No — not with an untreated retinal hole. Once it’s treated and your retina is confirmed stable, LASIK becomes possible for most patients.
Most pages on this topic just say “risky, consult a doctor” and stop there. Here’s what they leave out: the actual number your eye pressure spikes to during LASIK, what published safety data really shows about retinal holes, and a named clinical protocol for treating a hole before surgery.
Key Takeaways
- The LASIK suction ring pushes eye pressure to 60–90 mmHg — roughly 3 to 6 times normal — for a few seconds during flap creation.
- A published study found LASIK-related retinal detachment occurred in just 0.06% of eyes — lower than the detachment rate in myopic eyes generally.
- The main driver of retinal risk is the degree of myopia itself, not the LASIK procedure directly — high myopia raises detachment risk regardless of surgery.
- A specific pre-LASIK protocol exists: sealing retinal holes with 532nm laser photocoagulation before surgery, with documented successful sealing.
- Even a history of full retinal detachment surgery hasn’t ruled out LASIK later in documented cases, once the retina is stable.
The Facts, Verified
Here’s what actually happens to your eye during LASIK, and what published research says about the retinal risk.
| Verified fact | Why it matters for you |
|---|---|
| The LASIK suction ring raises intraocular pressure to roughly 60–90 mmHg for a few seconds — normal eye pressure is about 10–21 mmHg | This is the real mechanism behind the caution around retinal holes, not a vague “stress on the eye” |
| A study tracking LASIK patients found retinal detachment in 0.06% of eyes, compared to a 0.7–6.0% baseline rate in myopic eyes generally | LASIK itself doesn’t appear to dramatically raise detachment risk beyond what high myopia already carries |
| In one study, the median time between LASIK and retinal detachment was 12 months — researchers noted this makes a direct pressure-spike cause unlikely | Detachment risk tracks more with your baseline myopia and retinal health than with the surgery moment itself |
| A published protocol treated 42 eyes with peripheral retinal degeneration or holes using 532nm laser photocoagulation before LASIK, with holes documented as successfully sealed | “Treat first, then LASIK” isn’t just caution — it’s a named, studied clinical approach |
| Retinal specialists commonly recommend referral for clearance above roughly -7D of myopia, especially with lattice degeneration or peripheral tears; retinal holes are specifically correlated with an eye’s axial length reaching 30mm or more | Gives you two concrete numbers to ask your surgeon about, instead of a vague “high myopia” label |
Sources: Review of Ophthalmology; International Journal of Ophthalmology; peer-reviewed LASIK retinal detachment cohort studies.
Why Does a Retinal Hole Matter for LASIK?
LASIK reshapes your cornea, at the front of the eye — it has nothing to do with your retina directly. The concern is mechanical: creating the corneal flap requires a suction ring that temporarily locks pressure inside your eye up to 60–90 mmHg, several times normal. That brief pressure spike, plus the mechanical stretch it puts on the vitreous gel touching your retina, is the theoretical pathway by which an already-weakened spot (a hole or lattice degeneration) could be pushed toward a full detachment.
It’s worth being precise about what the evidence actually shows, though: the 0.06% detachment rate after LASIK is lower than the general detachment rate in myopic eyes, and the 12-month median gap between surgery and detachment in one study argues against a simple “pressure spike causes tear” story. The bigger risk factor is your underlying degree of myopia — which is also often why a hole developed in the first place. This is precisely why a dilated retinal exam is standard before LASIK, and why lattice degeneration gets the same scrutiny as an outright hole.
One detail worth knowing: “high myopia” isn’t just about your glasses prescription. The number that actually drives retinal risk is axial length — how elongated your eyeball itself is, measured in millimetres, not diopters. Two people with the same -8D prescription can have different axial lengths, and retinal holes specifically become more common as axial length approaches 30mm. If you know your axial length from a prior eye exam, that’s a more precise number to bring up with your surgeon than your prescription alone.
What Happens After Treatment?
| Situation | LASIK outlook | Why |
|---|---|---|
| Untreated retinal hole, active or recent | ❌ Not yet | Retina needs to be sealed and confirmed stable first |
| Hole treated with laser photocoagulation, recently | ⚠️ Wait for stabilization | Typically several weeks to months before re-evaluation |
| Hole treated with cryotherapy, recently | ⚠️ Likely longer wait | A randomized trial found cryotherapy causes more post-treatment inflammation than laser at every measured point |
| Hole treated, retina confirmed stable on follow-up | ✅ Usually a candidate | Matches the documented pre-LASIK photocoagulation protocol |
| History of full retinal detachment surgery, now stable | ✅ Possible, case-by-case | Documented in published cases; scar tissue can occasionally complicate the suction step |
Sources: peer-reviewed pre-LASIK retinal photocoagulation studies; randomized cryotherapy-vs-laser retinopexy trial.
Not all hole treatments are equal when it comes to healing time. A randomized trial comparing the two found cryotherapy produced significantly higher post-treatment eye inflammation than laser photocoagulation at every follow-up point measured, even though both approaches reached similar vision outcomes by 10 weeks. Practically, that means if your hole was treated with cryotherapy rather than laser, your surgeon may reasonably want a longer settling period before even discussing LASIK — worth asking about directly rather than assuming a fixed timeline applies to everyone.
Once a hole is treated, your surgeon will want retinal imaging and a stability check before clearing you — this isn’t a formality, it’s the same evaluation the published protocol used to confirm holes had sealed. If your retina shows related changes like macular involvement or you’re already noticing floaters, mention this directly during your consultation — it changes how closely your retina needs to be monitored, both before and after surgery.
What If LASIK Still Isn’t Right for You?
If your retina isn’t stable enough yet, or your myopia is high enough that your surgeon prefers to avoid the suction-ring pressure spike altogether, you still have real options.
| Option | Uses suction ring? | Worth asking about if |
|---|---|---|
| TransPRK | ✅ No | You want a laser option without the mechanical flap step |
| ICL | ✅ No | Your myopia is high and you’d rather not reshape the cornea at all |
| SMILE Pro | ⚠️ Different mechanism | You’re comparing femtosecond-only options; retinal screening still applies |
Source: comparative refractive surgery mechanism literature.
Bottom Line
A retinal hole isn’t a permanent no for LASIK — it’s a “not yet, until this is treated and checked.” The actual data backs a measured approach rather than blanket fear: LASIK’s detachment rate is low, but the suction-pressure spike is real and worth respecting when your retina already has a weak spot. Book a consultation for a dilated retinal exam before assuming either way.
FAQs
How long after treating a retinal hole can I get LASIK?
Typically several weeks to a few months, once your surgeon confirms on follow-up imaging that the hole has sealed and the retina is stable.
Does everyone with retinal holes need laser treatment before LASIK?
Not always — it depends on the type, size, and location. Your retina specialist decides this during your dilated exam.
Is the LASIK pressure spike painful?
No — it happens under topical anesthesia and lasts only seconds during flap creation, though you’ll feel brief pressure and dimmed vision.
Can lattice degeneration alone rule out LASIK?
Not automatically — it depends on whether it shows signs of being active or at risk. Many stable cases are cleared after evaluation.
Will I need retina check-ups after LASIK too?
Yes, especially if you have a treated hole or high myopia — periodic dilated exams remain important long after surgery.
