If you’ve lived with vision problems relating to significant refractive error for any length of time, the idea of laser eye surgery can be very attractive. However, many people are understandably nervous around the eyes. Is eye laser surgery safe, and what are the potential complications of laser eye surgery? Find out here. 

 

Is Eye Laser Surgery Safe?

The safety and efficacy of any medical procedure should always be a consideration before it is undertaken. According to the Royal Australasian College of Surgeons, questions to consider when approaching the specific question of is eye laser surgery safe include:

  • Has the technique been evaluated before?
  • How reliable is the evaluation?
  • How wide-ranging or complex is the procedure?

When it comes to laser eye surgery, there are a number of different techniques. Each technique is associated with its own pros and cons, including risks of certain complications. Some laser eye surgery methods, such as PRK (photorefractive keratectomy), have been around for much longer than newer techniques, such as SMILE (small incision lenticule extraction). This means there is more safety data available and a better understanding of these older surgical methods. 

 

 

Ultimately, the answer to ‘is eye laser surgery safe’ is yes. The vast majority of people undergoing laser eye surgery experience no long-term complications or adverse effects. The success rate of laser eye surgery across multiple techniques is generally accepted as 95 to 99%.

The definition of “success rate” not only encompasses whether a patient encountered any adverse effects or not but also the final visual outcome (measured in terms of visual acuity or sharpness) and patient satisfaction and impacts on quality of life. This does mean that the idea of success can vary from person to person. Though two people may achieve the same final visual acuity after their laser eye surgery procedure, one may have been expecting better vision. At the same time, the other is satisfied with the outcome, leading to differences in the perception of a successful operation. 

 

How Does Laser Eye Surgery Work?

The purpose of laser eye surgery, or any refractive surgery, is to permanently correct the refractive error of the eye. Refractive error encompasses vision problems, including myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism. 

In order to achieve this, laser surgery techniques involve sculpting the cornea with a laser device to adjust its curvature. By modifying the corneal shape, the refraction of light through this surface is corrected to focus sharply on the retina, which is what provides clear sight. 

There are three main techniques of laser vision correction:

  • LASIK (laser-assisted in situ keratomileusis). LASIK involves cutting a corneal flap from the outermost layers and then using an excimer laser to reshape the deeper tissues. The flap later re-seals.
  • PRK. Instead of creating a flap of tissue, as in LASIK, PRK removes the superficial layer of epithelial cells from the cornea in a process called debridement. The excimer laser is then applied to sculpt the remaining tissue. The epithelium then regenerates. 
  • SMILE. SMILE is the newest addition to the laser refractive surgery suite; not all surgeons are able to offer it. Without disrupting the outer layers of the cornea, a femtosecond laser device is used to separate a disc-shaped sliver of tissue from the deeper layers. This disc, or lenticule, is then extracted from the cornea through a keyhole incision.  

 

Potential Risks and Complications of Laser Refractive Surgery

Although the success rates of refractive surgery are considered to be exceptionally high, all surgical procedures come with the chance of a complication. Some of these complications can be treated or are only short-term adverse effects that will self-resolve. Other complications can be more severe. 

Some risks can be mitigated by ensuring a patient is properly suitable for surgery. For example, patients with thin corneas should be counselled away from LASIK and instead be offered PRK. Similarly, patients who are pregnant or breastfeeding are usually advised to wait as hormonal changes can affect sight. Following the surgeon’s post-operative aftercare guidelines can also help support a smooth and uneventful recovery period. 

These are some vision problems that might occur after laser refractive surgery. 

 

Dry eyes

This is more common after LASIK compared to PRK or SMILE. Dry eye syndrome is identified by an inability to produce sufficient tears, or the tears that are produced are of poor quality. This means the front surface of the eye is not adequately hydrated and protected. Lubricating eyedrops can often help manage dryness; many cases will self-resolve after a number of months. 

 

Corneal scarring

The body’s natural healing response after surgery can include scarring. Scarring of the cornea, however, can interfere with sight, depending on the location and extent of the scar. You may experience blur, haloes around lights, or glare sensitivity. Scarring may require further treatment to reduce its effects. 

 

efficacy safety procedure eye laser melbourneOver or under correction

If the pre-operative measurements were inaccurate, your surgeon may mistakenly over or undertreat your prescription, leading to a residual refractive error and imperfect sight.

In many cases, a follow-up laser surgery procedure can fix this. 

 

Infection

An eye infection can be one of the more sight-threatening complications after laser refractive surgery. Aggressive treatment with antibiotics is needed to avoid extensive damage to the eye’s structures. 

 

Corneal thinning

If too much corneal tissue was removed through surgery, it can lead to the weakening and an outward bulging of this structure. Deformation of the cornea impacts sight, so you will need further intervention to restore your vision, whether in medical treatment or contact lenses.

Although there is a small potential for complications, eye laser surgery is considered a safe and highly effective procedure.

 

Call us now on 03 9000 0389 today for a consultation.

 

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

 

 

 

References

General Guidelines for Assessing, Approving & Introducing New Surgical Procedures into a Hospital or Health Service.
https://www.surgeons.org/-/media/Project/RACS/surgeons-org/files/position-papers/rea_ase_3103_p_general_guidelines_for_assessing_approving_introducing_new_surgical_procedures_into_a.pdf?rev=45633c22bd9941129d471fc98e300083&hash=BB63DA90EEB5CA3A8B491CCCC0FFA185

What is the LASIK Success Rate?
https://americanrefractivesurgerycouncil.org/laser-eye-surgery-lasik-success-rate/

A Guide to Laser Eye Surgery.
https://www.choice.com.au/health-and-body/optical-and-hearing/optical/articles/guide-to-laser-eye-surgery

Eyes – Laser Eye Surgery.
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-laser-eye-surgery#side-effects-and-complications-of-laser-eye-surgery

 

 

 

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