Risks and Complications of LASIK Eye Surgery
Risks and Complications of LASIK Eye Surgery - LASIK is an elective procedure—meaning it is not medically necessary. You can safely correct your vision with eyeglasses or contact lenses instead of choosing LASIK.
By choosing LASIK surgery to correct your vision, you are accepting a certain amount of risk. No surgical procedure (including LASIK) will have a perfect outcome 100% of the time.
Thankfully, LASIK is very safe and the frequency of serious complications is quite low. But you should fully understand the risks and potential complications of LASIK before making your decision about whether or not to have the procedure done.
It is extremely rare for complications from LASIK eye surgery to cause permanent, significant vision loss. Also, many complications can be resolved through re-treatment or enhancements of the eye.
Selecting the right eye surgeon probably is the single most important step you can take to decrease any risks associated with LASIK. An experienced, reputable surgeon will make sure you are properly screened to let you know up front if you are not a good candidate for LASIK eye surgery.
The first step in the LASIK procedure is the creation of a flap on the cornea. This is usually performed with a surgical tool called a microkeratome. The microkeratome is placed on the surface of the cornea and is held in place with suction. A surgical blade within the instrument cuts the flap, leaving a small hinge to keep the flap partially attached to the rest of the cornea.
Flap complications can occur if suction is lost while the microkeratome blade is cutting or the instrument malfunctions in some manner.
Types of flap complications include:
- Irregular or incomplete flaps.
- Flaps that are too small or too thin.
- Buttonholes (small holes or tears in the center of the flap).
- Free caps (flaps without a hinge).
Research suggests the incidence of flap complications is 2% or less.
In most cases, flap complications cause no permanent decrease in visual acuity. When a flap complication occurs, the surgeon will typically halt the LASIK procedure and re-position the flap. LASIK can then be re-scheduled a few months later after the flap has healed.
Some patients develop glare, halos and/or double vision that can seriously affect nighttime vision. Even with good vision on the vision chart, some patients do not see as well in situations of low contrast, such as at night or in fog, after treatment as compared to before treatment.
People who are slow healers or who have ongoing medical conditions such as glaucoma or diabetes, uncontrolled vascular disease, autoimmune disease, pregnant and nursing women or people with certain eye diseases involving the cornea or retina, are not good candidates for refractive surgery.
Keratoconus, a progressive thinning of the cornea, is a common corneal disorder. It is believed that additional thinning of the cornea by way of refractive surgery may contribute to the advancement of the disease, that may lead to the need for a corneal transplant. Furthermore, some people's eye shape may not permit effective refractive surgery without removing dangerous amounts of corneal tissue. Those considering laser eye surgeries are advised to have a full eye examination with an experienced surgeon.
LASIK patients frequently report problems with dry eye in the first six months following surgery. These complaints appear related to the reduced sensitivity of the eye's surface immediately following the procedure. If you have this problem, temporary remedies such as artificial tears or prescription dry eye medication may be needed. After about six months to a year, however, most of these types of complaints disappear when healing of the eye is complete. People who already have severe dry eyes usually are eliminated as LASIK candidates.
Significant under correction or overcorrection of vision errors means that your outcome is less than optimal and makes it difficult to function in certain conditions. This type of result may be attributed to different reasons such as an inaccurate diagnosis or incorrect settings programmed into software guiding the laser during eye surgery.
In addition, changes can take place in the shape and thickness of the cornea during the healing process. These changes can result in a slight regression (loss of corrective effect) of the immediate LASIK result over time. In general, the stronger your eyeglasses prescription is prior to LASIK, the more risk there is that there may be some regression. This is especially true for the treatment of high amounts of farsightedness. Enhancements from additional laser vision correction or other refractive surgery methods might be used to sharpen vision.
In some rare cases, you may develop an eye infection, inflammation or irritation requiring treatment with eye drops containing antibiotics or anti-inflammatory medication such as steroids.
LASIK is a relatively new technology. The first laser was approved for LASIK eye surgery in the United States in 1995. Therefore, the long-term safety and effectiveness of LASIK surgery are not fully known.