Laser Eye Surgery Risks — Managing Potential Complications

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Laser eye surgery has emerged as a leading medical procedure in pursuit of corrected vision and to be liberated from the burden of wearing glasses or contact lenses. Although perceived as a miracle cure for refractive errors like short-sightedness (myopia) or long-sightedness (hyperopia), it’s not without its potential risks and complications.

Refractive Surgery: An Overview

Refractive surgery primarily aims to correct refractive errors, allowing light rays to focus on the retina for sharper vision properly. LASIK(Laser-Assisted in Situ Keratomileusis) is one of the most popular types of refractive surgery. It involves creating a thin flap in the cornea using a femtosecond laser. The underlying corneal tissue is then reshaped with an excimer laser to fix the refractive error.

The Principle of Laser Eye Surgery

Think of laser eye surgery as the fairy godmother of the vision world. This remarkable procedure, also known as refractive surgery, waves its magic wand over common vision hassles like nearsightedness, farsightedness, astigmatism, and presbyopia. And what’s the result? A dramatic cut down on your reliance on those pesky prescription glasses and contact lenses.

Now, let’s pull back the curtain on how this magic happens. Picture the cornea, the eye’s clear, domed front surface, while a skilled surgeon deftly reshapes this dome with the laser beam. The aim? To get those rays of light focusing just right onto the retina, the eye’s back wall. It’s a blend of precision, technology, and medical prowess that unlocks a world where clear vision is the name of the game!

The Common Types of Laser Eye Surgery

There are different types of laser surgery, including:

LASIK (laser in-situ keratomileusis): This is the most common laser eye surgery procedure. It is suitable for a high range of prescriptions. That type of procedure involves creating a thin flap on the eye, folding it to enable reshaping of the tissue beneath with the laser, and then repositioning the flap.
PRK (photorefractive keratectomy): This type is considered one of the latest types of laser eye surgery. PRK involves removing the extremely thin outer layer of the cornea itself and using a laser to remodel the underlying corneal tissue.
LASEK (laser epithelial keratomileusis): A hybrid of PRK and LASIK, LASEK involves preserving the extremely thin outer layer of the cornea by placing it on a contact lens or a special disc before it’s replaced after corneal reshaping.
SMILE (Small Incision Lenticule Extraction): Let’s dive into the world of SMILE or Small Incision Lenticule Extraction. This procedure is like a beautifully choreographed ballet of medical precision. Picture this: a femtosecond laser, in all its high-tech glory, crafts a tiny lens-shaped piece of tissue (think of this as the ‘lenticule’) right within your cornea. But the dance isn’t over. The same laser, with its unerring accuracy, makes a small arc-shaped incision on the cornea’s surface. It’s the moment of truth. The surgeon delicately lifts this incision, reaching in to remove the lenticule. The best part? All this happens with minimal disruption to your cornea’s ultra-sensitive surface. SMILE, it’s groundbreaking, it’s gentle, and it’s transforming the landscape of vision correction!
Advanced Surface Laser Ablation (ASLA): A sophisticated medical procedure used in ophthalmology to correct refractive errors within the eye. Unlike traditional methods, ASLA employs a technologically advanced excimer laser, which carefully reshapes the surface of the cornea without the need to create a corneal flap. This precision allows for a more controlled removal of the corneal tissue, leading to potentially better visual outcomes and reducing certain risks associated with other laser procedures. Utilised by skilled ophthalmic surgeons, ASLA is often indicated for patients who may not be suitable candidates for conventional LASIK surgery. The technique offers an enhanced level of customisation and may provide a safer alternative, particularly for those with thin corneas or other corneal abnormalities. Its effectiveness and safety profile make ASLA a valuable tool in modern refractive surgery.

The Procedure of Laser Eye Surgery

Although the specific steps can vary depending on the laser eye surgery type, the basic procedure remains quite similar. The eye surgeon uses a special cutting laser to change the shape of your dome-shaped cornea precisely. This improves the eye’s focusing power and provides you with better vision.

A local anaesthetic (numbing drops) is applied to the eyes first. Your surgeon may also give you some medication to help you relax. After that, a device will be placed to keep your eyelids open during the procedure, while your surgeon then uses the laser to reshape your cornea.

The reshaping part of the procedure is usually completed in less than a minute, with the whole procedure taking around 15 minutes for both eyes. The patient might experience blurry or hazy vision immediately after the procedure, but normal vision typically returns by the next day.

The primary advantage of laser eye surgery is visual freedom. It enables most patients to perform everyday tasks without wearing glasses or contact lenses. However, it’s important to have a thorough discussion with your eye doctor about your suitability for the procedure, what to expect, potential risks, and possible complications before you decide to go ahead with laser eye surgery.

Post-Surgery Considerations

The immediate aftermath of LASIK might involve minor discomfort, blurry vision, or sensitivity to light, but these issues usually resolve within a few days. However, patients must diligently use topical eye drops, including antibiotic eye drops, to prevent infection and facilitate healing.

Moreover, vision fluctuates over the first few weeks following surgery. While your vision gets clearer within a day or two, stabilising completely might take a few weeks. In very rare cases, patients might experience decreased best-corrected visual acuity (BCVA) when the vision with glasses or contact lenses post-surgery is not as sharp as pre-surgery vision.

Understanding Laser Eye Surgery Risks

Despite being a frequently performed procedure, the potential laser eye surgery risks should be noticed. Complications, although not common, can lead to optimal clinical outcomes.

