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Lasik and Marijuana, A Cannabis Point of View

Possible concerns regarding Cannabis, Lasik, and other laser eye surgery techniques.

Image of cannibus leaves.  
No direct studies have determined if cannabis is problematic for Lasik or similar refractive surgery techniques.  

The use of cannabinoids (related terms: cannabis, marijuana, marihuana, hashish, hashich, haschich, cannabinoids, tetrahydrocannabinol, delta-9-tetrahydrocannabinol (THC), dronabinol, nabilone, levonantradol) when receiving refractive surgery like  conventional or custom wavefront Lasik, Bladeless Lasik, PRK, LASEK, or Epi-Lasik does not seem to be directly contraindicated, but a patient should undoubtedly refrain from use for at least two months before surgery and until the end of the recovery period.

Cannabis As Medicine

Cannabis has been considered a medicinal agent for thousands of years and across many cultures. It reached a position of prominence within Western medicine in the nineteenth century and then became bogged down with legal controls early in the twentieth century. Recreational cannabis exploded into popular culture in the 1960s and has remained easily obtainable on the black market in most countries ever since. Many US states have decriminalized marijuana for personal or medicinal use. According to the US National Institute on Drug Abuse of the National Institutes of Health, marijuana is the most commonly abused illicit drug in the United States.

Medical Reviews

A examination of peer reviewed medical journals finds more than 70 properly controlled studies evaluating the therapeutic effects of cannabinoids. For each clinical trial, the country where the project was held, the number of patients assessed, the type of study and comparisons done, the products and the dosages used, their efficacy and their adverse effects are described. Cannabinoids present an interesting therapeutic potential as antiemetics, appetite stimulants in debilitating diseases (cancer and AIDS), analgesics, and in the treatment of multiple sclerosis, spinal cord injuries, Tourette's syndrome, epilepsy and glaucoma. It appears from a review of these studies that the use of cannabis concurrent with refractive surgery is not problematic, however no direct evaluation to any refractive surgery technique has been performed.

Anecdotal Observations

Marijuana users often experience a cottonmouth and dry eye. This happens as a result of vasodilation, or expanding blood vessels. Vasodilation happens automatically when THC is introduced to the body.

The amount of tissue removed from the cornea by the Lasik excimer laser is based, in part, upon the moisture content of the cornea. A dry cornea will lose more tissue per laser pulse than a moist cornea. This level of moisture content cannot be well managed with artificial tears. It is possible, even probable, that a person whose eyes are dried from marijuana use at the time of surgery may experience too much tissue being removed and Lasik overcorrection. Additionally, it is common for a patient to experience dry eyes after Lasik. Lasik induced dry eyes combined with cannibas induced dry eyes may complicate Lasik surgery and recovery.

Absence of Evidence

In the absence of a study indicating the use of marijuana is okay with Lasik, it is reasonable to refrain from its use for a long enough period of time before surgery that any elements would disperse, and until full recovery from surgery. If a surgery related complication were to occur, the patient would not have the added concern of a negative interaction with the medications or treatments necessary to resolve the complication.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Recent Marijuana and Lasik Medical Journal Articles...

Related Articles

Marijuana for Glaucoma: A Recipe for Disaster or Treatment?

Yale J Biol Med. 2015 Sep;88(3):265-9

Authors: Sun X, Xu CS, Chadha N, Chen A, Liu J

Marijuana has been shown to lower intraocular pressure (IOP) but with limited duration of action and numerous adverse effects. Use of marijuana to lower IOP as a means of glaucoma treatment would require frequent use throughout the day, leading to significant adverse effects, possible progression toward Cannabis Use Disorder (CUD), and/or withdrawal symptoms. The treatment of glaucoma based on the cannabis plant or drugs based on the cannabinoid molecule should be considered carefully before being prescribed. Considerations should include the adverse physical and psychological adverse effects, including substance abuse. Currently, the deleterious effects of marijuana outweigh the benefits of its IOP-lowering capacity in most glaucoma patients. Under extremely rare circumstances, a few categories of glaucoma patients may be potential candidates for treatment with medical marijuana. Further studies on alternate routes and more focused means of cannabinoid molecule delivery to the eye for glaucoma treatment are needed.

PMID: 26339209 [PubMed - in process]


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