Type of Surgery
Information
Last updated: 11/24/2009
Surgeons separate LASIK complications into two categories.
Intraoperative risks
- Cornea perforation. This complication has almost disappeared because of advances in microkeratome design.
- Flap complications. Newer microkeratomes...
also have reduced the likelihood of "free caps," where the cap becomes unhinged. An experienced surgeon replaces the cap after ablation. In some cases, the procedure must be aborted while the eye heals. - Laser hot spots. Higher energy surrounding the laser beam can cause irregular astigmatism. Proper laser testing before the procedure eliminates this risk.
- Central islands. This refers to a raised area in the central part of the treated zone that receives insufficient laser treatment. Any raised area can decrease the laser's effectiveness. The island either shrinks by itself or can be remedied with retreatment.
- Decentered ablation. This occurs when the laser beam is aimed incorrectly. This can result in permanent halos and ghost images.
Post-operative complications
- Undercorrection or overcorrection. Undercorrection can usually be treated with an enhancement, but over-correction will require the use of eyeglasses or contact lenses.
- Debilitating symptoms. These can be permanent or transient, and include glare, halos, double vision and poor nighttime vision. Some patients may also lose contrast sensitivity.
- Dry eye. This also can be permanent or transient. Most patients experience some dry eye immediately after surgery. Some patients continue to experience dry eye and are treated with artificial tears or punctal plugs.
- Displaced flap. Occurs after the eye is hit or rubbed. If immediate attention is given by the surgeon, who must lift the flap and clean under it, no long-term effects occur.
- Nonspecific diffuse intralamellar keratitis. Commonly known as Sands of the Sahara, this complication can range from corneal haze to eye clouding that resembles swirling sand. It is treated with topical steroids, although severe cases may require eye irrigation.
- Epithelial ingrowth. The cells of the lower cornea migrate under the corneal cap. The surgeon must lift the cap and remove the cells. If untreated, vision is impaired.
- Striae. These are wrinkles in the flap that can reduce visual acuity. The surgeon must lift the corneal flap and smooth the wrinkles.
- Photophobia. Extreme sensitivity to light can last a few days or a week after surgery.
- Infection. This rarely occurs after LASIK. It is treated with antibiotics.
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Crisp images from our world require that light is focused on the back of the eye. When light cannot focus properly, it is called an error of refraction and is often caused by an irregular or improperly shaped cornea. LASIK improved errors of refraction in the eye by reshaping the cornea, as the animation explains.
In LASIK surgery, the eye is held open with a speculum, and a suction ring is attached to the eyeball (A). A microkeratome is used to shave the protective flap off the top of the eye (B), which is then pulled back (C). A computer-controlled laser is used to reshape the cornea (D), and the protective flap is replaced (E). (Illustration by GGS Inc.)
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Other Information
LASIK or Lasik (laser-assisted in situ keratomileusis) is a type of refractive laser eye surgery performed by ophthalmologists for correcting myopia, hyperopia, and astigmatism. The procedure is generally preferred to photorefractive keratectomy, PRK, (also called ASA, Advanced Surface Ablation) because it requires less time for the patient's recovery, and the patient feels less pain, overall; however, there are instances where PRK/ASA is medically indicated as a better alternative to LASIK.
Other Information
Approximately 56% of all patients achieve results of 20/20 or better and over 90% achieve 20/40 or better (which is good enough to drive without corrective lenses in most regions).1 Those with moderate to high myopia (greater than 7 diopters) have a lesser chance of achieving that result. As technique and technology improve, the results continue to improve.
From: Eye Surgery Education Council
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