Yes, maybe and no. This is a hard question to answer.
The “Yes” answer. In my opinion, patients without diabetes, usually do well with laser vision correction, e.g. LASIK, if they meet certain criteria and their vision and correction is stable. By “correction” I mean that their prescription (measurement for glasses) is unchanged. The criteria that usually needs to be considered are; thickness of the cornea, pupillary dilation, health of the tear film and absence of eye disease. If all these criteria are met satisfactorily, then laser vision correction can be recommended.
Diabetes adds another variable. The correction, or prescription, in diabetics can fluctuate in situations where the sugar is not controlled. This would throw off the laser’s computers and too much or too little would lased. Patients with diabetic retinopathy may also have reduced vision due to the disease.
In patients with diabetes, but little or no diabetic retinopathy, laser vision correction, in my opinion, can be worthwhile. If a patient with diabetic retinopathy can be corrected to 20/20 (see post on “best corrected vision”), the retinopathy is stable and all other screening requirements are satisfied, I see no reason why a patient with diabetes can not undergo laser vision correction. The naysayers worry about unstable, or fluctuating, prescriptions. While this can happen due to fluctuations in the blood sugar; if the prescription remains stable, why not?
The “Maybe” answer. This is dependent upon the patient’s understanding of the results of laser vision, the presence of diabetic retinopathy and, maybe, the inability to be corrected to 20/20 due to early diabetic retinopathy. The decision would remain between the surgeon and the patient, and, in my opinion, would hinge on the patient’s ability to persuade the surgeon, that there is complete awareness of a less than perfect situation (i.e. the patient understands that while the results may be very good, the vision is limited to mild diabetic retinopathy).
The “No” answer. In no uncertain terms would I recommend laser vision correction to a patient with diabetes that has; loss of vision from another cause such as cataract or glaucoma, uncontrolled sugar and moderate/severe diabetic retinopathy. There are too many variables that would give conflicting measurements, uncontrolled sugar effects the prescription.
In the end, laser vision correction is a great procedure for those that meet the criteria. In my opinion, diabetes is not a contraindication for laser vision correction, but is something to consider. Remember, laser vision correction can only reduce your dependence upon glasses or contacts, it can not make you see any better!
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist