Relative Risk of Post-Surgical Complications:

• Prolonged healing periods: 3 months or more
• Night glare (halos, starbursts): 1 in 50
• Under/over-correction: less than 1 in 100
•  Increased intraocular pressure: non signifi cant
•  Corneal haze: 1 in 1,000
•  Corneal scarring: non signifi cant
•  Loss of BCVA: 1 in 100
•  Infection: 1 in 5,000
•  Corneal fl ap complications (dislocated fl ap, epithelial ingrowth) less than 1 in 100

Following LASIK, patients are cautioned to avoid rubbing their eyes and to stay out of swimming pools, hot tubs, or whirlpools for at least a week. Contact sports should be avoided for a minimum of 2
weeks, and many eye surgeons recommend wearing safety eyewear while playing sports. Even after the patient’s vision has stabilized and healing appears complete, the corneal fl ap may not be completely readhered.



There have been reports of corneal fl ap displacement due to trauma up to 38 months after the procedure.
After surgery, patients are cautioned to not wear eye makeup or use lotions and creams around their eyes for a minimum of 2 weeks and to discard all previously used makeup to reduce the risk of infection.
In some instances, LASIK may be an option for patients with higher refractive error than can be safely corrected with PRK or those with conditions that can delay healing (e.g., lupus, rheumatoid arthritis).
Since LASIK minimizes the area of the epithelium surgically altered, it reduces some of the risks associated with delayed healing.


Additionally, ablation of the underlying stromal tissue results in less corneal haze and the tendency for the cornea to revert back to the original refractive condition during the healing process (refractive
regression), which improves predictability. Most patients do not require long-term, postoperative steroid use, decreasing the possibility of steroid-induced complications (cataract, glaucoma).

As with any invasive procedure, there are surgical risks, and the recovery process often varies with each individual. Post-LASIK patients report experiencing mild irritation, sensitivity to bright light,
and tearing for a few days after surgery. For most, vision stabilizes within 3 months to near-predicted results, and residual night glare usually diminishes within 6 months. In rare cases, symptoms have lingered longer than a year. Earlier versions of LASIK used a smaller ablation zone which sometimes resulted in glare problems at night.
Ablation zones have an area of transition between treated and untreated corneal tissue. As the pupil dilates and becomes larger than the ablation zone, light (car headlights, streetlights, and traffi c signals
lights) entering through these transition areas becomes distorted, resulting in aberrations perceived as glare. These patients often complain of diffi culties seeing under low-light conditions.

Patients that develop postoperative haze during the healing process have complained of glare (halos and starbursts). Furthermore, it has been reported that exposure to ultraviolet radiation or bright sunlight
may result in refractive regression and late-onset corneal haze. It is therefore recommended that all refractive surgery patients wear sunglasses with UV protection and to refrain from using tanning beds for several months after surgery.

For those with larger amounts of refractive correction, the predictability of the resulting refractive correction is less exact. This can lead to under-correction (requiring an additional laser enhancement procedure and/or corrective lenses) or over-correction of the refractive error. In the case of overcorrection, premature
presbyopia and the need for reading glasses can result.

It has been reported that there can be a slower recovery of BCVA and UCVA with hyperopic LASIK compared with those having myopic LASIK. This is especially true for older patients who may be even
less likely to achieve UCVA of 20/20 or better. (Note: Loss of BCVA is reportedly 5 to 15 times more likely with refractive surgery than from the use of extended-wear contact lenses.)
Older patients with presbyopia may opt for monovision LASIK, which corrects the dominant eye for distant vision and the other eye for near vision. The procedure is intended to eliminate the need for a patient to wear corrective lenses for near and distant vision.

Anisometropia (difference in correction between the eyes) induced by monovision may result in decreased binocular vision, contrast sensitivity, and stereo acuity. After an adaptation period, patients are
often able to see and function normally. Patients who report blurred vision, diffi culty with night driving, and other visual tasks in low-light conditions typically do not adapt to monovision and may require an
enhancement on their non-dominant eye so that both eyes are fully corrected for distant vision. Airmen who seek monovision correction should consult an eye care practitioner to assist them in compliance
with standards outlined in the “Guide for Aviation Medical Examiners (see below):

Airmen who opt for monovision LASIK must initially wear correction (i.e., glasses or contact lens) for near vision eye while operating an aircraft. After a 6-month period of adaptation, they may apply for a Statement of Demonstrated Ability (SODA) with a medical fl ight test. If the airman is successful, the lens requirement is removed from their medical certifi cate.