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LASIK RISKS
Although Risks of LASIK are very low, they do exist.  The thoughtful patient can query which personal risk factors predispose their case to any particular complications, and ask the lasik surgeon what special steps may be needed to reduce the risks of these complications.

Some side effects of LASIK are extremely common, such as dry eye or night time glare symptoms in the first month.  While the majority of patients overcome these side effects, a small portion of patients may continue to have severe symptoms.  A patient with large pupils and dry eyes who also depends on excellent night vision for their occupation is probably not a good LASIK candidate because the risk of persistent glare symptoms may outweigh the patients desire to be less dependent on spectacles overall.  Risk and benefit are a patient driven balance.  A physicians task is to assist the patient to make the best decision for their situation and help minimize risk of LASIK or laser vision corrective surgery.

Here is a list and explanation of a few well described LASIK complications, many of which improve and resolve over time with appropriate treatment and conscientious care:

 


  • Dry Eye
  • Nighttime glare or halos
  • residual refractive error/astigmatism requiring glasses or a touch up procedure
  • Irregular flap or buttonhole flap
  • Ectasia after LASIK
  • LASIK flap without a hinge (freecap)
  • interface haze or Diffuse Lamellar Keratitis
  • Flap striae or wrinkles
  • Epithelial ingrowth under the LASIK flap
  • chronic epithelial erosions
 
 
The Following individuals are poor candidates of LASIK because of poor healing issues, increased risk of haze, or other complications:
  • •Accutane use (poor healing and risk of haze)

    history of keloid formation with skin injuries or surgeries

  • •frequent eye-rubbing
  • •those with unreasonably high expectations or no tolerance for any risk
  • •Unstable eyeglass prescription from previous year
  • •<475 microns corneal thickness
  • •Unstable corneal map or topography
  • •caution if < 21 years old
  • •best corrected vision less than 20/20
  • •Advanced glaucoma
 
Following excimer laser corrective eye surgery, the measurement of the steepness of the cornea (called curvature or keratometry values) should be more than 35 diopters and less than 50 diopters.  This range is felt to be the safer zone for a stable cornea and within range to allow for good vision if all other corneal and ocular issues are healthy.
 

Corneal ectasia is a condition where the cornea becomes unstable and has a warpaed shape to the corneal surface.  This may be due to the patient havinig an unstable cornea inherently (see keratoconus) or due to a thinned out cornea having too little tissue remaining in the corneal bed following refractive surgery.  These situations are avoided by avoiding large treatments in patients with thin corneas, and measuring the corneal bed during the refractive surgery.  Today LASIK surgeons carefully screen and avoid unstable appearing corneal surfaces prior to surgery to avoid ectasia risk.

beware post-op curvature!
Accutane use for facial acne has been attributed in the literature to poor wound healing and is felt to increase risk of haze formation after PRK or LASIK.  Patients should discontinue Accutane for 6 months before or after LASIK and consult with their ophthalmologist prior to undergoing vision correction.
    accutane
Buttonhole lasik flaps are at higher risk is those with thinner, steeper corneas and with higher amounts of astigmatism (over 2 diopters). 
  

healed buttonhole LASIK flap

Buttonhole LASIK flaps can heal if placed appropiately.  6 months later a new LASIK flap can be attempted or a patient can undergo a surface laser procedure without a flap called PRK (photorefractive keratectomy).  Mitomycin application to the cornea during this second surgery and oral Vitamin C may be beneficial in reducing risk of haze formation in the second procedure.

Questions or comments?  Email  MyEyeConsultant@gmail.com for more information about LASIK risk or your contribution to our website.  Your experience may benefit others as well!          ~staff

See www.MyLasikConsultant.Com for more information about LASIK and LASIK risks.



 

LASIK RISKS:   SAFETY FIRST!   

PREVENTION IS KEY.

AIM TWICE, SHOOT ONCE.

           

 

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