Risks of Laser Eye Correction Surgery
One key to satisfaction is having realistic expectations. Although up to 98% of patients will see 20/20 without glasses (depending on your prescription), laser vision correction is still best seen as a procedure that decreases your dependence on glasses or contacts. For example, you may still need corrective lenses for specific activities such as night driving or reading; safety glasses for work or with certain recreational activities (ex. racquet sports).
General Risks
Complications Mainly With PRK
Complications Mainly With LASIK
Complications Mainly with LASIK (with a Blade Microkeratome)
General Risks
Over-correction and under-correction
The healing that happens after your procedure is just as important as the procedure itself in determining your final result. Several factors affect how you heal. These include your initial prescription, the condition of your eyes, and your individual healing pattern. More correction is needed with a stronger initial prescription, requiring more healing. This increases the likelihood that one treatment will not be enough. If a second treatment is necessary, it is normally done no earlier than three months after LASIK, and no earlier than four months after PRK. LASIK patients requiring another treatment do not usually need another flap made.
If you are over-corrected after laser vision correction for nearsightedness, you may need reading glasses earlier than expected. Patients with lower levels of nearsightedness are able to remove their glasses for close tasks. After laser vision correction, this advantage is lost.
Infection
The possibility of infection is rare for both PRK and LASIK. Infection, if is does occur, can lead to permanent damage to the cornea and loss of vision. Keeping your follow-up appointments and using your eye drops as directed are important to minimize this possibility. The chances for infection are approximately one in 5,000 for LASIK and one in 1,000 for PRK.
Night Glare
Some patients may have haloes or night glare even before laser vision correction. This may worsen or begin immediately after laser vision correction. For most patients, this will resolve with time, ususally within several months. In a small percentage, however, this may be permanent. Advanced CustomVue™ WaveFront laser vision correction, however, increases the likelihood that your night vision will be maintained or even improved.
Loss of best-corrected vision
Less than 1% of patients will lose some sharpness of their vision. This means that the bottom line(s) of the vision chart that you were able to read with your glasses or contacts before laser vision correction, might not be readable afterwards. This is more common immediately after the procedure and tends to improve with time.
Link to FDA Approval
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Complications Mainly With PRK
Corneal Haze
Mild haze is often seen in the first few weeks to months after PRK. It usually does not affect vision and typically clears within several months. Significant haze happens in less than one percent of patients, and occurs usually when higher prescriptions are treated. When needed, haze can usually be removed with another excimer laser treatment.
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Complications Mainly With LASIK
Epithelial Ingrowth
The epithelium is the thin layer of tissue that covers the outer surface of the cornea. Occasionally, the epithelium may grow under the corneal flap. This occurs approximately 0.2% of the time with the initial surgery. It does not usually require treatment if it is only at the edge of the flap. If the epithelium continues to grow, however, gently lifting the flap and removing the epithelium may be needed. Retreatments (enhancements), have a higher rate of epithelial ingrowth, and may occur as high as 6% of the time.
Flap displacement
This occurs in less than 0.5% of cases usually within the first month after laser treatment. Inadvertent bumping or an injury is usually the cause. It may, however, occur months or years after surgery if a significant eye injury occurs. If the displacement is significant, the flap will require repositioning. 100% blade-free lasik with IntraLase® , has a lower likelihood of this occuring.
Interface inflammation
This inflammation has been described as “Sands of the Sahara” or diffuse lamella keratitis (DLK). There are a number of reasons why this may occur. If inflammation does happen (incidence of about one percent), steroid drops are used. Steroid drops usually resolve the inflammation with no effect on vision. Severe DLK occurs in approximately one in every 1500 cases and may require lifting of the flap.
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Complications Mainly with LASIK (with a Blade Microkeratome)
Difficulty Creating the Flap
This problem occurs in less than 1% of cases with LASIK when a blade microkeratome is used. Although uncommon, it can have a significant impact on vision. The characteristics of some eyes may make it more difficult to create a flap. This may result in too short a flap, an irregular flap, or too thin a flap. Should these occur, the flap must be repositioned, and the procedure stopped. The cornea is allowed to heal for several months. The procedure may be redone no earlier than three months later. Usually the flap will heal smoothly causing no loss of vision. If irregular healing occurs, a loss of best-corrected vision may result.
Although a poor quality flap may also occur with IntraLase®, to date (this is July 2007 after 3 years of using IntraLase®) this complication has only been a theoretical risk, and has not occurred.
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