Lasik Complications

Lasik surgery is a popular alternative to wearing glasses or contacts. It is an in-office procedure where the vision for most is corrected rapidly and the patient can return to work quickly. Most people experience only a minor amount of pain or discomfort. One of the best ways to avoid problems is to find an experienced doctor who will take the time to talk to you about your individual situation. Discuss with your doctor potential complications and alternatives that are available for you.

Due to the risk of complications, it may be advisable to do one eye at a time. Physicians often do not want to do this as it is not as efficient for them. If you are concerned, find a doctor that will accommodate your wishes.

Who is Most at Risk for Complications?

• A variety of people may experience complications from Lasik surgery. These include people who need a large vision correction, have large pupils, have thin corneas as well as those who already experience dry eyes. People who needed a prescription correction during their last examination may have a refractive instability, which can cause problems with Lasik. Additionally, people whose occupations or hobbies have high incidences of head trauma, such as boxers, wrestlers or football players, should avoid Lasik. People who have an eye disease such as glaucoma or blepharitis may be at risk. Talk to your doctor about any disease you may have, like lupus, diabetes or HIV. Individuals taking blood-thinning medicine or who have had previous refractive surgeries should discuss this with their doctor. Individuals of Asian decent may experience more difficulties with Lasik. Pregnant women may not be good candidates for this procedure. Lasik has not been approved for individuals under the age of 18.

Dry Eye

• The most common complication from Lasik surgery is dry eye. The seriousness of this condition varies from temporary to permanent. In some individuals, it can be easily treated with drops. In others, the treatments do not work. The reason for dry eye is that the corneal nerves that produce fluid are severed in creating the corneal flap. These nerves do not grow back.

Over-correction or Under-correction

• Another significant issue is over-correction and under-correction of the vision problem. Often, these problems are temporary and resolve themselves in a matter of months. Occasionally, they are permanent. Under-correction is more common than over-correction, and sometimes can be solved with glasses or contacts. Over-correction can often be solved the same way. The doctor may recommend an enhancement procedure or additional surgery to improve the vision. Astigmatism can also be induced during Lasik. This is rare and can normally be corrected with an enhancement procedure.

Flap Issues

• During Lasik surgery, a flap is cut in the cornea, and it is lifted while the laser is applied. At the completion of the surgery, the flap is lowered back into place. It stays in place in much the way a contact stays in the eye, by suction. In some individuals, the flap may become completely detached and slip. Others may experience a fold in the flap. This occurs sometimes due to the inexperience of the physician. It may also be due to head trauma or rubbing of the eyes after surgery. Normally, repairs can be made to correct this.

Long-term Issues

• Because of issues with the corneal flap, some tests after Lasik are questionable. For example, the glaucoma test, which uses puffs of air, often is unreliable and may cause misdiagnosis. Additionally, it is harder to have accuracy when selecting the appropriate intraocular lens implant for cataracts. This problem can be reduced if you make sure to obtain pre-operative, operative and post-operative eye measurements.

Other Potential Problems

• Other relatively common problems include halos or starbursts. These usually occur at night around bright lights and are more common in people with large pupils. Glare and blurry vision are also known complications. There is always a risk of infection or severe bleeding. The cornea may be thinned and there is risk that the retina could detach. Other, more rare errors can occur when there are mechanical failures and the laser is not centered correctly.