OHSU

Casey Eye Institute at OHSU, Portland, Oregon

Where Healing, Teaching and Discovery Come Together


Risks and Considerations

In qualified hands, LASIK and other vision correction procedures are extremely safe. However, on rare occasions complications do occur and you should be aware of this possibility. Some potential drawbacks of LASIK can include:

Flap Complications: In a very few cases, the corneal flap may wrinkle or shift shortly after surgery. These problems occur in less than 1 percent of LASIK cases at the Casey Vision Correction Center. The problem may resolve on its own, or the doctor may gently smooth or straighten the flap. In some cases, a bandage contact lens may be needed for a short time. Other potential flap complications include infection and debris or inflammation under the flap. These complications are very rare, occurring in fewer than 0.5 percent of patients at the Casey Vision Correction Center. If these problems occur, they can usually be quickly treated with the appropriate eye drops.

Corneal Haze: Fewer than 2 percent of PRK patients and 0.5 percent of LASIK patients experience corneal haze. Haze is most noticeable at night and usually peaks two to three months after surgery. In many cases, the haze is unnoticed by the patient and is only observed by the doctor during an eye exam. In most patients, the haze clears up on its own within a year. Rarely, the doctor will recommend an enhancement to reduce haze.

Dry Eyes: Some people may experience dry eyes temporarily after surgery, although in a few cases it may become a long-term problem. Dry eyes may feel scratchy, itchy, irritated or even watery, but the discomfort can usually be relieved with a type of eye drop known as artificial tears. If artificial tears do not solve the problem, small silicone plugs called punctal plugs can be gently placed in the ducts through which moisture drains from the eye. Punctal plugs are usually only needed for a brief period, but may occasionally be a long-term solution. People who have dry eyes before surgery are more likely to experience dry eye problems afterwards.

Under-Correction or Over-Correction: Although most LASIK patients achieve the targeted refraction, the occasional person may have an unusually aggressive or unusually weak healing response. In these cases, the eye can be under- or over-corrected. Once the healing process is complete and vision has stabilized, the doctor assesses the eye's refraction: if myopia of one diopter or more remains at that time, the surgeon may recommend an enhancement. At Casey Vision Correction Center, enhancements are performed at no charge for one year following the initial surgery.

 

 

Additional Issues For You to Consider

Although not technically considered risks of refractive surgery, the following potential problems should be considered by anyone contemplating refractive surgery.

Impaired Night Vision: Recent media reports suggested a link between LASIK and reduced night vision. However, these were based on an English study that used old lasers on patients requiring high levels of correction. The vast body of evidence from studies conducted at world-recognized refractive laser centers demonstrates an incidence rate of less than 2 percent. In most cases, these effects are not troublesome. It should be noted that night vision problems after LASIK are linked to factors such as large pupil size, unusually flat corneas or the use of a laser with a small treatment zone. Checking for factors that would predispose someone to night vision problems is a routine part of a pre-operative exam at the Casey Vision Correction Center. Casey's excimer lasers can be programmed to treat larger optical zones, thus minimizing the incidence of night vision problems.

Possibly Needing Corrective Lenses. No refractive surgery can promise everyone perfect results, and no reputable surgeon will make such a guarantee. Every eye has its own unique healing pattern, and the occasional person may not heal as expected. In these cases, glasses may be needed for activities such as driving or watching television. In general, the more severe the focusing problem before surgery, the greater the likelihood that an enhancement may be appropriate or that glasses may be needed occasionally after surgery.

Needing Reading Glasses. No eye surgery can prevent presbyopia, so if you already need reading glasses or bifocals, you will still require reading glasses after surgery. If you are in your twenties or thirties, reading glasses will probably become necessary in the next few decades. For some people, monovision (different levels of correction for each eye) may be a viable alternative.