry out the procedure. If you have well controlled blood sugar levels and minimal diabetic retinopathy you are unlikely to have any issues. Insulin dependent diabetics (type 1) and those who have had the condition for many years are less likely to be suitable as there is a higher chance of them having retinopathy. The only way you will know for certain if you are suitable for surgery is by having a consultation. You should ask your GP for a letter stating how well controlled your blood sugar levels are and take this along with you. Attending aftercares and sticking diligently to the post surgery instructions is especially important if you suffer from diabetes.


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Originally posted by on August 19, 2010