Lasik Surgery – Understanding the Risks

Lasik, like all other surgeries, does carry the risk of complications. Though these complications are not fatal, they can compromise the health of the operated eye and have an effect on the vision. The complications are not commonly seen with Lasik procedures especially if the surgeon handling it is highly experienced and knowledgeable.

A look into Statistics

Statistics and studies in the late part of 90’s show that only around 5% of patients who got Lasik treatment experienced complications. This rate according to the professionals has come down to around 1% as the screening and evaluations are done much more carefully than before.

If complications arise, they often are temporary and need no treatment. Some of them will need re-treatment with a second surgery and very rarely is any complication arising out of the procedure permanent in nature.

Complication due to the Flap

A very common complication that arises with Lasik procedure is because of the flap. The flap is that portion of the cornea which is reflected to reach into the inner layers of the eye. Once the flap is reflected, the inner layers are reshaped to take a different shape that will change the way the light falls on the retina. Once the reshaping is through, the flap is placed back and acts like a bandage in protecting the inner layers.

One possible complication is a breach of the flap. The possibility of this is higher if a microkeratome is used. This is avoided by using the IntraLase technique that has made the procedure more precise and avoiding complications from the flap.

If the flap has irregular edges, it may not sit back when replaced after surgery. Another flap complication is when the thickness of the flap is either high or not adequate. This can cause wrinkling of the flap when it is placed back after the surgery. Flap complications might lead to vision problems like irregular astigmatism and distorted vision.

Another flap complication is Diffuse Lamellar Keratitis (DLK). This is a condition where dead cells get ensnared below the flap. The body will react to these foreign particles and it leads to swelling, inflammation and scar formation. The result could be loss of vision permanently if it is not treated in time with medication like antibiotics and steroids. Furthermore, the flap might again have to be reflected and the foreign particles scraped out to avoid further problems.

Irregular Astigmatism

One of the complications of Lasik is irregular astigmatism. This occurs when the reshaping has not been properly performed or the flap has not been properly incised. The common symptoms of this condition include diplopia, double vision or seeing ghost images. This is corrected by performing surgery a second time or by using eye enhancements.

If healing occurs asymmetrically, then also symptoms like double vision and ghost images can be seen. In these cases, the symptoms are temporary and will go away as the healing progresses and there is no need for further treatment.

Overcorrection and Under correction

If the person is suffering from an extreme form of visual problem, the results seen after the procedure is likely to go down gradually due to regression.

Based on the kind of healing that takes place, it is possible to evaluate whether there was any overcorrection or under correction during the Lasik treatment. The outcome that is generally seen if such a thing occurs will not be optimum.

In such a case, the results can be improved by performing a second procedure termed a enhancement.

Keratectasia

Keratectasia can result if the flap incision is very deep or if a lot of tissue is removed at the time of surgery. This weakens the cornea and causes it to become thin and bulged. This causes vision to be distorted that cannot be rectified using enhancement procedure. The only option to correct this is to use a rigid contact lens to avoid the bulging of the cornea.

Dry Eye and Other complications

Another complication commonly seen after Lasik is dry eye. There may be other complications like distorted vision, redness, irritation, inflammation, infection, etc. A few other visual complications include halos in low light and glare. These occur generally due to the treated area being far lesser in comparison to the untreated area leading to changes in accommodation of the eye in low light.

With the improvements in technology and due to the experience of the surgeons in performing the surgery, the complications that arise are becoming much reduced as the times progress.