Complications Associated with Laser Eye Surgery

Laser  eye surgery has become the standard in laser eye surgery for people with astigmatism, far sightedness, and near sightedness so that the need for eyeglasses or contacts is eliminated. LASIK eye surgery is typically an uncomplicated procedure with a very short recovery time. However, as with any surgical procedure, there is the risk of complications and any person considering LASIK should understand what complications could occur and what can be done to prevent complications from occurring.

Preventing complications is very much in the hands of the patient. Once the surgery is over, it is up to the patient to follow the orders of the doctor and use their own common sense to avoid some of the most common complications. An overview of what could happen is included here; however, it is important to note that most people have no complications and that LASIK eye surgery is relatively uncomplicated surgery that yields excellent results.

Complications that Could Occur

The first and main complication that could occur with LASIK eye surgery is the same that can occur in any surgery and that is infection. The eye doctor will typically prescribe antibiotic eye drops before and after the surgery in an effort to prevent this from occurring. Starting the antibiotics prior to the surgery helps to minimize the risk of picking up an infection before the surgery that is dormant and then pops up after the surgery and creates problems. Patients can also help avoid infection by wearing the eye shield for the first 48 hours and for the first week avoiding getting water directly in the eye by wearing the shield during showering and exercise, which can create sweat that falls in the eye.

Movement of the flap is another complication that could occur if the eye is irritated by rubbing before it has had time to properly heal. The healing process is fairly quick and this should not be a problem, however, if blurry vision, pain or redness occurs this could be a sign that the flap has moved and should be considered an emergency situation. If the flap has moved, a second surgery is required to put it back into place and then the flap will need time to heal.

This complication is typically found if Intralese is performed to lift the flap. Intralese is a more precise laser incision but it does create a very thing flap that has more of a tendency to move. The advantage of this procedure is the tiny incision that it makes. Preventing this complication is simply a matter of not rubbing the eyes during the healing process. Using the prescribed eye drops will help to keep the eyes from becoming irritated which in turn make them itchy, will facilitate healing without rubbing.

Skin cell growth that occurs under the flap is another complication that could occur. It can show up months after the surgery is performed. These cells will grow on the flap around the outer edges and cause vision to be somewhat hazy. The eye doctor will go in and lift the flap to wash out the cells and then there should not be any other issues with this growth.

Another flap complication that may occur is wrinkling underneath. If this does happen, the doctor will simply lift the flap up and flatten it back out. There are typically no further complications once this is corrected. There is nothing that can be done to prevent this from occurring and should not be considered the fault of the patient or the doctor.

In some cases, an extreme swelling can occur. This is sometimes referred to as “Sands of the Sahara” due to the appearance of sand dunes being seen by the eye doctor. An application of steroids typically solves the problem.

Finally, the most serious complication that could occur is called ectasia. Ectasia is an occurrence of irregularities to the endothelium or the inner most layer of the cornea. The eye doctor should detect this before surgery; if not, the LASIK surgery can have detrimental effects and cause vision to be worse than before and not be correctable by surgery or glasses. The end result is the patient having to use hard contacts or even have a cornea replacement. This is the only complication that is directly related to the surgeon and can be prevent pre-op with a test called an Orbscan. If the eye doctor who is performing the surgery does not do an Orbscan, the surgery should be cancelled.

While complications with LASIK surgery are not typical, it is a good idea to know what can occur so that symptoms can be watched for and dealt with quickly.

Tagged After Surgery, Ectasia, endothelium, Intralese, Orbscan, Sands of the Sahara