LASIK Surgery: Safer Than Contacts?
Analysis Shows Higher Long-Term Risk of Infections for Contact Lens Wearers
Oct. 10, 2006 -- The widely held belief that wearing contact lenses is safer
than having laser surgery for vision correction is being challenged.
A leading eye doctor says contact lens users are actually more likely to
develop complications that lead to vision loss over time than patients who have
Based on their review of several large studies, ophthalmologist William
Mathers, MD, and colleagues concluded that daily contact lens wearers have
about a one in 100 chance of developing a serious lens-related eye infection
over 30 years of use, and a one in 2,000 chance of suffering significant vision
loss as a result.
The researchers calculated the risk of significant vision loss due to LASIK
surgery to be closer to one in 10,000 cases. They reported their findings in a
letter published this month in the journal Archives of
"One shouldn't just assume that contacts are safer," Mathers tells
WebMD. "This may have been true at one time, but for the average person
this is certainly not the case anymore."
Direct Comparisons Difficult
Between 20 and 25 million people in the U.S. wear contact lenses; about a
million Americans have laser surgery to correct vision problems each year.
Mathers is an eye surgeon who specializes in treating vision-threatening eye
infections at the Oregon Health & Science University's Casey Eye Institute
"Several times a year, I have patients who lose eyes from complications
because they've been wearing contacts and they've gotten an infection," he
says. "By this I mean their eye has to be physically removed from their
Direct comparisons of the risks vs. benefits of contacts and laser surgery
have been difficult because surgical complications are immediate and the risks
associated with contact lenses accumulate over many years.
The risks associated with long-term use of contact lenses are greater when
lenses are used improperly, but they remain even when wearers do everything
right, Mathers says.
"Almost everyone who wears contact lenses violates some principle of
proper use at some point," he says. "Either they don't wash their hands
before putting them in or they use tap water [to store the lenses]. But
infections can occur even when this doesn't happen."
Los Angeles ophthalmologist Jim Salz, MD, tells WebMD that sleeping in
contacts dramatically increases the risk of infection. Salz is a spokesman for
the American Academy of Ophthalmology.
"Out of 10,000 daily contact lens wearers, about one will develop a
serious infection over the course of a year," he says, adding that risk
increases to one in 1,000 for wearers who sleep in their contacts.
"We advise patients to never sleep in contacts, even if the contacts are
approved for this purpose," he says.
Salz has been performing LASIK surgeries for the past 15 years. He says
better lasers and better training have reduced the incidence of nighttime
vision problems and other complications that were not uncommon years ago.
One big advance, he says, was the introduction of wavefront LASIK several
years ago, which allows eye surgeons to customize the procedure for each
A professor of ophthalmology at the University of Southern California, Salz
says the risks of wearing contact lenses and having laser surgery are probably
"In most cases the decision really comes down to patient
preference," he says.
Mathers acknowledges that his risk estimates are "approximate and
subject to change."
He adds that advances in both laser surgery and contact lens technology
should make both approaches to vision correction even safer in years to