
Risks
and Side Effects
The
overwhelming majority of patients who have had LASIK
are extremely satisfied with their results and indicate
they would undergo LASIK again if they had the choice.
However, as with any surgical procedure, for certain
patients the outcome of LASIK may not meet all their
expectations. A small percentage of patients experience
complications.
It
is precisely for this reason that a thorough examination
and discussion occur with the surgeon before the
procedure. Each patient is informed of the risks
and benefits of LASIK and needs to feel comfortable
that they are making an educated decision based
upon facts.
Important
side effects to be aware of are as follows:
- Undercorrection/Overcorrection:
The excimer lasers that are used to perform
LASIK are highly precise. However, in a small
percentage of cases there may be residual nearsightedness,
farsightedness or astigmatism after LASIK. Fortunately,
these side effects are easily treatable with
no cost enhancement procedures typically performed
as soon as 12 weeks after the first procedure.
The enhancements are used to optimize the visual
outcome. Rarely, there may be a mild long-term
reduction in results known as regression. Regression
may be treated with enhancements or a mild pair
of glasses or contacts. On occasion, the cornea
may not have sufficient thickness for an enhancement
and glasses or contacts may have to be used
to optimize vision. Dr. Kelly bases the need
for an enhancement on patient satisfaction and
relevant medical factors. An enhancement can
be performed at almost any time beyond 12 weeks
after the initial procedure. In general, the
higher the initial degree of visual error the
higher the probability of needing an enhancement.
- Loss
of Best-Corrected Vision:
LASIK cannot provide
perfect vision to every patient. An extremely
small percentage of patients do not see as well
after LASIK as they did with their glasses or
contact lenses before LASIK. This may be true
even with the use of glasses or contacts or
enhancements after LASIK. This may be due to
loss of contrast sensitivity. Contrast sensitivity
is the ability to distinguish individual objects
from one another. It is the distinctness of
vision. It usually improves over time. Bear
in mind that almost everyone who has undergone
LASIK finds their vision to be equal to or better
than it was with glasses or contacts before
LASIK.
- Glare/Haloes:
Especially under dim lighting conditions some
patients report that the aura around certain
lights appears more noticeable after LASIK than
before. This condition often improves throughout
the healing period. Although highly unlikely,
it can possibly affect one's ability to function
at night, such as when driving an automobile.
- Dry
Eye:
It is very common
for the eyes to experience dryness after the
procedure. Dryness is usually described as an
uncomfortable scratchy and sandy feeling in
the eyes. It is temporary in the overwhelming
majority of cases but may be chronic in a tiny
percentage. It is treated with artificial rewetting
drops among other methods.
- Presbyopia:
This is an aging change and not
a LASIK complication. It is the gradual loss
of ability to focus on near objects. Presbyopia
typically begins at around age 40-45 and progresses
into the 60s. LASIK does not
correct presbyopia. Presbyopia is usually corrected
with over-the-counter reading glasses to see
near objects. Monovision is
a technique that can be used with LASIK where
one eye is corrected to see distant objects
and the other eye is corrected to see near objects.
It dramatically reduces a presbyopic person's
dependence on reading glasses. However, it usually
decreases one's depth perception and peripheral
vision. Monovision is considered by many to
be a viable compromise to correct distance and
near vision for the person with presbyopia.
Dr. Kelly usually has patients considering monovision
undergo a trial with contact lenses before the
procedure.
- Fluctuating
Vision:
It is common for vision to fluctuate during
the first few weeks to months after laser vision
correction. One may experience episodes of clear
vision combined with intermittent episodes of
blurry or hazy vision. Light sensitivity is
common. All of these side effects diminish with
time.
- Red
Patches:
It is also common
for red spots to be present over the white parts
of the eyes for a couple of weeks after LASIK.
They completely resolve and are harmless.
- Corneal
Scarring:
This is one of
the most dreaded complications after LASIK but
is extremely rare. It can be the result of infection
or flap problems. There have been cases where
scarring has caused very poor vision requiring
transplant for treatment.
Please
keep in mind that vision threatening complications
are extraordinarily rare. Most side effects
resolve over time and can be treated successfully.
The
healing process is an important determinant in
the final result. Everyone heals in an individual
manner that is not always predictable. Healing
determines, in part, the speed of recovery, the
sharpness of vision, and the likelihood of the
need for an enhancement. The medications Dr. Kelly
prescribes assist in the healing process and should
be used according to the instructions. As a general
rule, the higher the initial visual error the
longer the healing.
It
is important that anyone considering laser vision
correction have realistic expectations. People
looking for perfect vision after LASIK run the
risk of being disappointed. Dr. Kelly is proud
that 99% of his patients achieve vision within
2 lines of 20/20. In his experienced hands, using
the best technology, success is likely but not
guaranteed.

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