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Written and reviewed by Dr Gozlan, ophthalmic surgeon · 13 November 2026 6 min read
Two clear protective eye shields placed side by side on a white cloth, next to a closed kraft folder and a penlight, in an ophthalmology consulting room, with no person or text visible

Operating both eyes on the same day, or one after the other?

Dr Gozlan
Dr Gozlan
Ophthalmic surgeon – refractive surgery

When considering laser surgery for myopia, a practical question often arises: will both eyes be operated on the same day, or one after the other? This schedule does not replace the choice of technique. It is the ophthalmic surgeon who, at the preoperative assessment, selects the technique suited to your eyes — LASIK or PRK — and the timetable consistent with that indication. The patient does not choose the technique. This article summarises official sources; it does not replace a consultation.

Why LASIK is often performed on both eyes on the same day

The American Academy of Ophthalmology (AAO) states that LASIK can be performed to correct myopia and other refractive errors in both eyes on the same day, and that this approach is routinely used around the world. That does not mean the arrangement is automatic, nor that a visual result is promised.

Two documented points help explain this practice, when the assessment allows it. First, visual recovery after LASIK is generally faster than after PRK, and the technique is usually less painful: that is the conclusion of a Cochrane review comparing LASIK and PRK for myopia (13 trials, 1,135 participants, 1,923 eyes). The authors judged the overall quality of the evidence to be low. Visual results at one year were comparable. A shorter recovery makes a period in which both eyes are healing at the same time easier to understand.

Second, operating on only one eye creates a period during which the two eyes do not have the same correction. The U.S. Food and Drug Administration (FDA) notes this: if only one eye is treated, the difference in vision between the two eyes may make seeing difficult, unless the untreated eye is compensated with glasses or contact lenses, or the second eye is treated.

A study published in Ophthalmology in 1999 compared same-day bilateral LASIK with LASIK performed in two stages. The authors observed no statistically significant difference in intraoperative or perioperative complication rates, nor, for the most part, in results at 3–6 months. It is a retrospective study, carried out with instruments of that period: it does not guarantee the absence of complications and does not replace the FDA information.

Limits of operating on both eyes on the same day

The FDA recalls that LASIK may be performed on both eyes on the same day or on one eye at a time. In its view, despite the practical appeal of a single session, treating both eyes on the same day is riskier than two separate procedures. If both eyes are treated at the same time, or before the first has fully healed, the surgeon does not have the advantage of seeing how the first eye responds before treating the second. Another drawback mentioned: vision in both eyes may be blurred after the procedure, during the initial healing period, whereas operating on one eye after the other allows you to rely on the vision of the eye that has not yet been treated.

A patient information booklet published by the FDA also states that, even when a same-day procedure on both eyes has been planned, it is the doctor who decides, on the day of surgery, whether the second eye will actually be treated immediately afterwards.

No refractive surgery offers a guaranteed result. The information sheet of the French Society of Ophthalmology (SFO) recalls that the intended result can never be fully assured, and that additional correction with glasses, contact lenses or an enhancement is sometimes needed. The FDA makes the same point: some patients still need glasses or contact lenses after the procedure, and adverse effects (dryness, halos and glare, among others) are possible.

PRK: sometimes in two stages

PRK differs from LASIK in that recovery is more gradual. The SFO states that eyes operated on with PRK are painful for about 2 to 3 days, that vision recovers progressively from the first week, and that a recovery period should be planned, the length of which is specified by the surgeon. A bandage contact lens is sometimes placed. After LASIK, the eye is generally slightly painful or not painful, and visual recovery takes place over a few hours to a few days.

The AAO states that PRK can be performed on one eye at a time. In that answer, the return of clearer vision is described as usually taking about 4 days, after which the same period would start again for the second eye. This does not mean that PRK must be done in two stages, nor that the patient chooses this timetable.

A randomised trial published in 2000 compared simultaneous bilateral PRK with sequential PRK in 52 people (104 eyes) with myopia of less than −6 dioptres. The authors observed no significant difference in uncorrected visual acuity or in the proportion of eyes within ±0.5 dioptre of the target; pain scores were higher in the sequential group. It is an older, small trial: it shows that both arrangements have been studied, not that one of them is required.

What is decided at the assessment, and follow-up

The preoperative assessment precedes any procedure. The ophthalmic surgeon uses it to assess whether laser surgery is possible, which technique to select, and whether it is consistent to operate on both eyes on the same day or to separate them in time. The patient does not have to “choose” the technique in order to shorten time off work or to organise daily life: the technique selected also shapes, in part, the timetable.

The assessment is based in particular on corneal thickness and shape, the correction to be made, the condition of the ocular surface, age and activities. If a contraindication appears, or if an event involving the first eye warrants it, the second eye may not be operated on in the same session. Risks, alternatives (glasses, contact lenses) and the limits of the result are explained at the consultation. Amounts and practical arrangements are set out on the Fees page.

Postoperative follow-up is essential. The SFO describes the usual care: eye drops, pain treatment in the case of PRK, possible wear of a bandage contact lens for a few days, and sunglasses strongly recommended in case of sun exposure after PRK. After LASIK, care is generally limited to instilling drops. The exact schedule of follow-up visits is set by the ophthalmic surgeon, according to the technique and how your eyes evolve. It is important to follow the instructions and to seek care without delay in case of unusual pain, a drop in vision, or warning signs that will have been explained to you.

In practice

Operating on both eyes on the same day is a common arrangement for LASIK, with practical advantages and limits set out by the FDA. For PRK, both approaches — same day or two stages — exist in the literature. The decision belongs to the ophthalmic surgeon, on the basis of the preoperative assessment.

Going further

Sources