LASIK and pregnancy: when is the right time for your surgery?

Are you considering refractive surgery and wondering whether an ongoing pregnancy, or plans to have a baby, changes anything? The answer is clear: LASIK is not performed during pregnancy, nor during breastfeeding. This is not a question of risk to the baby, but of the reliability of the visual outcome and of precautions regarding post-operative eye drops. In this article, I explain why refractive surgery must wait, from what point you can reasonably schedule it, and how to prepare for this project during these months when your eyes are changing.

Direct answer: LASIK and pregnancy, what you need to know

Key takeaway. LASIK is contraindicated during pregnancy and throughout the entire breastfeeding period. This rule is the subject of an international consensus in refractive surgery. Resuming the process is possible 3 months after the end of breastfeeding (or 3 months after delivery if you are not breastfeeding), provided that your refraction is stable, verified across two measurements taken at least 6 months apart.

In practical terms, if you find out you are pregnant when an assessment was scheduled, the appointment is postponed. If you have already had surgery and become pregnant, there is nothing to fear for your baby: it is the timing of the surgery that is in question, not the outcome once the eye has healed.

Why is LASIK not advised during pregnancy?

Four cumulative reasons, each sufficient on its own to postpone the procedure.

Hormonal changes and the cornea

Pregnancy is accompanied by a marked rise in oestrogen, progesterone and relaxin. These hormones alter the rigidity of corneal collagen, the water content of the stroma and the thickness of the cornea. Several studies have documented a transient decrease in corneal rigidity and variations in keratometry during the second and third trimesters, which regress in the weeks to months following delivery.

Yet LASIK is a surgery that sculpts the cornea to within a micron. Operating on a cornea whose biomechanical properties are temporarily altered exposes the patient to a non-reproducible refractive outcome and to an increased risk of healing abnormalities.

Reversible refractive shift

This is the most concrete point for you. Pregnancy frequently causes a refractive shift: your myopia may increase by 0.50 to 1.50 dioptres, more rarely more, without this reflecting a true progression. This shift is generally reversible within the 3 to 6 months following delivery (or the end of breastfeeding).

If surgery were performed on this transient refraction, the laser would be programmed to a false target. Possible result: over-correction (you would become hyperopic once the refraction returns to baseline) or under-correction. In both cases, the benefit of LASIK is compromised, and an enhancement would need to be considered.

Increased dry eye

Hormonal changes also affect the tear film and the Meibomian glands. Many patients report new or worsened dry eye during pregnancy, sometimes persisting for several months after delivery. Yet LASIK itself induces transient dryness for 3 to 6 months after surgery. Combining the two is neither comfortable nor prudent: dryness increases the risk of delayed healing and lasting discomfort.

Post-operative eye drops

After LASIK, I typically prescribe a topical antibiotic and a topical corticosteroid for one to four weeks, then artificial tears for longer. The systemic absorption of these eye drops is low but not zero. During pregnancy, the precautionary principle applies: any non-essential drug exposure is avoided. During breastfeeding, certain molecules pass into the milk at low but debated concentrations. Since LASIK is elective surgery (it is never an emergency), there is no reason to take this risk, even a theoretical one.

What about breastfeeding?

Breastfeeding prolongs the particular hormonal situation of the postpartum period: prolactin levels remain high, the return of menstruation may be delayed, and dry eye often persists. From a refractive standpoint, many patients only return to their previous correction after complete weaning.

Added to this is the matter of post-operative eye drops, already mentioned. Antibiotics (such as topical fluoroquinolones) and topical corticosteroids have low systemic absorption, but data on their use during breastfeeding are limited. The precautionary principle leads, once again, to postponement.

This is why I systematically recommend that my patients wait until the end of breastfeeding, whether it lasts 6 weeks or 18 months.

AFTER THE PROCEDURE

How long to wait after delivery / breastfeeding?

Here is the practical rule I apply at my practice in Cachan:

• If you are not breastfeeding: wait at least 3 months after delivery.
• If you are breastfeeding: wait at least 3 months after the last feed.
• In both cases: the refraction must be stable across two measurements taken at least 6 months apart, with a difference of less than 0.50 dioptre on the sphere and the cylinder.

This stability criterion is essential. A refraction that is still changing at 6 months postpartum is not operable, even if the chronological delay has been respected. Conversely, a patient who has been very stable for 9 months after breastfeeding can perfectly well undergo surgery.

Can I have my pre-LASIK assessment while pregnant?

Technically yes. In practical terms, it is not useful.

The pre-operative assessment relies on measurements that are precisely the ones disrupted by pregnancy: refraction, corneal topography, pachymetry, aberrometry. Having a pre-operative assessment while pregnant would give you figures that cannot be interpreted, and the assessment would have to be redone postpartum. This represents a waste of time and money.

What I offer my pregnant patients who want to plan ahead: a pre-consultation appointment. We discuss the project, your medical history, your expectations, I answer your questions, and we schedule the full assessment once the required delays have been respected.

What about PKR? SMILE? ICL?

All refractive surgeries are subject to the same contraindications during pregnancy and breastfeeding.

• PKR: same issues of unstable refraction, dryness, and post-operative eye drops (PKR even uses slightly more topical corticosteroids than LASIK).
• SMILE: same logic, it is a corneal laser surgery like LASIK.
• ICL (phakic implant): adds an intraocular procedure with antibiotic and corticosteroid eye drops and a peri-operative antiseptic (povidone iodine). Contraindicated during pregnancy and breastfeeding.

