LASIK, like any other surgical procedure, comes with some risk of complications. While majority of people have an uneventful procedure, you have to be aware of the possibility of some adverse events, and arm yourself with information to reduce risks where possible!
Here is a non-exhaustive list:
Flap Complications
Flaps that are made too small, too thin, incomplete, or become detached
In order to minimize the risk of flap complications, the surgeon may recommend to opt for bladeless LASIK, where the flap is created by a femtosecond laser rather than a traditional blade (microkeratome). This is what I chose for my own procedure.
Infection
Just like any surgery, infections can happen with LASIK although they're extremely rare (0.005%)
Infections are treated with antibiotics and may lead to scarring and permanent vision loss depending on the severity.
Dry Eyes
One of the most common side-effects; many patients experience dry eyes in the first few month post-LASIK, however some experience chronic dryness beyond this period
Dry eye is an exclusion for LASIK. Patients who have dry eyes before LASIK are more likely to experience dry eyes after LASIK
Dry eyes can be treated with Artificial Tears, Hot Eye Compresses, or punctal plugs
Halos & Starbursts
Some patients experience halos & starbursts around lights after LASIK; these aberrations around light can make night driving difficult
Many patients only experience this for a few weeks to months after LASIK, but the effect may be permanent in 1-2% of patients
People with larger pupils or higher refractive errors are more likely to experience halos & starbursts
Wavefront-guided LASIK is customized to your unique eyes, and thus reduces the likelihood of experiencing halos & glare. This is an optional upgrade at some surgery centres, and this is what I chose for myself. The results of wavefront-guided LASIK are superior to conventional LASIK.
Ectasia
Rare (0.03%) but one of the most devastating complications of LASIK. Progressive weakening of the corneal structure leading to irregular astigmatism, bulging of cornea, and vision loss
The risk of ectasia is reduced by screening out ineligible candidates who have corneas that are too thin or irregular, or have corneal degenerative conditions such as Keratoconus
Diffuse Lamellar Keratitis (DLK)
Inflammation under the corneal flap occurs in 5-10% of patients; the body's immune system is overreacting to the 'wound' created by the surgery
It can be treated with steroid therapy but must be treated promptly or loss of vision will result
Trauma / Flap Dislodgment
The corneal flap is susceptible to trauma and dislodgment, especially in the first 3 months following the procedure. It is recommended to wear protective eyewear during sports.
People who play contact sports should consider PRK instead of LASIK.
Debris under the Flap
This is why it is important to manage blepharitis (have good lid hygiene), avoid wearing wearing makeup for 1 week before surgery, and avoid wearing wool/fleece on surgery day
Transient Light Sensitivity Syndrome (TLSS)
Rare (1 in 100 -1000) and not permanent
Intense sensitivity to light that can be treated with steroid drops
Occurs with femtosecond laser bladeless LASIK, and is one if its main disadvantages
Corneal Neuralgia (Severe Corneal Pain)
This is a rare complication, and occurs in 1 in 20,000 LASIK patients
Corneal nerve cells become overly sensitive after healing from surgery, and signal too much to the brain resulting in severe persistent localized pain
Persistent Post-operative Pain (PPP) syndromes can occur with other types of surgical procedures as well, not just LASIK
Now that you know the POTENTIAL RISKS, you can make an informed decision. Keep in mind that most complications are RARE. Choose an experienced eye surgeon you trust who can advise you.
So you still want LASIK? Stay tuned to learn about my personal experience!
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