If something happens?- Lasik risks and complications

According to my research, there are so many complications after Lasik. I had consulted with many eye doctors. None can sure what kind complications I will have after Lasik. They all said that it depends on individual. It made me more confused about Lasik surgery.

When LASIK complications occur, they may be associated with the creation of a hinged flap in the clear front covering of the eye (cornea), which is lifted for laser re-shaping of the eye. The flap then is replaced to form a type of natural bandage.

If the LASIK flap is not made correctly, it may fail to adhere correctly to the eye’s surface. The flap also might be cut too thinly or thickly. After the flap is placed back on the eye’s surface, it might begin to wrinkle. These microscopic wrinkles in the flap are called corneal striae.

These flap complications can lead to an irregularly shaped eye surface. Most such problems can be resolved through re-treatment of the eye with enhancement surgery.

Studies indicate that flap complications occur in from 0.3 percent to 5.7 percent of LASIK procedures, according to the April 2006 issue of American Journal of Ophthalmology. But inexperienced surgeons definitely contribute to the higher rates of flap complications. Again, remember that you can reduce your risk of LASIK complications by choosing a reputable, experienced eye surgeon.

Some problems associated with LASIK flap complications include:

Irregular astigmatism can result from a less than smooth corneal surface. Irregular astigmatism also can occur from laser correction that is not centered properly on the eye. Resulting symptoms may include double vision (diplopia) or “ghost images.” In these cases, the eye may need re-treatment or an enhancement.

Diffuse Lamellar Keratitis (DLK), nicknamed “Sands of the Sahara,” is inflammation under the LASIK flap that may have several causes. Some inflammation of the cornea after LASIK surgery is normal. But if it is uncontrolled, as in DLK, it can interfere with healing and cause vision loss. If DLK occurs, it usually responds to therapies such as antibiotics and topical steroids. The flap also might need to be lifted and rinsed for removal of inflammatory cells and to prevent tissue damage.

Keratectasia or keratoconus is bulging of the eye’s surface that can result from a flap that is cut too deeply, when too much tissue is removed from the cornea during LASIK or when the cornea initially was weakened as evidenced from cornea topography mapping prior to LASIK. Resulting distorted vision likely cannot be corrected with laser enhancement, and gas permeable contact lenses or corneal implants (Intacs) may be prescribed to hold the cornea in place.

A promising new treatment for keratectasia (also called “ectasia”) is corneal collagen cross-linking with riboflavin (C3-R). In this non-invasive procedure, eye drops containing riboflavin (vitamin B2) are placed on the cornea and then are activated with ultraviolet (UV) light. This strengthens the links between the collagen connective tissue fibers within the cornea to halt the bulging of the eye’s surface.

Other, more commonly reported complications that can result from LASIK eye surgery include:

• Dry Eye After LASIK: Almost half of all patients reported problems with dry eyes after LASIK within the first six months, according to the April 2006 issue of American Journal of Ophthalmology. These complaints appear related to reduced sensitivity of the eye’s surface immediately following the procedure. If you have this problem, temporary remedies such as artificial tears or prescription dry eye medication may be needed along with oral flaxseed oil capsules.
• Significant Undercorrection, Overcorrection, or Regression: This means that your outcome is less than optimal and makes it difficult to function in certain situations. There are various reasons for these problems. In many cases, the cause is simply that a patient’s eyes did not respond to laser eye surgery in a predictable fashion. But it’s also possible that results are related to an inaccurate diagnosis or incorrect settings programmed into software guiding the laser during eye surgery.Regression from “over-healing” occurs when your eyesight is optimal at first, but then begins to deteriorate over time. In most cases, a significant undercorrection or regression can be treated with additional laser vision correction or other refractive surgery methods such as conductive keratoplasty, once it is certain that the refractive error is stable.

• Eye Infection or Irritation: These problems are rare and may require treatment with eye drops containing antibiotics or anti-inflammatory medication such as steroids.When bacterial infection occurs after LASIK, it appears to be related increasingly to an antibiotic-resistant form of Staphylococcus aureus. Survey results indicating a growing problem with this type of infection were reported at the 2008 annual meeting of ASCRS.LASIK surgeons also reported that infections occurred more frequently with surface ablations such as PRK and when bladed instruments called microkeratomes are used to create the flap during LASIK surgery. ASCRS reports indicate that flaps that are lifted and replaced on the eye during LASIK, serving as a type of “natural” bandage, appear to create a more sterile surgical environment than PRK and other surface ablation procedures.

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