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All eye surgery carries risk. Contact lens wear also has risk. Glasses have almost no risk. Refractive surgery has fewer risks than almost any
other eye surgery, much less than relatively safe surgeries such as cataract surgery or corneal transplantation. Not all possible risks can be listed here. Some of the most important are stated below:
1. Under Correction:
It is possible that not all of an individual's refractive error will be corrected by surgery so that some of the original eye prescription remains. This is called under correction.
If there is significant under correction for a patient, the distance vision without glasses will almost always still be improved over the pre-surgical vision, but will not be as good as it could be if the eye’s prescription was fully corrected.
For mild under correction, glasses may be prescribed. For significant under correction, further surgery (repeat LASIK or PRK) may be recommended. Another alternative is to wear glasses or hard
contact lenses, which should be thinner than the originals.
99% of our laser refractive surgeries have been 20/40 (legal to drive) or better without correction the first time. Under correction does occur, but
not usually by a significant amount.
2. Over correction:
The surgery could correct more refractive error than intended. This is termed surgical over correction. A mild amount of over correction is
usually well tolerated so that distance and reading vision are minimally affected. For significant over correction following surgery, the only effective treatment is glasses, contact lenses, or a repeat procedure.
Again, 99% are legal to drive after the first surgery, so this isn’t often very severe.
3. Glare and Photophobia:
Early side effects of any corneal surgery include light sensitivity and glare.
These symptoms are usually gone within days of LASIK, and in about a month for Surface Ablations (PRK), depending on the size of the prescription corrected.
On rare occasions they have been reported to last
for months. The cause may be due to poor healing of the surface of the cornea, surface cells trapped under a LASIK flap, decentration of the optical center of the procedure compared to the patient's actual visual
center, infection with resultant scarring, trauma or wrinkles in a LASIK flap, or an allergic or toxic reaction to the post-op eye drops. Treatment is directed toward the cause. Successful re-treatment is
usually possible.
4. Dry Eye:
More severe after LASIK and less after PRK, dry eye does appear post operatively in both. Usually, this is treated with artificial teardrops. If this does occur
it tends to last about 9 months after PRK and 2 years or more after LASIK.
5. Infection:
Any surgical procedure carries risk of infection. We use every precaution to prevent infection at the time
of surgery, and antibiotics are prescribed after surgery to prevent infection. We have seen about one infection per 500 procedures, many of these not serious. There is a potential for infection with permanent
corneal damage and the need for a corneal transplant, but this is very rare and we have never seen this at our center after refractive surgery.
6. Loss of contrast sensitivity:
Numbers vary
depending on which procedure and which study you look at. One set of recent figures taken after wavefront guided surface ablation show 3% of patients had a measurable significant loss of low contrast visual
sensitivity (which affects night driving), but 9% had a measurable significant improvement of low contrast visual sensitivity.
7. Other:
Please consult your ophthalmologist for more detailed information.
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