Risks of LASIK Surgery

LASIK surgery is all the rage. If you don't already have it you probably know someone that does, and you are here to find out how you can take advantage of technology without harming your health, right? Great!

While LASIK surgery provides patients many benefits, it is not without risk. As with any surgery, the complications or risks of LASIK surgery should be weighed against the benefits of surgery. Before getting involved with any surgery, you should educate yourself about the risks. This is true of LASIK, IntraLase, PRK and all other types of LASIK surgery available today.

LASIK Complications - Common & Uncommon
There are several complications associated with LASIK procedures, some more prevalent than others. How do you know if you have to worry? Most studies conducted during the late 1990s suggest the risk of complications averaged 5%.

Since that time however, newer technology and better-qualified surgeons now report the risks associated with LASIK are more along the lines of 1%. This of course, only applies to patients that are meticulously screened prior to surgery. The good news is most of these complications resolve relatively quickly after surgery. Other side effects are temporary and resolve with time. It is your job however, to talk with your LASIK surgeon to identify these common risks and find out what steps you might have to take to correct them should something go awry.

Among the more commonly reported complications of surgery are flap complications. Flap complications occur in the hinged flap covering the front of the cornea. Usually patients undergoing traditional microkeratome LASIK are more at risk for flap complications than are patients undergoing other more precise procedures including bladeless LASIK. With traditional LASIK procedures, doctors typically lift the corneal flap they created to reshape and/or resize the cornea then replace this flap. Basically, the flap serves as a bandage or covering that protects the cornea following surgery.

One of the risks associated with cutting the flap using a microkeratome is abrasion. This means the flap may be cut incorrectly or scratch the surface of the cornea, or have "rough" outer edges, all of which may result in visual disturbances following surgery. While some of these will go away with times, others may be permanent or result in permanent problems, including haloing or the need to wear glasses even after surgery!

However, new technology including use of IntraLase technology has limited this risk significantly. Bladeless LASIK allows surgeons to create a corneal flap with lasers, which are far more precise than the "crude" microkeratome, although patients have reported good and bad outcomes with each.

Some studies suggest cutting a flap and then using custom LASIK procedures may result in adverse outcomes, in part because surgeons don't use custom procedures to create the hinged eye flap. Therefore replacing it over the reshaped cornea may result in less than optimal outcomes. If your doctor wants to cut a corneal flap using a microkeratome and then customize your LASIK procedure, be sure to ask your surgeon why they want to do this. Ask them what will happen if they replace the corneal flap and it doesn't fit right. Again, you always want to make sure you are looking out for your best interests. While in theory the surgeon will be doing this too, ultimately it is up to you to decide whether you will or will not have surgery and with what physician.

Another risk associated with LASIK is Diffuse Lamellar Keratitis or DLK. Many call this disorder the "Sands of the Sahara". It results when dead cells lodge beneath the corneal flap and the cornea. The cornea mistakenly assumes these cells are harmful and initiates an inflammatory response. If this happens, your eye may swell up and shut so you cannot open it. Alternately you may develop an infection or start to feel sick as your immune system kicks into super drive as it attempts to fight off the "foreign" invaders. Unfortunately this may result in scarring, and permanent vision loss may occur if prompt treatment is not initiated. How do you address this risk? You should ask your surgeon if they have experience handling this type of complication before surgery. If not, find out who does and talk to them. Find out what the risks are given you unique surgery, and what signs and symptoms you should look for to detect this type of complication early.

Ultimately, you should ask your doctor and surgeon long before your first surgery what the most important steps are to care for your eye and reduce the risk of infection. You should also have a detailed list of signs or symptoms to look for that may suggest something is awry. Be sure you have your doctor's on call number or the number of someone you should contact if you suspect something has gone wrong with your surgery. Do not delay, because you may risk permanent injury or vision loss.

Irregular Astigmatism
One other common but not always talked about side effect resulting from traditional LASIK procedures is "irregular astigmatism". This can result when laser correction isn't conducted properly or when the corneal surface is not smooth. Remember that LASIK surgery is a precise surgery, and the tiniest misjudgment or slip of the hand may result in undesirable consequences. How do you know if this happened?

