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Concerns with Lasik, PRK, LASEK, Epi-Lasik, etc.

Image of light clouds in a blue sky with floaters obscuring clarity.  
Floaters often appear as tiny 'worms' within aperson's vision,  

Floaters are small particles of the inner eye that float around in the clear liquids and gels within the eye. They are common among all people, but can be created or exacerbated by conventional or custom wavefront Lasik, Bladeless Lasik, and Epi-Lasik. Existing floaters can be disturbed by almost any eye surgery.

Increased Intraocular Pressure

During Lasik, Bladeless Lasik, and Epi-Lasik surgery, the pressure inside the eye is elevated when the microkeratome vacuum ring is attached. Extended elevated internal pressure can cause minor to major detachment of the vitreous or retina. Such detachment can cause floaters or other more serious problems. Although the duration of the elevated pressure during these procedures is short, it may be enough to induce floaters in those who are already predisposed to floaters.

Severe Myopia

People who are severely myopic (nearsighted, shortsighted) have a higher risk of retinal problems because the eye is elongated and the retina is often stretched over this larger than normal eye ball. For this reason, people with extreme myopia tend to be predisposed to floaters.

Changes in contrast sensitivity may cause existing floaters to become more noticeable. Changes in contrast sensitivity are not unusual with refractive surgery, but it is rare the change is significant enough to be problematic.

There is no cure for floaters, however the brain seems to become accustomed to them and will ignore minor floaters.

VitreoRetina Specialist

If you have a history of floaters or problems with the vitreous or retina, it may be wise to be evaluated by a retina specialist before having Lasik, Bladeless Lasik, or Epi-Lasik.

Although there is always the possibility of problems, PRK and LASEK do not require the high inner eye pressure of Lasik, Bladeless Lasik, and Epi-Lasik, therefore PRK or LASEK may be appropriate alternatives.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

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

Recent Floaters Medical Journal Articles...

Related Articles

Objective assessment of symptomatic vitreous floaters using optical coherence tomography: a case report.

BMC Ophthalmol. 2015;15(1):22

Authors: Kennelly KP, Morgan JP, Keegan DJ, Connell PP

BACKGROUND: Vitrectomy for symptomatic vitreous floaters carries significant risks. Justification of surgery is difficult, particularly in healthy eyes with normal visual acuity and without a posterior vitreous detachment. This is the first reported case of optical coherence tomography being utilized to objectively assess the impact of a vitreous opacity on the macula.
CASE PRESENTATION: A 37-year-old Caucasian female complained of the sudden onset of a ring-like floater in the central visual field of her left eye. Visual acuity was 20/20, there was no intraocular inflammation and the posterior vitreous was not detached. Complete blood count with differential, serology screen (including cysticercosis and echinococcus), chest x-ray and abdominal ultrasound found no evidence of systemic infective or cystic disease. A color photograph and B-scan ultrasound confirmed a 4.31 mm free-floating semi-translucent vitreous cyst with a hyperechogenic, pigmented surface and faint internal strands suspended in the mid-vitreous cavity, in the visual axis. The cyst moved with ocular movements, but only within the vitreous lacuna it resided in. Humphrey and Goldmann visual fields were normal. However, spectral domain optical coherence tomography (OCT) demonstrated shadowing on either side of the fovea, consistent with the ring-like scotoma described by the patient. Removing the retinal layers from the 3D-reconstructed macular cube OCT revealed a circular shadow on the macula. The patient elected for conservative management and at 3-month follow-up her symptoms had almost fully resolved as the cyst migrated to the inferior vitreous cavity, no longer casting a shadow on the macula.
CONCLUSION: To our knowledge, this is the first description of using OCT as an objective, qualitative assessment of symptoms caused by large vitreous opacities and may provide a simple yet useful adjunctive tool in evaluating the risk-benefit ratio of vitrectomy in patients with large symptomatic vitreous floaters.

PMID: 25884156 [PubMed - as supplied by publisher]


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