What are the typical complications and side effects of LASIK?

     Laser vision correction is subject to complications. The complication rate is very low and problems can usually be readily treated. Complications will be more common in patients with high amounts of nearsightedness, farsightedness, or astigmatism, because these patients require larger amounts of treatment.

     By far the most common complication of laser vision correction is under-correction or over-correction. This occurs because the patient absorbs slightly less or more of the laser energy than anticipated, or because the patient experiences an abnormal healing response. Further laser treatment, known as an "enhancement" or a "touch-up", can then be used, usually resulting in excellent vision without glasses or contact lenses.

     Under-corrections and over-corrections are the main reason that all patients do not have perfect uncorrected vision after the initial laser treatment.

     About 2% of laser vision correction patients will experience increased optical aberrations, including glare or halos at night. Every person, even if you have never had laser vision correction, to some degree has glare or halos when viewing a bright object against a dark background. Most people are not aware that they have glare or halos. You can demonstrate this to yourself by going outside, away from other lights, and viewing the moon; every person will notice a small glow or unevenness around the edge of this bright object. After laser vision correction, increased glare or halos is common during the first three months of healing. After the initial healing period, only a very small percentage of people will have more glare or halos than prior to the treatment, and a greater number of people will experience a decrease in the glare or halos. Large pupil size in low light in combination with a high amount of correction is more likely to result in increased glare or halos. Use of the newer lasers, with eye trackers and substantially larger treatment areas, has dramatically improved this problem.

     Many patients will experience dryness during the first weeks or months following treatment. Dryness is most common in people who have a lot of dryness prior to laser vision correction. Eyedrops or pills are used to control the dryness, which usually resolves by three months after treatment.

     Complications affecting the health of the eye are extremely rare, but are possible. During the early healing phase, the eye is susceptible to infection. You will be asked to follow certain instructions, including using antibiotic eye drops. Carefully following these instructions will decrease the infection rate to far below 1%. Even if an infection does occur, use of antibiotic eye drops will almost always control the infection.

     Steroid eye drops are very important after laser vision treatment, because they are used to control the healing response. However, if used improperly for too long, these drops can damage the eye by causing cataracts or glaucoma. It is very important to go to all scheduled follow-up appointments, especially if you are still taking steroid eye drops

 

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The number one, two and three reasons that people do not have LASIK is fear.  I am always surprised when someone tells me that they are afraid of LASIK but over-wear or abuse their contact lenses.  I believe that the risk of blindness from LASIK is less than 1 in 1,000,000.  In contrast, the risk of blindness from contact lenses is greater than 1 in 40,000.  Corneal infections are common from contact lenses and it is quite possible for this infection to lead to loss of the eye.  LASIK is much safer than contact lenses but not as safe as glasses.  One of the most important keys to LASIK is to have a comprehensive evaluation from a LASIK surgeon who is willing to tell you if you are anything less than a perfect candidate.  Your risk of significant problems, in that case, is extremely small.

LASIK is a wonderful procedure for excellent candidates There are numerous potential side effects and I recommend being examined to determine your candidacy for the procedure. The results do vary depending upon your prescription so it is important to have the preoperative evaluation by the eye doctor performing the procedure. As with any surgical procedure, healing issues account for the majority of side effects.

The most common LASIK complication is not achieving the endpoint vision that was desired and thus sitll needing glasses or contact lenses or another procedure. The incidence of this was about 10% with older laser technologies but now is less than 5% in most practices.
There are serious complications possible including but not limited to infection, damaged or lost flaps, scarring, dry eye, DLK, loss of vision, and others.
Minor complications such as mild dry eyes, light sensitivity, glare and halos are also possible.
Before having LASIK you will sign an informed consent which should be available to you before the day of your procedure. It will list many of the potential side effects and complications of LASIK for you to understand. You should discuss anything that you do not understand or concerns you with your doctors.
Fortunately, serious complications are extremely rare after LASIK and most patients enjoy good results with few problems.

Most LASIK side effects are rare and not serious. Like any surgery, there are inherent risks, but LASIK is generally regarded as one or the safest surgeries available. Typical side effects include temporarily reduced night vision and dry eye.
Serious but rare side effects include infection, distorted vision, and complications with the flap. Listing all the possible side effects of any procedure is almost impossible, so you should address any specific concerns with your doctor.

The first thing I like to address with my patients is that there is clear documentation that Laser Vision Correction(LASIK or PRK) is safer, with fewer side effects, than wearing contact lenses. People are generally amazed at this. Just think, though, about how often you, as a contact lens wearer, "pushed the envelope" and went well above and beyond what was recommended by your eye doctor when wearing contacts. So, in a way, what are you afraid of? You have run greater risks already!

That said, there are some potential side effects from LASIK or PRK that you need to know about. Many issues like dry eye, glare and halo are seen much less frequently now as compared to ten or fifteen years ago. The reason is that the lasers have improved and with the all laser approach many "flap complication" issues are just not seen anymore. I have never had an infection with either one of these procedures, but the chance does exist. Good follow up care is essential.

The best way to avoid complications is to choose a well established surgeon, have a thorough preop evaluation, follow all of the instructions and your chances of a seamless experience are terrific.