Possible Risks, Side Effects and Complications of Laser Eye Correction

At Medownick Laser Clinic, we won’t take unnecessary risks with your eyesight. We will only perform your treatment if we are confident that we can improve your vision. We advise more than 30% of our patients not to have laser vision correction, because they are not Ideal Laser Vision Candidates.

Over 40 countries are currently using Laser Vision Correction. Around 30 million treatments have been performed worldwide. Results for all countries are similar and consistently positive.

Our thorough patient screening process minimizes any risk, and following surgery, your eyes are carefully monitored and treated for as long as it takes for them to settle down. Fortunately, serious or long term complications are extremely rare.

As with any type of surgery, in any medical category, complications are possible. You should not be alarmed, the potential risk is small, but you need to be aware of them. We  will discuss risks and benefits of Laser Eye Surgery in great detail in your particular case during your Free No Obligation Consultation. Knowing your eyes in fine detail means lower risk and better results. So we never rush the Screening Process.

We will help ensure successful recovery after your Laser Eye Surgery with comprehensive, detailed aftercare. Read on about The Medownick Care Policy.

The complication rate of Laser Eye Surgery is very low and problems can usually be readily treated. Complications will be more common in patients with high amounts of refractive errors, because these patients require larger amounts of treatment. Complications will be more common with LASIK procedure than with Surface Laser Treatments (“Lasik without a Flap”, Lasek, Advanced Laser Surface Ablation or Advanced PRK).

For your information, we have listed some of the side effects that can occur, and how they can be treated. Fortunately, most side effects and complications resolve within three months of surgery and they do not result in long-term vision problems.

The final outcome of laser procedures is dependent on the individual healing process of each patient, sometimes resulting in under or overcorrection. Although a final visual outcome can be suggested from studies of large numbers of patients, and visual results can be considered reasonably predictable, the final amount of correction cannot be absolutely guaranteed. For your peace of mind, we offer a  Lifetime Aftercare Program

By far the most common complication of Laser Eye Surgery is Under-Correction or Over-Correction. This occurs because the patient absorbs slightly less or more of the laser energy than anticipated, or because the patient experiences an abnormal healing response. Further laser treatment, known as an “Enhancement” or a “Touch-up”, can then be used, usually resulting in excellent vision without glasses or contact lenses. The chance of under-correction or over-correction will be more common in patients with high amounts of nearsightedness, farsightedness, or astigmatism, because these patients require larger amounts of treatment.

Under-Corrections and Over-Corrections are the main reason that not all patients have perfect uncorrected vision after the initial laser treatment.

Corneal Healing Haze occurs to some degree with all patients, particularly during week six to eight following treatment. This is usually controlled by increasing the dosage of eye drops. It causes few, if any symptoms. The degree of healing response varies between patients due to age, health, and the severity of the refractive error being treated. It may take up until a few months before stable vision is restored. A small number of patients may require temporary glasses for this period of time. Healing Haze is becoming much less common with our more advanced laser surgery techniques and our refined technology.   You should avoid UV light exposure for a few months after Laser Eye Surgery to obtain optimal results. It means you should always wear protective sunglasses while outside and avoid skiing and surfing during this time.

Following Excimer Laser you might experience minor pain or some discomfort for a short period of time. We will provide you with anesthetic eye drops and medication so this can be controlled.

The cornea’s healing process may cause a loss of contrast sensitivity, which can result in poorer quality vision in low light or so called Night Vision Problems. This is very similar to Halos/Starbursts and Healing Haze, in that these difficulties are related to the healing processes and are temporary in nature. Loss of low contrast vision is a normal consequence of treatment, but causes symptoms in only a minority of patients. Usually, once the healing process is complete, the contrast sensitivity shows a return to normal levels without intervention.

At night and in dark conditions, the pupil becomes larger to permit the maximum amount of light to enter the eye. Laser Eye Correction needs to take this fact into account. If the optical zone is smaller than the size of the pupil at its largest, there is a good chance that the patient will experience poor night vision or problems with glare and halos around bright objects such as oncoming headlights. Our Laser – the ALLEGRETTO WAVE® Eye-Q is able to produce a larger optical zone, virtually eliminating Glare and Night Vision Problems associated with older generation lasers.

The ALLEGRETTO WAVE® Eye-Q customizes every treatment to the patient’s individual prescription and cornea while aiming to improve what nature originally designed. Wavefront Optimized™ treatment considers the unique curvature and biomechanics of the eye, preserving quality of vision and addressing the spherical distortions than can induce glare and night vision reduction.

Altering the shape of the cornea with the Excimer Laser results in a temporary increase in the higher order aberrations of the eye. These have the effect of creating Halos around lights (induced spherical aberration), or distorting bright points of light into Starburst effects. These are more evident in low illumination, hence the fact that they are only reported at night.

Less than 2% of laser vision correction patients will experience increased optical aberrations, including Glare or Halos at night.

You may experience increased Glare from oncoming headlights or bright light sources at dusk or night time during stabilization, or even permanently.

Every person, even if you have never had Laser Eye Surgery, to some degree has Glare or Halos when viewing a bright object against a dark background. Most people are not aware that they have glare or halos. You can demonstrate this to yourself by going outside, away from other lights, and viewing the moon; every person will notice a small glow or unevenness around the edge of this bright object. After laser vision correction, increased glare or halos is common during the first three months of healing especially with Lasik. After the initial healing period, only a very small percentage of people will have more glares or halos than prior to the treatment and a greater number of people will experience a decrease in the glare or halos. Large pupil size in low light in combination with a high amount of correction is more likely to result in increased glare or halos. Use of the newer lasers, with eye trackers and substantially larger treatment areas, has dramatically improved this problem.

