Complications and Concern of Lasik

Potential Complications of LASIK
Other vision-threatening complications are seen following LASIK surgery, such as infection, retinal breaks and detachment, macular holes and hemorrhage, optic nerve damage, diffuse lamellar keratitis, irregular flaps, flap folds and striae, slipped flaps, epithelial defects, and epithelial ingrowth. These and other complications may have severe, lasting adverse effects.


Bilateral Simultaneous LASIK
Performing LASIK on both eyes in the same day is convenient and financially beneficial for surgeons, but is not in patients’ best interest. In a 2003 survey of American Society of Cataract and Refractive Surgery (ASCRS) members, 91% of surgeons who responded did not offer patients the choice of having one eye done at a time.27 Bilateral simultaneous LASIK places patients at risk of vision loss in both eyes, and denies patients informed consent for the second eye.

Inaccurate IOP Measurement after LASIK
Changes in corneal thickness and biomechanical properties following LASIK affect intraocular pressure (IOP) measurements, resulting in falsely low readings. LASIK patients face lifetime risk of undiagnosed ocular hypertension, which may progress to glaucoma. Glaucoma is a leading cause of blindness.

Complicated Cataract Surgery after LASIK
Like the general population, LASIK patients will eventually develop cataracts. The altered corneal surface following LASIK prevents accurate measurement of intraocular lens power for cataract surgery. This may result in a “refractive surprise” following cataract surgery and exposes LASIK patients to increased risk of repeat surgeries.

LASIK Results in Loss of Near Vision
Patients are routinely misinformed that they will require reading glasses after the age of 40 whether they have LASIK or not. Nearsighted patients who do not have refractive surgery actually retain the ability to see up close naturally after the age of 40 simply by removing their glasses. LASIK increases the need for reading glasses by changing the eye’s focus from near to distance. The loss of near vision after myopic-LASIK affects many daily activities, not just reading. LASIK patients over the age of 40 may discover they have simply traded one pair of glasses for another.

Progressive Loss of Corneal Keratocytes after LASIK
A Mayo Clinic study demonstrates persistent decrease in corneal keratocyte density after LASIK.28 Keratocytes are cells vital to the function of the cornea. This progressive loss of corneal keratocytes may have long-term implications in terms of corneal stability, refractive stability and cellular integrity of the cornea after LASIK. Ophthalmologists have speculated that progressive keratocyte loss may ultimately lead to post-LASIK ectasia. 28,29.

Limited Rehabilitation Options after LASIK
LASIK is irreversible, and treatment options for visual rehabilitation after a poor LASIK outcome are extremely limited. Rigid gas permeable contact lenses may improve vision if the patient can tolerate lenses and obtain a good fit. The post-LASIK contact lens fitting process can be time consuming, expensive, and complicated by LASIK-induced dry eyes. Many patients eventually give up on hard contacts and struggle to function with impaired vision. In extreme cases, a corneal transplant may be required.