No surgical alternative is therefore offered during this period. The right approach is to be patient and to continue correction with glasses or contact lenses.

RISKS

Planning a baby after LASIK: any risks?

This is a frequent question, and the answer is reassuring. If you have had LASIK, a later pregnancy does not threaten your surgical outcome.

Corneal healing is established in the weeks following surgery. The sculpted corneal tissue does not “remodel” because of pregnancy hormones. You may notice slight transient visual blur during pregnancy, related to the refractive shift described above, which resolves after delivery. A few rare patients who had surgery long ago may see their myopia evolve again independently of pregnancy, but this is linked to the natural evolution of the eye, not to the procedure.

In practice: no delay to observe between LASIK and conception. You can start a baby project as early as the month following the procedure, once initial healing has been established.

IN PRACTICE

How to prepare during pregnancy?

Continue glasses or contact lenses

Pregnancy is not the time to give up your correction. If your vision changes, do not hesitate to have your lenses adjusted. For contact lenses, many patients tolerate them less well because of dryness: switching to daily disposable lenses or going back to glasses for a few months is a common-sense option.

Ophthalmological monitoring

An ophthalmological consultation during pregnancy is useful, especially if you are highly myopic (beyond -6 dioptres) or diabetic. A baseline fundus examination makes it possible to detect any peripheral retinal lesions. This check has nothing to do with refractive surgery: it is part of overall ophthalmological care.

Managing dry eye

Preservative-free artificial tears are compatible with pregnancy and breastfeeding. They relieve discomfort and limit the inconvenience of wearing contact lenses. Avoid self-prescribing anti-redness or anti-allergy eye drops without medical advice.

Booking a post-breastfeeding assessment

This is the final step: scheduling your pre-operative assessment at least 3 months after the end of breastfeeding (or 3 months after delivery if not breastfeeding). This gives you a clear horizon and avoids passive waiting.

FAQ

Frequently asked questions

Scientific sources

Transparency note. The references below were validated via NCBI E-utilities (PMID verification 2026-04-25). This article also reflects the recommendations of the French Society of Ophthalmology (SFO) and the international clinical consensus on the contraindications of refractive surgery.

1. Garg P, Aggarwal P. Ocular changes in pregnancy. Nepal J Ophthalmol. 2012. PMID 22344013. https://pubmed.ncbi.nlm.nih.gov/22344013/
2. Taradaj K, Ginda T, Maciejewicz P, et al. Pregnancy and the eye. Changes in morphology of the cornea and the anterior chamber of the eye in pregnant woman. Ginekol Pol. 2018. PMID 30618038. https://pubmed.ncbi.nlm.nih.gov/30618038/
3. Goldich Y, Cooper M, Barkana Y, et al. Ocular anterior segment changes in pregnancy. J Cataract Refract Surg. 2014. PMID 25217070. https://pubmed.ncbi.nlm.nih.gov/25217070/
4. Kanellopoulos AJ. Does Pregnancy Affect Refractive and Corneal Stability or Corneal Epithelial Remodeling After Myopic LASIK? J Refract Surg. 2020. PMID 32032433. https://pubmed.ncbi.nlm.nih.gov/32032433/
5. Jani D, Asbell P. Progressive corneal ectatic disease in pregnancy. Clin Exp Optom. 2021. PMID 34384340. https://pubmed.ncbi.nlm.nih.gov/34384340/
6. Bower KS, Woreta F. Update on contraindications for laser-assisted in situ keratomileusis and photorefractive keratectomy. Curr Opin Ophthalmol. 2014. PMID 24837576. https://pubmed.ncbi.nlm.nih.gov/24837576/
7. Ortega-Usobiaga J, Llovet-Osuna F, Djodeyre MR, et al. Update on contraindications in laser corneal refractive surgery. Arch Soc Esp Oftalmol (Engl Ed). 2023. PMID 36114139. https://pubmed.ncbi.nlm.nih.gov/36114139/
8. Alonso-Santander N, Gómez-Resa M. Laser in situ keratomileusis and surface ablation in pregnancy. J Fr Ophtalmol. 2023. PMID 36670012. https://pubmed.ncbi.nlm.nih.gov/36670012/

For the pharmacology of eye drops during breastfeeding, the CRAT (Reference Centre for Teratogenic Agents) and LactMed (NIH) databases are usefully consulted.

Further reading

• LASIK: indications, procedure, recovery
• PKR: an alternative to LASIK
• Pre-operative assessment: what is measured
• Book an appointment at the practice

Cachan practice · Tel. 01 45 47 08 11

Disclaimer

This article is for informational purposes. A personalised ophthalmological opinion remains essential for any therapeutic decision.

This article is intended for general information and does not replace an individualised medical consultation. The indications and contraindications of refractive surgery depend on your personal situation (refraction, corneal anatomy, medical history, pregnancy plans, breastfeeding). Refractive surgery procedures (LASIK, PKR, SMILE, ICL) are performed by Dr Moïse Tourabaly at the Clinique Laser Victor Hugo (Paris).

Consultations and pre-operative assessments take place at the Cachan practice or in Paris 13. Cataract surgery is performed at the Clinique Sainte-Geneviève. For any question regarding your project, book an appointment via the Contact page.