LASIK vs. Cataract Surgery

Written by David Evans, PhD, MBA   Posted on January 4, 2016

I receive a lot of questions about LASIK and cataract surgery. It seems that many people confuse these two popular corrective procedures (e.g., people with cataracts often ask if they should have LASIK to help with their vision loss). This is understandable, because LASIK and cataract surgery share some similarities. But the truth is, they are two different procedures that work in totally different ways to correct vision. To eliminate some of the confusion, I thought I’d spend this post comparing LASIK and cataract surgery.

How Do They Differ?

LASIK reshapes the outer layer of the eye (cornea) to change the way the eye focuses light on the retina. In contrast, cataract surgery is a treatment applied to the lens of the eye. The natural lens of the eye becomes cloudy for cataract patients. During surgery, the cloudy lens is removed and replaced with an artificial lens (intraocular lens) called an IOL.

LASIK typically is performed on both eyes in the same session, while cataract surgery is typically performed on two separate days for the right and left eyes. LASIK is not reimbursed by insurance, though a flexible savings account (FSA) can be used to pay for it. On the other hand, basic cataract surgery is covered by insurance. (Patients can opt for additional bells and whistles, but these extras must be paid out-of-pocket, just like LASIK. (The out-of-pocket cost of cataract surgery can increase substantially if you elect a premium IOL or laser surgery.)

How Are They the Same?

Both procedures incorporate lasers to perform at least some of the surgical steps.

For example, all-laser LASIK, two lasers are used: a femtosecond laser to create the corneal flap and an excimer laser is used to change the corneal shape. For cataract surgery, a femtosecond laser is used to remove the natural lens from the eye.

Both procedures provide patients with very good vision after surgery, often 20/20 or better. And both procedures are performed under local anesthesia while the patient is awake. Each procedure is relatively quick, requiring less than 15 minutes to perform, though LASIK is bit quicker coming in at less than five minutes per eye. Finally and perhaps most importantly, there is virtually no recovery time for these procedures.

Can You Have LASIK AND Cataract Surgery on the Same Eye?

Since LASIK is performed on the cornea and cataract surgery is performed on the lens, it is possible to have both procedures performed on the same eye. LASIK would typically be performed at a younger age to correct for myopia, astigmatism or hyperopia. Cataract surgery typically would be performed a number of years later when the natural lens has become cloudy and should be replaced by the artificial lens.

Are They Ever Used Together?

Indeed they are. This occurs when the natural lens is replaced by an artificial lens, but the vision is not quite perfect. The LASIK procedure — or more commonly PRK — is then performed on the cornea to correct the small amount of defocus left after cataract surgery. However, this combination procedure occurs less and less as the technology for IOLs has improved dramatically and there is less chance that the patient’s vision is not perfectly corrected by cataract surgery.

The image shows where the lens is in the eye compared to the cornea.