As with all forms of surgery, Lasik has the potential for side effects. Although these side effects are not considered life threatening, they can affect the overall health of the eye, or eyes, as well as the quality of vision. In addition, complications with Lasik are less likely to occur with a surgeon who is experienced and who has performed the procedure many times.
A study that took place in the late 1990s showed that nearly 5% of people who underwent Lasik surgery encountered some sort of problem. Experienced surgeons, however, are currently reporting a complications rate of below 1% if candidates are screened and selected carefully.
When Lasik complications do occur, most are resolved by re-treating the eye with lasers or by using eye enhancements. Rarely are the complications of Lasik permanent or significant.
The most common form of complications associated with Lasik is problems with the flap. The flap is what is created when the clear front covering of the eye, or the cornea, is cut and lifted to assist in the reshaping of the eye. After the reshaping is completed, the flap is replaced and serves as a form of natural bandage.
On rare occasion, this flap is cut through. This most often occurs when a microkeratome is used for this procedure rather than an IntraLase laser. In fact, IntraLase has been shown to increase the accuracy of the procedure and, therefore, reduce the number of flap complications.
If the flap is cut incorrectly, it may not adhere correctly to the surface of the eye. In addition, the flap can be cut too thinly or too thickly. When the flap is put back in position over the eye, it can start to wrinkle. These flap complications can cause the eye surface to be irregularly shaped, thereby creating irregular astigmatism and vision distortions.
Dead cells can also get trapped beneath the flap. This phenomenon, called Diffuse Lamellar Keratitis (DLK) or, Sands of the Sahara, causes the cornea to react to the presence of this foreign matter, which leads to inflammation and scarring. This can potentially lead to permanent vision loss if not treated promptly with topical steroids and antibiotics. In addition, the flap might need to be lifted and scraped in order to remove the infiltrates and the resulting growth.
Irregular astigmatism can also result from Lasik surgery. This complication results when the corneal surface. This happens when the laser correction is improperly centered on the eye. The symptoms of this complication include double vision, or diplopia, or ghost images. This can generally be remedied by re-treating the eye or by using enhancements.
Irregular healing of the cornea or swelling after the surgery is complete can also cause ghost images or double vision. In this case, the symptoms are likely to disappear without additional treatment once the healing process is finished.
Overcorrection and Undercorrection
A person with severe visual problems is more likely to encounter a gradual decrease in visual acuity over a period of time after Lasik. This is known as regression.
The healing response of each person receiving Lasik can also determine whether or not overcorrection or undercorrection occurred. Both of these situations can also lead to less than perfect results.
With all of these scenarios a follow-up procedure with Lasik, known as enhancement, can alleviate the problem.
If the flap is cut too deeply or if too much tissue is removed from the cornea during the Lasik procedure, keratectasia can occur. This condition causes the cornea, which has been weakened, to bulge. This can result in distorted vision that is unable to be corrected with laser enhancement. In this case, a rigid contact may be put in place to help hold the cornea in place.
Dry Eye and Other Problems
Dry eye can also occur after Lasik surgery. In addition, infection, inflammation, redness, irritation, and visual distortion can occur. Some patients report seeing glares or halos around objects that are brightly lit at night. The Lasik treatment zone being too small can cause these complications, because it is unable to accommodate the larger size of the pupil while in a lowly lit area.
As surgeons become more and more skilled with performing Lasik eye surgery and technology continues to advance, the likelihood of developing complications from this innovative procedure decreases.
Image: Wellcome Images