Laser-Assisted Refractive Surgery Complications

Written by John Taylor

Laser-assisted refractive surgery is an extremely effective and safe means of improving a patient's vision, but like any surgery there is a risk of complications during and after surgery.

LASIK, LASEK and PRK have all been proven to be safe ways to fix corneal deformities that inhibit perfect vision, in fact, the overall success rates of these procedures is above 90 percent. This success rate doesn't mean that patients won't experience discomfort or less than perfect outcomes from their surgery. While many of these complications are minor and will abate with time, some can have serious long term consequences. Knowing and understanding the possible complications of laser assisted refractive surgery is important for people considering undergoing the procedure.

For the purposes of this article, we'll categorize possible complications of laser-assisted refractive surgery into three groups: intra-operative, short-term postoperative, and long-term postoperative.

Intra-operative complications of laser-assisted refractive surgery include flap complications in LASIK patients. This means the flap the surgeon cuts in your outer corneal layer could be displaced or you could get particles in the flap. The chance of this is very small, about .02444 percent. These complications also are, by large, correctible by your surgeon. Pain is also an intra-operative complication for LASEK and PRK patients, much more so than for LASIK patients, but is managable by sedatives and painkillers adminsitered by the medical staff on duty during your operation.

The majority of complications involving laser-assisted refractive surgery occur in the short-term postoperative period, the first six months after your surgery. These complications include lamellar kearatitis (or dry eye), infection of the corneal flap and subconjunctival hemorage.

The most common complication of all refractive surgeries is dry eyes, which impacts about a third of all laser-assisted refractive surgery patients. This condition usually clears up after a few weeks, but a very small number of laser-assisted refractive surgery patients can suffer from chronic dry eyes.

A subconjunctival hemorage is an incidence of burst blood vessels in the eye which cause the eye to appear red. This condition should clear up in time.

Infection is the most serious short-term complication of laser-assisted refractive surgery. It can occur for a variety of reasons, and have some pretty terrible results, such as necessitating corneal transplant surgery. Following the aftercare advice of your surgeon to the letter is very important to avoiding this.

Other possible short-term complications of laser-assisted refractive surgery include over correction or undercorrection of the patient's vision, fluctuation in the patient's vision, poor night vision, including seeing halos are star bursts around sources of light at night, sensitivity to light, floateers and a macular hole, among others.

A macular hole is a break in the macula of the eye, which is located in the middle of the retina. This can cause blurry vision and is a serious complication of laser-assisted refractive surgery.

Long-term complications of laser-assisted refractive surgery include epithelia ingrowth in LASIK and LASEK patients. This occurs when the epithelia flap created in these surgeries grows inward, causing severe pain and discomfort and difficulty in seeing. Many of the short-term complications of laser-assisted refractive surgery are also long term complications, such as seeing halos, dry eye, poor night vision and sensitivity to light.

Of the three main types of laser-assisted refractive surgery, LASIK usually has the least and the mildest complications and PRK has the most severe and frequent complications. LASEK takes longer than LASIK to recover from, and patients may experience some complications as a result of the chemicals used on the eye during the surgery. Flap complications do not occur in LASEK however, so if your doctor has determined that you may experience flap complications if you have LASIK surgery, LASEK may be a better fit for you.

LASIK patients also notice improvements in their vision before LASEK and PRK patients. If you don't notice an improvement immediately after LASEK and PRK, be patient, it's just taking your eye a little longer to heal.

Overall, the rate of serious complications for laser-assisted refractive surgery is about three percent, which is fantastic... unless you're in that three percent. By understanding the possible complications of laser-assisted refractive surgery, you can evaluate whether you're likely to suffer from these side effects and make an informed decision regarding whether you should undergo the procedure.

Perhaps the best way to avoid complications of laser-assisted refractive surgery is to carefully follow all doctors' instructions regarding your post-operative care. These guidelines were established for your comfort and safety, so it only makes sense to go along with them.