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LASIK vs. Contact Lenses: Which Is Better For Your Long-Term Eye Health?

By Zawn Villines
Reviewed by Eric Donnenfeld, MD, and member of the Refractive Surgery Council editorial advisory board on February 17, 2021
Here's how to decide whether LASIK is better for you than your contact lenses.

For some people, the fear of a laser or scalpel in their eye is a major deterrent to vision surgery. But the risks associated with long-term contact use may actually be higher than the immediate or long-term risks of laser eye surgery. Here's what you need to know when evaluating your options.

Risks of LASIK

Most LASIK patients end up with 20/20 vision, and about half end up with eyesight that is better than 20/20 without glasses. Choosing a skilled surgeon can improve outcomes and lower the risk. You should also ask if you are a good candidate for LASIK.

There is a small risk of vision loss with LASIK. In most cases, blindness immediately follows surgery. A 2020 study found that less than 1% of LASIK patients (.06 percent) lost up to two lines on the eye chart of vision after surgery.

Some people also have short-term vision disturbances such as dry eyes, halos, unusual glares, and difficulty focusing. These symptoms usually are temporary, but they can be permanent. Some LASIK patients develop chronic eye pain or serious infections.

Risks of Contact Lenses

Most contact lens users are able to wear them without a problem for many years. However, minor complications are fairly common. A 2017 review found that as many as 47 percent of users develop conjunctivitis--a type of eye infection sometimes called pink eye--at some point. Fifty percent report dry eye, and 23 to 94 percent report lens-related discomfort.

Keratitis, a type of infection that may threaten vision even if properly treated, can also happen. The rate of keratitis varies from a fraction of a percent to 25.4 percent depending on the type of keratitis researchers assess for.

The rate of complications increases when people misuse contacts, such as by wearing them for too long or when they are dirty. Complications also vary with the type of lens a person chooses and whether they have underlying eye health issues.

In most cases, the complications of wearing contacts build slowly, steadily damaging the eye, while complications related to LASIK happen shortly after treatment.

LASIK vs. Contact Lenses: Which is Better?

According to a 2016 analysis that compared contact lens users to people who underwent LASIK over 3 years, satisfaction with LASIK is higher. At the beginning of the study, 63 percent of contact lens users expressed high satisfaction with their contacts. At 3 years, that percentage decreased to 54 percent. Three years following LASIK surgery, 88 percent of people who previously wore glasses and 77 percent of prior glasses users expressed strong satisfaction. This suggests long-term satisfaction with LASIK is significantly higher.

The absolute risks of either option are low.