First, you should ask your doctor if they know of this complication and if they do what signs they want you to look for. Remember, the key again to your good health is proper knowledge. Different surgeons will have different ideas about what the signs and symptoms as well as treatments are for this complication or any other.

So you know SOME information, the symptoms can include seeing double or experiencing blurry vision. This may result in vertigo, instability or dizziness. Many patients experiencing this complication will need additional surgery to correct the problem.

Sometimes double vision is caused not by astigmatism however, but by minor swelling after surgery and resolves after healing has occurred. If you are concerned about your vision following surgery, talk to your doctor. Ask your doctor if you can take anti-inflammatory to prevent swelling, and if not, what you can do to minimize your risk of infection.

Other Common Complications
Here is a list of some other complications associated with LASIK:

Keratectasia - This condition results when a surgeon cuts the flap too deeply or removes too much tissue during surgery. This results in weakening and bulging of the cornea. Distorted vision may be permanent.
Dry eye - Dry eye is a much more commonly reported side effect of LASIK surgery. This can contribute to inflammation and infection, but is typically resolved using artificial tears. While most people will not experience dry eye permanently, it can become a long-lasting complication of LASIK, especially if you have dry eyes before surgery. You should make a point to ask your doctor about dry eye and assess your risk for it before agreeing to surgery.
Infection - Some patients will develop infections following surgery. Fortunately the risk of infection is relatively low. Some doctors prescribe prophylactic antibiotics to help reduce the risk of infection.
Night Vision Problems - These are more common when surgeons use traditional LASIK procedures. They may also result when the surgeon treats too small of an area surrounding the pupil. This often happens, so you should make a point to ask your surgeon if he or she can assess your risk for this. It won't help you much if you see well during the day, but can't drive alone at night. Night vision problems may include seeing halos or lights around objects, making it difficult to drive. You may also find you see glares that impair your ability to see well. Sometimes these symptoms do not resolve. The more experienced your surgeon, and the healthier you are, the less likely you are to suffer from side effects as this.
Over or under correction - This can result in blurry vision or minor visual disturbances. Many times patients will have to wear contact lenses or glasses to resolve the problem. Some people become quite upset when they find they still need glasses to read after undergoing LASIK surgery. The whole point for most people is to avoid having to wear glasses. Ask your doctor what your risk is for this side effect, and then get a second opinion. Know that re-treatment with the laser is often possible and can sometimes correct the under or over correction. While it sounds a bit funny, if you suffer from this you will not feel like laughing, so be sure to talk with your doctor thoroughly before you go under the knife.
Slow healing or complicated infection - People with compromised immune systems including those with chronic autoimmune disorders or those taking an immunosuppressant are more at risk for complications following surgery, often because their bodies take a lot longer to heal than others. You should always mention any health conditions you have before surgery. Your doctor may prescribe prophylactic antibiotics or administer them during surgery to help reduce your risk of infection.
Permanent vision loss - Sometimes LASIK doesn't work; if this happens you may find your vision worse than before surgery, and you have no choice but to wear even stronger glasses than before. While this is rare, it is something to ponder. Make sure you find out whether you are at risk for this, and what your surgeon's policies are should something like this happens to you.

Read The Fine Print
Most people will undergo LASIK surgery with few complications. Some people are more at risk than others, which is one reason you should talk to a qualified physician, and always seek a second opinion even if you feel comfortable with the first surgeon you talk to. Remember, laser surgery can permanently change the shape and size or your cornea. You only have one pair of eyes, so you want to maximize your potential for a positive outcome.

Most of the time, any risks or complications you may face are listed in a patient disclosure form you receive before surgery. Don't just sign this form; make sure you go over the risks once again with your doctor BEFORE you sign this. Many people do not realize often these disclosures have a clause that releases the surgeon from liability if you lose your vision or your surgery does not go well, which means you will have no recourse if something happens. You don't want that to happen.

Now that you are scared to death of LASIK, please know most people enjoy the surgery with few complications.

It is important you carefully weigh your risk of complications and side effects when talking with your doctor. Your doctor can help you make an educated decision and decide whether the benefits of surgery outweigh the risks. Remember a positive attitude can go a long way toward achieving your health goals, so go into surgery if you choose with a smile on your face, and you will probably walk out with one too!

This Article contributed by Snappy Writting

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