One major risk involves the corneal flap. Flap complications, such as a displaced or wrinkled flap, can lead to blurred or double vision. Another potential risk is an under-correction or over-correction of the refractive error. This might necessitate further surgery, known as an enhancement procedure, a few weeks after the initial surgery.

There’s also the risk of developing complications like dry eyes, a condition caused by disrupted tear production. Patients may need to use lubricating eye drops for relief. In some cases, LASIK can induce higher-order aberrations, resulting in symptoms like glare, halos, or night glare around lights, particularly when viewing distant objects.

Some Vision Problems That May Happen After The Surgery

After undergoing laser refractive surgery, such as LASIK or PRK, patients may experience various vision problems, though these are relatively uncommon.

Dry Eyes

One of the most common side effects of the laser eye surgery is dry eyes. This is when the eyes may feel itchy, gritty, or have a burning sensation. This condition happens due to decreased tear production during the healing process, but it usually resolves within a few months by following up with your doctor and maintaining the proper treatment they will prescribe to you.

Corneal Scarring

Corneal scarring is a rare complication that can lead to hazy or blurred vision, usually caused by poor wound healing after the surgery.

Over or Under Correction

Over or under-correction of the refractive error can sometimes occur, resulting in residual nearsightedness, farsightedness, or astigmatism. These issues can be addressed with enhancement procedures if necessary.

Infection

Infections are extremely rare but can occur after the surgery, leading to redness, pain, and light sensitivity. Prompt medical attention is mandatory to prevent complications in such cases.

Corneal Thinning

Another uncommon but serious concern is corneal thinning, which may result in a condition called corneal ectasia. This causes progressive bulging of the cornea, leading to distorted vision. Careful screening and evaluation of patients before surgery help reduce the risk of such complications.

Overall, while laser refractive surgery is generally safe and effective, patients should be aware of potential risks and undergo a thorough consultation with their surgeon to ensure they are suitable candidates and understand the possible vision problems that may arise.

Is Laser Eye Surgery Safe?

Given the risks mentioned above, is laser eye surgery safe? While complications are possible, most people have successful results with LASIK. Much of this success relies on a thorough preoperative assessment. Potential patients with thin corneas, dry eyes, large pupils, or certain systemic and ocular conditions may be at a higher risk for developing complications.

Discussing all potential risks and benefits with an experienced surgeon is crucial. A systematic review of your overall health, eye health, and family history of eye disorders is essential. The skill of the eye surgeon also plays a significant role in the outcomes and potential complications of the surgery.

The Expense of Corrected Vision

Despite its potential to deliver independence from glasses or contact lenses, LASIK is an expensive procedure. Some people may choose LASIK for cosmetic reasons, while others may find it economically justifiable, considering the costs associated with a lifetime of wearing and replacing glasses or contact lenses.

Who Is Eligible For Laser Eye Surgery

The eligibility for the procedure depends on several factors:

Ideal candidates for laser eye surgery should possess clear and healthy eyes, free from major concerns like glaucoma, cataracts, or extreme dry eye. It’s also important to note that if you’re pregnant or currently breastfeeding, it’s typically recommended to hold off on the procedure until after your little one has arrived and breastfeeding is completed.

Moreover, a key to success with laser eye surgery is setting realistic expectations. While this innovative procedure has transformed many lives, it doesn’t always mean you can toss out your glasses or contact lenses for good.

Think of getting laser eye surgery as a significant investment in your vision’s future. Before taking the plunge, ensure you consult with a professional ophthalmologist. Their expert advice will gauge your suitability for the procedure and pave the way for optimal results. Your eyes deserve nothing but the best!

How To Take Care of Your Eyes After Surgery

After undergoing laser eye surgery, proper post-operative care is essential to ensure a smooth and successful recovery.

Patients should diligently follow their ophthalmologist’s instructions to promote healing and minimise potential complications.

It is common to experience some discomfort, dryness, and temporary vision fluctuations immediately after the procedure. Eye drops and medications the surgeon prescribes should be used as directed to reduce inflammation and prevent infection. It’s crucial to avoid rubbing or touching the eyes during the healing process.

Additionally, patients should refrain from strenuous activities and sports for a specified period to avoid putting undue pressure on the eyes. Mark your calendars! Those follow-up dates with your ophthalmologist aren’t just a casual catch-up. They’re crucial checkpoints on your road to vision recovery. This is when your ophthalmologist can take a good look at how you’re healing and address any concerns you might have.

But here’s the silver lining. With the right aftercare, you’re looking at a future where improved vision is the norm, and dependence on glasses or contact lenses becomes a part of your past. So, picture yourself, in just a few weeks, seeing the world in a whole new light, all thanks to the wonders of laser eye surgery!

Conclusion

LASIK is a widely used procedure to correct myopia, hyperopia, and astigmatism. Its safety and efficacy have been well-established over the years. However, laser eye surgery may not be for everyone, and potential risks are associated with this medical procedure. Thorough preoperative evaluation and an understanding of the possible complications are imperative for prospective patients to make an informed decision about LASIK. Consulting with an experienced eye doctor is the first step towards gaining corrected visual acuity. Contact us 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.

Sources

LASIK surgery: Is it right for you?
https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/in-depth/lasik-surgery/art-20045751

Laser Eye Surgery
https://www.healthdirect.gov.au/laser-eye-surgery

Eyes- Laser Eye Surgery
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-laser-eye-surgery