Complication Prevention and Resolution

Looking at a long list of potential complications from refractive surgery can be overwhelming. When put into proper perspective, the issue may not seem so dire. There are a gazillion things that can go wrong with any surgery, just like there are a gazillion things that can harm you every day. For most people considering refractive surgery, the more important issue is the probability of something going wrong, not the possibility. Also, it is very important to distinguish between the rate of occurrence of a problem and the rate of an unresolved problem.

It is important to remember that refractive surgery is often more a six-month process than a 20-Minute Miracle. During those six months, treatment may include medications or even an additional enhancement surgery. Fluctuation in vision quality is normal, minor haze, halos, often resolve within weeks, temporary dry eye is relatively common with Lasik and All-Laser Lasik. Nearly all problems that can occur have a resolution available, although that process may be undesirable.

We have listed the most commonly reported complications of the most common refractive surgery techniques. Although these are the most commonly reported complications, they are not very common. About 3% of refractive surgery patients have unresolved complications (all procedures and all kinds of problems combined) at six months after surgery, with about 0.5% of those being complications that require extensive management or aggressive intervention. See Lasik Eye Surgery Expectations. There are a small percentage of refractive surgery patients who have long-term complications.  The possibility of a long-term complication will always exist, even if the probability is very, very small.

A competent doctor will provide every patient with an informed consent before surgery. This document needs to be read closely and fully understood. It will provide a more comprehensive list of potential problems. It is wise to discuss with the doctor the probability of having one of these problems, based upon your own individual circumstances.

Conventional or Custom Wavefront Lasik and All-Laser Lasik
Dry eyes
Over/undercorrection
Halo around light sources
Starburst from light sources
Ghosts/double vision
Light sensitivity
Wrinkles in flap (striae)
Decentered ablation
Unstable cornea
Debris/growth under flap
Epithelium erosion

PRK, Wavefront PRK
Over/undercorrection
Visual acuity fluctuation
Halo around light sources
Starbursts around light sources
Decentered ablation
Corneal Haze
Epithelium erosion

LASEK, Wavefront LASEK, Epi-Lasik, Wavefront Epi-LASEK
Same as PRK plus
Loss of epithelial flap

CK
Over/undercorrection
Visual acuity fluctuation
Light sensitivity
Glare sensitivity
Induced astigmatism
Regression

Intacs
Over/undercorrection
Visual acuity fluctuation
Light sensitivity
Glare sensitivity
Induced astigmatism

P-IOLs
Over/undercorrection
Endothelium cell loss
Trauma induced cataract
Induced astigmatism

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

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Current Lasik Medical Journal News...

A retrospective comparison of efficacy and safety of 680 consecutive lasik treatments for high myopia performed with two generations of flying-spot excimer lasers.

Related Articles

A retrospective comparison of efficacy and safety of 680 consecutive lasik treatments for high myopia performed with two generations of flying-spot excimer lasers.

Acta Ophthalmol. 2010 Jan 22;

Authors: Gazieva L, Beer MH, Nielsen K, Hjortdal J

Abstract. Purpose: To compare the visual refractive outcome and complication of laser in situ keratomileusis (LASIK) carried out with a Carl Zeiss-Meditec MEL-70 Excimer laser and a MEL-80 laser for treatment of high myopia. Methods: Journal records of 680 consecutive eyes that underwent LASIK with a Schwind Supratome microkeratome and a MEL-70 Excimer laser (Group A), or a Moria M2 microkeratome and a MEL-80 Excimer laser (Group B) were reviewed. Manifest refraction, uncorrected and best spectacle-corrected visual acuity (BSCVA), corneal topography and central corneal thickness (CCT) were recorded before and 3 months after treatment. Pre- and postoperative complications, visual and refractive outcome and frequency of retreatments were registered. Results: Mean preoperative spherical equivalent refraction was -8.52 dioptres (-5.50--18 dioptres), and the mean attempted laser correction was -8.02 dioptres (-5.50--11 dioptres). Three months after LASIK, the average treatment error (difference between achieved and attempted correction) was 1.20 (SD = 1.19) dioptres of under correction in Group A and 0.52 (SD = 1.00) dioptres in Group B. Four eyes lost more than two lines of BSCVA (0.6%). In 110 eyes (16%), a re-LASIK procedure was performed to reduce remaining myopia after the primary procedure. Conclusions: Laser in situ keratomileusis treatment for high myopia can effectively reduce high degrees of myopia. Under correction was observed in both treatment groups but Group B has a slightly better predictability. Significant loss of BSCVA occurs infrequently after LASIK for even considerable grades of myopia (0.6% in each group).

PMID: 20102346 [PubMed - as supplied by publisher]