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Safely, Can You Get Lasik While Pregnant?

Safely, Can You Get Lasik While Pregnant?

Family planing is already difficult enough. Let alone family planning when you want to get your vision corrected with lasik. Having a baby is most likely going to take priority, but is it possible to do both at the same time?

Correcting your vision with lasik while pregnant is NOT recommended. Technically it is possible, but in general, it is best to avoid extra medications when pregnant; especially medications for an elective procedure. Pregnancy can also potentially slow the recovery after lasik or make lasik less accurate.

It is best to wait until after the baby is born in order to get lasik done. Just ends up being a safer more conservative option for your eyes and for the health of the developing baby.

So what are the main reasons why lasik may not be the best idea while pregnant?

The first is that your body and even your eyes go through a lot of changes during pregnancy.

Eye Changes Due To Pregnancy

The cornea is an important determinant of the prescription of the eye (and also the reason why lasik can correct vision by changing the shape of the cornea). Interestingly enough, there can be some subtle changes to the cornea during pregnancy.

Change In Shape

One big concern about lasik during pregnancy is that it just may not be as accurate. If the prescription of the eye changes because of a change in the shape of the cornea, then lasik isn't treating a correct prescription.

Light focusing in the eye by the cornea and lens

Light focusing in the eye by the cornea and lens; image by Sunshineconnelly at en.wikibooks, CC BY 3.0, via Wikimedia Commons

During pregnancy, the cornea can develop a little bit of swelling and get a little thicker. This has the potential to not only change the curvature of the cornea (which changes the prescription of the eye), but also can change how much the cornea bends light (also known as the refractive index of the cornea) which also changes the prescription. But these changes aren't consistently seen in studies; not everyone will develop changes in their prescription during pregnancy.

If these changes were permanent, that would be one thing; But in almost all cases, the prescription change with pregnancy is temporary and returns back to original levels after completion of nursing. This can leave the vision off target and blurry if the wrong prescription was treated.

So let’s say your prescription hasn’t changed during pregnancy, are you good for lasik? Well, even with a perfectly stable prescription, other changes occur which can slow the recovery after lasik.

Increase in Dry Eye

The cornea can become more dry during pregnancy. The eye can produce less tears and inflammation can build up on the surface of the eye. This makes it easier for the eye to dry out during pregnancy.

Contact lens wearers suffer more. This increase in dry eye can make contact lenses more uncomfortable and difficult to wear for extended periods of time.

Some will start using artificial tears to help treat this dry eye. Some will switch over to glasses. But a few may think that lasik is the best solution to get out of these contact lenses.

The trouble with lasik is that lasik will also cause a short term increase in dry eye.

The cornea has tiny nerves that run through it. When the cornea dries out, these nerves send signals to the tear glands to produce more tears. But this pathway becomes impaired shortly after lasik. The lasik flap and the laser treatment break the connections of these nerves. Until these nerves regenerate, the eye is more prone to drying out. Everyone will have some increase in dry eye in the first few months after the procedure.

Because of this, any dry eye before lasik must be optimized and controlled beforehand. This allows for the shortest and the smoothest recovery. Extra dry eye due to pregnancy just poses an extra hurdle to having the smoothest recovery after lasik. It’s best to let the eyes recover first.

Medications

Perhaps the biggest reason why lasik is generally avoided during pregnancy is because of the eye drops used afterwards.

There are few medications which have been scientifically studied for use during pregnancy. (It’s impossible to do a study which may have the potential to harm the developing baby). Any medication that enters the body while pregnant has the potential to affect the developing baby.

Fortunately for the eyes, there is very limited exposure of eye drops to the whole body circulation. Most of the medicated eye drop get absorbed into the eye and not the rest of the body. But surprisingly, there is still some absorption.

Within the corner of our eyelid is a small drainage hole called the punctum. This small hole drains tears and eye drops from the surface of our eye down into the back of our nose.

Punctum on eyelid

Punctum on eyelid; image by Diogo Melo Rocha (dmelorj), CC BY 2.5, via Wikimedia Commons

Each eye drop has about 10x more volume than necessary to fill the surface of the eye with medication. This extra volume will either run over your eyelid and onto your cheek or drain through the punctum where it can be absorbed into the rest of the body through the nose. Thus, medication eye drops don’t get a free pass during pregnancy - they will still make their way into the body at some small concentration.

After lasik, there are two types eye drops prescribed: an antibiotic and a steroid eye drop. Additionally, during lasik, a numbing eye drop is given.

  • For antibiotics, there are actually a few options that can be used during pregnancy. Many topical antibiotic eye drops have been used during pregnancy without any issues. The most popular class of antibiotics used after lasik, called fluoroquinolones, may be considered safe, but as with many medications during pregnancy, there is limited data. Other antibiotics such as erythromycin ****may be considered as a safer alternative but may need to be combined with other antibiotics in order to match the full anti-bacterial activity of the fluroquinolones.
  • Taking steroid pills has been linked to birth abnormalities. Less is known about steroid eye drops, but as to date there hasn’t been any linkage between the eye drops and any issues with the pregnancy. Thus, steroid eye drops may be safe to use during pregnancy if there is significant benefit.
  • The only other required eye drop during lasik is a topical numbing drop so that you don’t have pain during the procedure. (Can’t skip this one). Once again, no birth-related issues have been identified with these eye drops and can be used during pregnancy if necessary; but still, like most medications, with limited actual scientific data.

So yes, the medications may not be harmful to your pregnancy or developing baby but we can’t say for certain that the medications are definitely safe.

If the medication is absolutely needed, such as you develop an eye infection and need to treat it, than it is important to get that eye drop (with consultation with your obstetrician) even if pregnant.

But lasik instead is an elective optional procedure. Nobody actually NEEDS lasik. It can wait until taking the required post-operative medications is less risky after pregnancy.

Summary

In general, lasik should be avoided while pregnant. If your prescription changes during pregnancy, lasik may end up treating the wrong prescription. The increase in dry eye during pregnancy can make the recovery more difficult. And lastly, there is limited data that the medications necessary after lasik are perfectly safe for your developing baby. Best just to postpone lasik until the pregnancy finishes.

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