For patients with myopia weighing up LASIK against continued contact lens wear, convenience and freedom from lenses may carry considerable appeal. A new systematic review and meta-analysis suggests that this appeal translates into markedly higher patient satisfaction after LASIK – but the evidence for a corresponding improvement in quality of life is less clear-cut.
Writing in Eye & ENT Research, researchers from Cairo University in Egypt compared vision-related quality of life, patient satisfaction, dry eye disease, and adverse events between patients undergoing LASIK and those wearing contact lenses. The prospectively registered review identified four eligible studies from 1,806 records, incorporating 2,141 participants: 1,275 LASIK recipients and 866 contact lens users.
Three studies, involving 341 participants, contributed to the pooled quality-of-life analysis. Under a common-effect model, LASIK produced a moderate and statistically significant advantage over contact lenses . However, heterogeneity was substantial, and the random-effects estimate was smaller and nonsignificant.
One study, which included an exclusively female contact lens cohort, favored contact lenses. When that study was removed in a sensitivity analysis, the remaining data showed a consistent benefit for LASIK, with heterogeneity falling to 0%. The study authors nevertheless caution that differences in study populations, designs, follow-up periods, and quality-of-life instruments limit the certainty of the findings.
The satisfaction data were more striking. Across the included studies, 88% of LASIK patients reported being satisfied compared with 54% of contact lens users, while 97% of participants who transitioned from contact lenses to LASIK preferred the surgical option.
Safety outcomes also highlighted trade-offs between the two approaches. In one large study, adverse events were reported in 9.5% of LASIK patients versus 19.9% of contact lens users; events included abrasion, infection, and ulceration. Dry eye remained an important consideration for both groups: chronic dry eye was reported in 71% of contact lens wearers, whereas LASIK-related symptoms affected around 50–58% of patients and were predominantly acute during the early postoperative period.
The study authors conclude that LASIK appears to offer an advantage in patient satisfaction and may reduce overall complication burden, but the evidence surrounding quality of life remains uncertain. With the overall certainty of evidence rated low to moderate, they call for larger, prospective studies using standardized patient-reported outcomes and longer follow-up. For clinicians, they also emphasize routine assessment of dry eye risk before LASIK and individualized counseling that accounts for ocular health, lifestyle, and patient preferences, so that myopic individuals may choose the vision correction option most suitable to them.
