LASIK eye surgery, like all surgical procedures, carries some degree of risk. Though rare (occurring in about 1 to 5 percent of cases), some patients do experience laser eye surgery complications. Being aware of potential risks can allow you to have realistic expectations of not only your procedure, but the recovery process as well. Most importantly, being mindful of LASIK surgery risks can allow you to make an informed decision regarding your eye care.
Risk and Complications
There are a number or potential risks and complications that can occur as a result of LASIK surgery. With experience, skill, and the latest in refractive surgery technology, these risks can be greatly mitigated. However, individuals considering refractive surgery should be aware of potential risks and common side effects nonetheless. Risks include:
With LASIK eye surgery, overcorrection and undercorrection are both possible. These and other potential laser eye surgery complications can usually be attributed to the fact that corneas can vary greatly from patient to patient, in terms of water content, healing ability, and other variables that are beyond the control of the surgeon. While extreme cases of over- or undercorrection may necessitate further treatment, mild cases can be effectively addressed by wearing glasses when necessary.
As with any surgery, a risk of infection is possible with LASIK. If left untreated, eye infections can result in scarring on the cornea or significant and permanent loss of vision. However, eye infections from LASIK surgery are very rare. Antibiotic eye drops are normally prescribed after surgery to prevent infections, and patients should schedule regular post-operative visits to make sure eyes heal properly. If an eye infection does develop after your LASIK treatment, your surgeon will discuss treatment options with you.
Small folds in the corneal flap are among the most common complications of LASIK surgery, but the surgeon can easily identify and remove them. Also, within the first few hours following surgery, wrinkles can form in the corneal flap if the patient tightly shuts the eye. The surgeon can fix this by re-laying the corneal flap to smooth out any wrinkles. However, flap wrinkles are a rare laser eye surgery complication and occur in less than 1 percent of cases.
Central Corneal Islands
Central corneal islands are small areas of raised tissue that show up on the cornea when the laser used during surgery does not remove tissue uniformly. This type of complication occurs in less than 1 percent of LASIK cases, and can usually resolve itself after a few months. If central islands persist, the surgeon may prescribe contact lenses to smooth out the cornea surface or a laser touchup if necessary.
Another LASIK risk occurs when cells from the corneal epithelium start growing under the corneal flap. In some cases, this epithelial ingrowth will stop growing, die, and be absorbed into the cornea. But if the epithelial cells continue to grow, they can significantly affect vision. To treat this, the surgeon must lift the LASIK flap and remove the ingrown cells. However, this eye complication happens in less than 1 percent of LASIK cases.
Corneal ectasia refers to a weakened cornea that may bulge out months after LASIK surgery. This occurs when the surgeon makes too deep an incision during the flap creation process or removes too much corneal tissue during surgery. Ectasia can only be treated with a corneal transplant. If left untreated, the patient may have a recurrence of nearsightedness or astigmatism. This LASIK complication is rare and can be prevented if the thickness of a patient’s cornea is measured prior to surgery.
Diffuse Lamellar Keratitis (DLK)
Diffuse lamellar keratitis (DLK) is a post-operative LASIK risk that occurs when foreign bodies become trapped behind the corneal flap. Patients with DLK may experience pain, sensitivity to light, blurred vision, or the sensation that there is something trapped in their eye. Some patients experience no symptoms at all, but DLK can be detected during follow-up examinations after surgery. Symptoms typically present themselves within a week of LASIK surgery, but DLK complications have been known to occur even years after surgery if patients experience corneal trauma. Patients who experience any sort of eye trauma should be evaluated by an eye care professional. Though DLK is one of the more dangerous post- LASIK risks, it is easily treatable with topical and oral medication when caught in its earlier stages.
In rare instances of laser eye surgery complications, a patient’s cornea can permanently warp as a result of scarring. This may lead to astigmatism and an inability to use traditional contact lenses. Astigmatism after LASIK surgery, known as induced astigmatism, may cause blurred or distorted vision. Patients who encounter astigmatism as a result of LASIK usually must continue to use corrective eyeglasses.
Presbyopia and LASIK Surgery
Prospective LASIK candidates should be aware that LASIK surgery does not prevent presbyopia – the decline of near vision as an individual enters middle age. Generally thought to be caused by a gradual loss of flexibility in the eye’s natural crystalline lens, presbyopia affects virtually everyone and generally requires the use of reading glasses. Learn more about presbyopia and other presbyopia treatments, such as IOLs, by visiting the appropriate DocShop pages.
Reducing Your Risk of Complications after LASIK
Advances in LASIK technology provide patients with choices that can reduce the risk of post- laser eye surgery complications and provide more precise results. With IntraLASIK, the surgeon uses a laser instead of a blade, or microkeratome, when creating the corneal flap, ensuring fewer flap-related complications. During custom LASIK surgery, a three-dimensional map of the eye is used to guide the excimer laser, providing superior visual results and less risk of corneal irregularity and over- or undercorrection. While these methods are considered safer, LASIK – like any surgery – does pose some risks, and some LASIK patients do experience complications.
LASIK Side Effects
Patients who are considering undergoing LASIK eye surgery should be aware of possible side effects that can occur. The most common side effects associated with LASIK include glare, halos with night vision, and dry eyes. In many cases, LASIK eye surgery side effects disappear within a few days to a few months following the procedure. However, if LASIK side effects last more than six months it is important to undergo an eye exam with your surgeon. For more information on statistics related to LASIK side effects, visit our LASIK statistics page. If you have considered LASIK surgery for the treatment of nearsightedness, farsightedness, or astigmatism, you should take into consideration the possible side effects before making a decision on treatment.
Sensitivity to Light
Sensitivity to light is one of the most commonly experienced LASIK side effects. While it will be tempting for patients to rub or touch their eyes when they experience this sensation, this could impede the healing process or damage the eyes during LASIK recovery. Light sensitivity generally subsides within the first few days after a LASIK procedure.
Halos, Starbursts, and Glare
Halos, starbursts, glare, and other general vision problems can occur when the corneal flap does not adhere correctly to the eye after it is replaced, or when the pupil dilates to a size that is larger than the treatment zone. These complications of LASIK surgery most commonly disappear within the first month after a LASIK procedure, but if symptoms persist, the use of glasses or additional treatment can usually remedy this problem.
Loss of visual clarity or regression, one of the more uncommon LASIK side effects, is usually only temporary and occurs during the first few months of healing. Visual regression after LASIK surgery is usually caused by wrinkles or folds in the corneal flap or hazing of the cornea, and is typically resolved as healing progresses. Women on hormone therapy may be at particular risk of regression, and should discuss all medications they are taking with their doctor to avoid unnecessary laser eye surgery complications.
One of the most common complications of LASIK surgery is dryness of the eyes, which can manifest itself in the form of redness, itchiness, blurred vision, crusting, or the sensation that there is a foreign body in the eye. Fortunately, post LASIK dry eye complications usually subside within the first three months after surgery, and are easily relieved by the use of preservative-free lubricating drops. If you are experiencing dry eyes after your LASIK procedure, contact your doctor to learn what kind of eye drops will most effectively relieve your symptoms.
Loss of Contrast Sensitivity
Loss of contrast sensitivity after LASIK surgery can impair the patient’s ability to clearly discern objects. This is particularly noticeable in low light conditions and may affect night driving ability. Patients usually find that contrast sensitivity returns to normal within six months.
Consult a LASIK Surgeon in Your Area
It is best to speak with a LASIK surgeon if you are experiencing complications after LASIK surgery, have questions about the risks associated with laser eye surgery, or are interested in learning more about how recent developments can help reduce LASIK eye surgery complications.