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...

Broader corneal characterization with PulseESPI applied to elasticity measurements.

Related Articles

Broader corneal characterization with PulseESPI applied to elasticity measurements.

Eur J Ophthalmol. 2010 Mar-Apr;20(2):306-9

Authors: Gualini MM, Iqbal S, Sixt W, Khan WA, Zulfiqar K

Purpose. A novel application of pulsed electronic speckle pattern interferometry (PulseESPI) techniques in important corneal elasticity measurements is presented in this pilot study. For laser-ablative procedures like laser-assisted in situ keratomileusis, it has been found that elastic properties of the cornea have a role in the outcome of corneal refractive surgery, while for optimal ablative laser power calculations this measurement method may possibly be helpful. It may also help in earlier diagnosis of degenerative corneal disorders such as keratoconus. Methods. The approach of this study is to observe dynamic behavior of cornea against stresses as mapped with PulseESPI. For this purpose, strain was induced to the cornea using a fine rod with a mechanical vibrator. Results. It was found that cornea has a response pattern to the dynamic stressing. Its surface exhibits a resonance frequency which can be measured with PulseESPI. This information of resonance frequency can be characteristic to the cornea. Conclusions. PulseESPI may help in important corneal elasticity measurements used for complication-free optimized ophthalmic surgery. It seems to be a promising method to conduct stress-related investigations on biological samples. To our knowledge, this is the first time that PulseESPI has been used for such ophthalmic measurements.

PMID: 20213620 [PubMed - in process]