The complications experienced by patients who have undergone LASIK surgery are very similar to the complications experienced by patients who underwent other refractive surgical procedures such as Radial Keratotomy, Photo Refractive Keratotomy, (PRK) ALK and a host of other refractive eye surgeries. These complications or events can take place weeks after the surgery or years later. Many of these unanticipated events will not go away but remain with the patients for the rest of their lives. The post-LASIK (and R-K, PRK, etc.) complications include but are not limited to:
1. Severe Dry Eye is the most common complication of LASIK affecting over a third of the entire post-LASIK population. LASIK surgeons will often tell a patient that this condition is temporary, but the reality based on the thousands of post-LASIK patients who I have taken care of is that it is often permanent. It is for this reason that Restasis eye drops are advertised on television. Twenty years ago there were only a handful of lubricating eye drops on display in the eye drop section of your local pharmacy. Now there are hundreds of different eye drops available. The reason for this has been the popularity of LASIK and other refractive surgeries.
2. An irregular, uneven or rough corneal surface. This is due either to the LASIK procedure itself or due to the healing process of the individual eye. It is important to remember that we all different and that we heal differently. Not every patient will experience the same result after LASIK surgery.
3. Blurred, distorted and unstable vision. This could be due to a number of factors relating to the LASIK surgery.
4. Reduced vision indoors and at night. Large pupils could be the cause of this along with a small treatment (ablation) zone.
5. Glare, halos, double vision and starbursts. These are known as higher order aberrations. It is due to a corneal surface in front of the pupil that is irregular or not smooth. The best way to treat this non-surgically (that is the best way) is to fit this eye with a gas permeable scleral lens.
6. Eye pain. This could be due to a chronically dry eye or to issues with the corneal flap. If the corneal flap in undisturbed, a well fit gas permeable scleral lens should be fit in order to restore quality vision. In addition, because the cornea is enveloped in a liquid environment, the lens will have a therapeutic effect on the eye.
7. Posterior vitreous detachment and vitreous floaters. This can occur years after the LASIK surgery. It is due to the LASIK surgery. To create the LASIK flap, the intra ocular pressure within the eye needs to be increased dramatically. It is thought that by doing this, the deeper internal ocular tissues are disturbed causing a delayed reaction causing the vitreous to pull against the retina over time.
8. Light sensitivity and ghost images. The ghost images are most likely due to an irregular corneal surface. Light sensitivity or photophobia may indicate an issue with the LASIK flap or incomplete corneal healing.
9. Complications with the LASIK created corneal flap. This can include wrinkles in the flap, debris behind the flap or a condition known as epithelial ingrowth. Epithelial ingrowth refers to cells from the outer layer of the cornea (the epithelium) getting behind and under the corneal flap. The cells under the flap are of a different nature that the epithelial cells. When epithelial cells get under the flap, they can grow and cause cloudy vision. The proper treatment when this occurs is to lift the LASIK flap and clean under it. Very often this is just a temporary solution as any cells left behind may continue to grow.
10. Corneal ectasia. This is a protrusion or bulging of the cornea. This condition can occur weeks to years after having undergone LASIK surgery. LASIK thins out the cornea. Over an extended period of time, the pressure from within the eye against this weakened corneal "wall" can cause this to take place. The result is a very irregular distorted cornea. There is no surgery that can correct or undo this. The best non-invasive treatment for restoring quality vision once again is to fit this eye with a gas permeable scleral lens. I do not recommend additional invasive procedures such as Intacs surgery to correct this condition.
11. Severe depression and in some instances thoughts of suicide..