The healing process takes time to complete and the aberration increase is evident for approximately 3 months. At Medownick we  routinely perform Wave Front optimized treatments on all patients, which specifically reduce total post-operative aberrations.

Your eyes might develop sensitivity to light during the 3-6 month stabilization period, or in rare cases, even permanently.

Many patients will experience Dryness or Dry Eye Syndrome during the first weeks or months following treatment. Dryness is most common in people who have a lot of dryness prior to laser vision correction. Eye drops or pills are used to control the dryness, which usually resolves by three months after treatment. Dryness is usually more severe with LASIK than with Surface Laser Treatments . A small number of patients may need an additional treatment for dry eyes.

Complications affecting the health of the eye are extremely rare, but are possible. During the early healing phase, the eye is susceptible to Infection. You will be asked to follow certain instructions, including using antibiotic eye drops. Carefully following these instructions will decrease the infection rate to far below 0.5%. Even if an infection does occur, use of antibiotic eye drops will almost always control the infection.

If  before Laser Eye  Surgery you could not see 20/20 with your glasses, most likely your vision will not be 20/20 after  Laser Eye Surgery.

As we acknowledged earlier, any surgical procedure can cause theoretical complications, and it would be impossible to list them all here. Some of them are extremely rare and might include recurrent ulceration.

Steroid eye drops are very important after laser vision treatment, because they are used to control the healing response. However, if used improperly for too long, these drops can cause cataracts or glaucoma. It is very important to go to all scheduled follow-up appointments, especially if you are still taking steroid eye drops.

Less than 1% of laser vision correction patients experience some loss of best-corrected vision, which is the best vision possible when using glasses or contact lenses. It is more common with the LASIK procedure than with Surface Laser Treatments . Many patients will experience an improvement in the best corrected vision. Of course, you probably will no longer use glasses or contact lenses for distance vision after the surgery, so you may not even be aware that your best possible vision is different.

A mild loss of best-corrected visual acuity might not even be noticed or might be just a minor annoyance. A severe loss of best-corrected visual acuity would be noticed by almost every patient and might make it hard to work in occupations that require fine vision. Severe losses of best-corrected visual acuity are exceedingly rare. Either an irregularity or haziness in the corneal surface could cause a decrease in best-corrected vision. Short-term irregularities during the initial months of healing may occur in up to 5% of cases and almost always resolve as the healing progresses.

It is possible that during the stabilization period following surgery, your sight may return towards Myopia again. It is called Regression. If the Regression causes significant Myopia, we can correct it with an Enhancement procedure.

Understand that regression is more common with cases of high and very high myopia, and more likely to occur with Hypermetropia. At your consultation, we shall provide you with the statistical data for your specific Refractive Error.

If an eye remains Myopic after the full healing process, this eye can be retreated at no further cost.

Golfing superstar Tiger Woods had had multiple enhancement procedures following his Laser Eye Treatment and finished with better than 20/20 vision.

Most patients who achieve a good refractive visual result early in their course maintain this full correction.

Many of these are common to all forms of Laser Eye Surgery, and should not cause unnecessary alarm. We emphasise that fortunately, serious or long term complications are extremely rare.

Let’s have a look at possible risks and complications specific to LASIK.

The disadvantages of LASIK are associated with Microkeratome or IntraLase. For example, Flap displacement can occur, although it is extremely rare. If it does occur, it can easily be realigned.

Sometimes the flap may be too short. This is of virtually no clinical significance.

Epithelial Ingrowth can occur when the epithelium (the outer layer of cells), grows within the interface between the corneal flap as well as over the flap. The incidence of significant ingrowth is less than one percent, and a small ingrowth is of no clinical significance.  If there is any sign of corneal melt, which is a serious problem, we may need to consider a surgical intervention. The flap must be lifted and carefully cleaned to remove these cells.

Perforation. This is only a theoretical risk…

Understand that in Australia, there has not been a single case of blindness reported as a result of many tens of thousands of Laser Vision Corrections.

There have been around 30 million performed worldwide.

Irregular Astigmatism can be due to the flap healing on its bed in an abnormal manner, like a mild crinkling effect. It may take some time to settle (rarely more than a few months), and during that time cause suboptimal and double vision to occur. Surgical enhancement or contact lenses might be needed at some point in the future.

Multiple Small Subconjunctival Haemorrhages can result from the suction ring, but clear up after two to four weeks. These are outside the eyeball, and only in very rare cases disturb vision.

Small Epithelial Defects or Abrasions can occur, but usually close within days.

Fluctuating Vision can be common in the first weeks following LASIK.

Localised Keratitis (Mild Inflammation) may be visible for a few days.

A big disadvantage of Lasik procedure is that Flap literally never heals properly and can be easily displaced many years after your procedure in any accident involving your eyes (say, your child could poke you in the eye or any sport injury).
Another disadvantage of the IntraLasik procedure (IntraLase is used instead of Microkeratome, so called Lasik without a blade) is that in many cases it is not possible to cut another Flap. So if you need an Enhancement procedure, you can have only ALSA (Surface Laser Treatment). So why not to have a less invasive treatment in the first place?

The risk of complications specific to LASIK, high incidence of Dry Eye Syndrome and induced aberrations has made many patients reluctant to have LASIK. They opt for less invasive Laser Vision Procedures like “LASIK Without A Flap” or Advanced Laser Surface Treatment or Advanced PRK.

All specific complications relevant to your eye conditions will be discussed in details during your Free Assessment. Click here to book online your Free no Obligation Laser Vision Assessment at Medownick now.

Find out if you are suitable for Laser Eye Surgery at the Medownick Laser Eye Surgery Clinic today.

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Want to know more? Book your Free Laser Eye Surgery assessment online now at Medownick.