How Safe Is LASIK Anyway?

Laser eye surgery has illustrated its safety and efficacy over a 23-year period. So far, there have been over 36,000,000 laser eye surgeries performed over the globe and no-one has ever lost one of their eyes from having the procedure performed. The risk associated with laser vision correction is safer than that caused by using contact lenses and regarding infection, LASIK represents a small one-time risk, as apposed to the constant risk of eye damage via infection found in those who use contact lenses.

The safety of LASIK has been meticulously assessed by governmental organizations such as NASA, the Australian Army and the Military. The result of their investigations is that LASIK eye surgery performed with a femtosecond Laser creating the flap (Blade-free laser eye surgery) is now approved for astronauts, the SAS and Top Gun pilots.

Sports professionals have had laser eye surgery to optimize their performance, among them are Barry Hall and David Beckham.

The procedure despite having the best safety record of any procedure still carries with it the potential for complications however, which I will discuss below.

Enhancement:
LASIK eye surgery is carried out on living tissue. Although extremely precise, there is on average a 3-4% potential the vision correction will be decent but not absolutely optimal. In these instances, I generally wait about 3 months to ensure that the residual glasses prescription is stable and then lift up the same corneal flap created before to fine tune the result. As enhancements are small corrections they are correspondingly more accurate. One of the best things about laser eye surgery is that although mostly very stable in the long term, should anyone experience any refraction change in their sight, enhancements such as these can be performed at almost any time in the future.

Risk of infection:
The infection rate for LASIK eye surgery is very low, much less than the infection rate with contact lenses. The likelihood of scarring of the eye resulting from an infection eventuating is rarer still, likely less than 1: 20 000. In the event that this happens, I can correct it by transplanting the cornea. However, I am a corneal subspecialist and perform a good deal of corneal transplants, but I have never had to transplant a cornea for this reason.

Issues With The Corneal Flap:
The risk of getting an irregular flap, for instance a buttonhole flap, a possibility with blade laser, is by and large done away with with Femtosecond (Blade-Free) laser. Thanks to the improved safety this entails, blade-free is the sole type of LASIK eye surgery I will conduct.
Swelling under the flap can occasionally develop (diffuse lamellar keratitis) but can be treated with an increased usage of anti-inflammatory eyedrops.
Epithelium, or cells that grow on the surface of the cornea, can very seldom grow into the flap interface. Typically if this transpires these cells break down and go away, however should they do not go away, the flap is raised and the offending cells are removed.

Dry Eye Phenomenon:
Whenever the corneal nerves are cut (such as when creating a corneal flap), it will cause dry eye. It is advised to use lubricating eye drops to renew the tear film during this time period, as the nerves will come back throughout a 3 month period and everything generally goes back to normal.

Ectasia:
Very rarely, LASIK eye surgery brings with it a danger of ectasia, that is when the cornea bulges forward over a period of time because of it becoming too pliable. Extreme cases have required transplantation of the cornea to repair the issue. Fortunately the screening of patients pre-operatively has improved and become more and more precise and unsuitable persons for laser vision correction are typically determined. The new process of collagen cross-linking can prevent the further development of this uncommon issue and if performed early will allow for the patient to maintain their vision and steer clear of the need for corneal transplantation. I am one of but a handful of eye specialists in Australia who is skilled in this process and perform it in my rooms, however fortunately I have never needed to perform this on my own patients.

Halos and Glare:
Patients can in some cases see an increased amount of glare around lights at night, following the surgery. It is extremely unusual to see this last much more than about a week, as it is normally attributed to the corneal flap stabilising.

Quality of Vision:
Almost all patients subsequent to LASIK eye surgery see as clearly or more clearly when compared to their vision with glasses and contact lenses. There will always be a tiny minority who may feel their quality of vision isn't as crisp as what it was at first. Usually this issue is resolved with a laser eye surgery enhancement and will scarcely persist.

LASIK surgery has proven its effectiveness over a 23 year outstanding safety and precision track record. This is only going to develop too, as new advances such as blade-free laser vision correction assure heightened safety and precision, rendering it the clear choice in eye surgery.

Dr James Genge (M.B., B.S., B.Med.Sci. (Hons)., F.R.A.N.Z.C.O.) is an internationally trained and highly regarded eye doctor and laser eye specialist in the Sydney area.. If you would like to know more, take a look at his website at Laser Eye Surgery Sydney.