No
surgery is risk-free. The vast majority of Laser Refractive Surgeries, such as LASIK and PRK, cause no significant side effects or long term problems. The majority of patients, especially patients who have difficulty wearing glasses or are contact lens intolerant (or because of their profession, like policemen & firefighters) have benefited from LASIK for years.
However, complications do occur and in some cases can be very debilitating. Some complications have required patients to have multiple surgeries and have a permanent loss of vision. Many of the common side effects, such as dry eye
or other discomforts, clear up within a few days to a few months. But some complications can be catastrophic and
require further surgery or cause permanent damage.
The most
common issues/risks/complications after LASIK and PRK include:
1. Over- or under-correction of vision, requiring glasses or contacts after surgery
This is the most common issue after LASIK which does not require a re-cutting of the cornea but does require a re-lifting and re-treating. Each re-lifting of the cornea increases the risk of infection, epithelial (the front corneal surface) ingrowth, and corneal inflammation.
2. Regression
This is also very common. Regression is when the LASIK resulted eventually in great vision, but over time, the cornea has changed and the need for glasses has returned. Laser re-treatment is often needed.
3. Chronic foreign body sensation or burning from permanent dry eye
This is the third most common complication I have seen after LASIK. Dry eye symptoms go away in most patient after 6 months, but some remain for years or return after years. This can be truly debilitating and even lead to a permanent loss of vision.
Do not have LASIK if you already have dry eye symptoms, any arthritis, Lupus, Rheumatoid Arthritis, or any other inflammatory condition as the long term risks are too high for chronic dry eye.
4. Halos, glare, or double vision: can make night driving difficult
This is the 4th most common complication I have seen after LASIK and PRK. Again most of these symptoms improve over time, but some of the most unhappy patients have chronic halos and glare. Part of this is due to chronic dry eye.
5. Laser surgery creates issues if a patient needs future cataract surgery. This is not a complication but a current fact. Choosing the right implant for a patient for cataract surgery is more difficult if the patient has has laser correction in the past. New technologies help, like the ORA machine which I use. Still the risk of needing an implant exchange is higher.
6. Infection.
This is rare but a devastating condition as it can lead to loss of part of the cornea (the corneal flap) and lead to permanent vision loss requiring a corneal transplant.
7. Corneal Epithelial Ingrowth:
This is rare: where the corneal epithelium grows under the flap. This will need to be removed to avoid long term scarring and decrease vision.
8. Endophthalmitis.
This is very rare but can lead to permanent loss of vision even with multiple surgeries.
Avoid if have severe dry eye condition or other corneal diseases
(Kerataconus), Glaucoma, have lens changes. Discuss with MD: risk of
still needing glasses, regression, touch ups; & if mono vision when
older; know laser surgery can make cataract surgery later in age more
challenging: in getting the right implant power. Biggest risk of LASIK
is chronic dry eye in most patients.