A lot of hype and speculations has been around on the validity of LASIK surgeries because of the fear of complications and risks that may develop after surgery. As we go through this article we will try to dissect all the myth that has been around, not to mention that this article is not supplementary of preoperative discussion with the surgeon, it is rather a trial to help the audience to construct a general idea about the complications of this type of surgeries.
Unrealistic predictions and expectations:
This is the most common complication after surgery because the patient has expected something that is not fully applicable in his case. A wrong belief that LASIK surgeries eliminate the need for spectacles is the origin of this complication. It is better to think about LASIK surgeries as a method to enhance the quality of life of patients by decreasing the dependence on spectacles but eventually this type of surgery doesn’t eliminate the need for spectacle wearing. Some patients after undergoing LASIK surgery might need a reading spectacle prescription afterwards, some other might need to wear spectacles to perform fine activities especially at night and in dim light. To solve this problem the patient has to define a set of milestones that he wants to achieve post operatively without wearing spectacles and discuss them with the surgeon so as to get to know what is applicable and what is not regarding his case.
This is a common temporary manifestation after LASIK surgery because the peripheral nerves in the cornea are cut while the flap is made, so the patient might feel sandy or unpleasant sensation for the first 1-3 months, that why artificial tears eye drops and lubricating eye gels are extremely important in that period until regeneration of the nerves and restoration of the normal function of the cornea. It is extremely important to till the surgeon if you had suffered from dry eye symptoms before whether while using spectacles or contact lenses so that he can perform a full assessment of the condition of the eye prior to surgery.
Over and under correction:
Over and under correction although not very common put still they do occur. All refractive surgeons do their best to minimize the incidence of that complication by continuously developing the normogram patterns they use, but humans are not pieces of metal that you can put in a molding machine to get exactly the same result. Every human body is unique and even the response of the same body to the same event might differ from time to time according to the general health state. The majority of these results are often temporary but they will need follow up up to 3 months so the surgeon can determine whether they are temporary or permanent effects as permanent effects might need an enhancement procedure to correct.
Night glare and halos:
The normal human lens peripheries scatter light in a non-uniform way but this is usually unnoticed except if the pupil is fully dilated as in low light conditions as at night. The older versions of the excimer lasers used in LASIK surgeries had limited treating zones so some patients used to complain of seeing halos and starbursts especially at night when their pupils dilate beyond the treating zones. This is almost not seen now with the new generations of eximer lasers with wider treating zones.
Corneal flap complications and corneal abrasions:
The most important in this category is the corneal flap shifting after operation resulting in wrinkling and striae which might affect the quality of vision these striae were in the central cornea. Avoiding eyelid touching and rubbing of eyes is of supreme importance to avoid these complications. Corneal flap repositioning can be done later with restoration of the clarity of vision and with almost no sequelae.
Other extremely rare complications include:
1. Loss of Best Corrected Vision.
2. Epithelial Ingrowth.
3. Diffuse Lamellar Keratitis (DLK).
4. Infection or Severe Inflammation.
In a nutshell:
LASIK Surgery is considered one of the most successful surgeries in history thanks to; a high success rate, a very low complication rate and durability of results over long periods of time. Like any other treatment modality, LASIK surgery is not free of complications but these complications are very rare and mostly patient dependent. On the other hand LASIK surgeries have contributed in the enhancement of the quality of thousands of people by minimizing their dependency on vision aids in performing most of their daily activities.