I am trying to get "real" information that supports the idea that a woman should not have lasik while breastfeeding.

My vision has been stable for at least 6 yrs. Since 1999 I have been either pregnant or nursing. My vision has been checked every year since 1999 and there have been no changes to my prescription. I do not experience problems with eye dryness- but I have not worn contacts for about 2 years secondary to minor structural changes in my eye that my latest exam has shown to have resolved.

I am currently nursing a 16 mth old. I have had a regular cycle for 12 mths. I plan to "self-wean" (I'm an RN and know far too much about the benefits of human milk for human infants to do anything else- but that's another topic!). I do not anticipate my baby weaning anytime soon.

My experience has been that when a doctor tells a woman that she cannot have a medical procedure or take a med during lactation they are wrong 90% of the time. Usually what it boils down to is that one must DIG for info about this topic, it is not everyday knowledge and since they really do not know for sure they just say that breastfeeding is contraindicated with X to cover their butt.

This is why I question the advice that a woman who is 16 mths post partum who has a normal menstral cycle can not have lasik because her infant nurses 2-4 times a day. I have researched every reource I can think of regarding lactation and cannot find anything regarding vision changes secondary to lactation. I find it interesting that hormonal birth control and menopause do not seem to be any concern but breastfeeding is a concern.

I would appreciate any knowledge on this topic! Thanks!

Let's analyze this situation. You believe doctors are wrong 90% of the time but you come to the "Ask LASIK Doctors" BBS for information. Sounds like yet another topic.

It is known that women's hormones which are at different levels during pregnancy and nursing can affect the measured prescription. Measuring your prescription for contacts or glasses is not nearly as critical as what you need for LASIK. Your eyeglass optomotrist probably factored in that you were pregnant or nursing along with the satisfaction level of your previous prescription when he/she continued to give you the same prescription year after year.

For LASIK, your doctor will probably perform a dilated pupil exam. This will relax your eye muscles (which would compensate for prescription inaccuracies) and give you a more accurate prescription. However, if your hormone levels have changed, you cannot expect this to be your prescription once you are beyond pregnancy/nursing.

How could you even consider LASIK without getting the most accurate prescription measurement possible? That's like a brain surgeon saying "I think we'll start about here."

You can trust my answer; I'm not a doctor [a little sarcasm there].

Trust your doctor on this one. Maybe this is one of those 10% times.

I can appreciate your excitement to have Laser Vision Correction (LVC), but you must remember this is elective surgery. George (separate post) notes some reasons to discontinue breast feeding prior to LVC as it relates to stability of your prescription. While this statement are true, for me, the concern has more to do with the healing response.

We know that female hormones are different from normal even with normal cycles because you are still making nurse milk for your baby.

We also know that the hormonal changes associated with pregnancy can affect the healing following laser vision correction. PRK done during pregnancy is associated with aggressive haze formation.

Yes, you are right, not much is known about a women over a year out from delivery with normal menstruation cycles but still breast feeding. Coming back to elective surgery, it is not right to risk it!

After you stop breast feeding, surgery can safely be performed at 3 months.

Yes, I wish we had more data! However, I am not going to risk it.

Gary A. Varley, M.D.
Medical Director, Cincinnati Eye Institute Laser Centers

I agree with Dr. Varley.
As well - the laser is calibrated to remove a specific amount of tissue to result in a final visual acuity of 20/20. After the laser is applied, the cornea does undergo a healing process. The problem with people who are breast feeding or pregnant is that the hormone composition is much different, and this can cause an alteration in the healing process - such that a person may be at high risk of ending up with residual myopia (and thus require an enhancement).

I hope this helps

Best of luck

Bill Trattler, MD
Miami, FL

I have search far and wide for info regarding lasik correction and breastfeeding. I too, will self-wean my child who is now 13 month old. I am scheduled for the lasik proceedure in 3 weeks. my doctor is unconcerned with the fact that I am nursing my child and feels that since my prescription has not changed in so long that it is fine to have the surgery. I have contacted the la leche league about this topic and the healing process is not an issue. I have the info if needed I can e-mail anybody the info from la leche league, it's good reading and may educate all of us! thanks maggie

I would be more concerned about what the hell you would do if you had a bad outcome. It is stressful enough dealing with an infant. Why throw in the possibility of getting permanent eye problems to go along with it?

Try surgicaleyes.com and do a search under "tabbysmommy" to find out what life is like being visually impaired while trying to raise infants and youngsters. Not a pretty picture.

Wait till your kids are older. Technology will improve, and you will be less stressed. Also, more reports on the long-term effects of LASIK, and you may decide against it.

As a medical professional, you should know intuitively that LASIK is an elective procedure that is highly invasive, and that permanently weakens the physical structure of your most important sensory organs. Just my take...

I think your points are well taken - but whether a person has a baby or is actively working, etc - having a complication following elective surgery can be very problematic. So the key is to educate oneself about whether the benefits of laser eye surgery (PRK/LASEK/LASIK) outweighs the risks.
Laser surgery is a real surgery with real risks. Of course, for those who have excellent outcomes - the results can be lifep-changing. Of course, with a complication, the results of laser eye surgery can also be life-changing in a negative way. That is why it is important to carefully determine whether laser eye surgery is appropriate and also why it is important for a person to get atleast 2 opinions to make sure that they are a good candidate for surgery.

Best of luck.

Bill Trattler, MD
Miami, FL

Dear Dr. Trattler-What are your feelings regarding prolonged lactation and lasik correction? Healing is not an issue. I am so torn as to whether to have it or not. There is so little info regarding this topic. thank you and I appreciate your input. maggie

The reason there is no information is that in general surgeons recommend patients wait 3 months after they have finished breast feeding for surgery. This is because some patients who underwent PRK in the mid-90s had significant shifts in their vision while breast-feeding or with pregnancy.
So there is no research - and there will be no research since this is the popular thinking amongst surgeons.
My advice in general is to wait! This is elective - there is no rush in general.

Best of luck

Bill Trattler, MD
Miami, FL

>The reason there is no information is
>that in general surgeons recommend patients
>wait 3 months after they have
>finished breast feeding for surgery. This
>is because some patients who underwent
>PRK in the mid-90s had significant
>shifts in their vision while breast-feeding
>or with pregnancy.
>So there is no research -
>and there will be no research
>since this is the popular thinking
>amongst surgeons. My
>advice in general is to wait!
> This is elective - there
>is no rush in general.

>Best of luck

>Bill Trattler, MDMiami, FL

Is the reason why it is not recommended to have lasik while breastfeeding because a change in hormones may cause a change in vision? My perscription has not changed in over 20 years, even after 2 pregnancies for which I breastfed for over a year. I am still nursing my twins, and plan to self ween. If the reason is because my vision may change, I I feel very confident that it won't. However, if there is another reason why doctors do not like to perform the procedure until a patient has stopped breastfeeding, I would be curious to know. I am interested in having the procedure done as soon as possible, but I want to be safe. Regards, Nicki