Safety and Risks : Laser Eye Surgery
Satisfaction and safety
Most survey data collected on laser eye surgery shows significant amounts of patient satisfaction with their visual improvement, usually between 92 and 98%. Satisfaction is directly linked to expectations, so it is crucial to have a realistic idea of what surgery can achieve. It is also important to note that your safety is maximized by carefully researching any potential clinic and surgeon in order to obtain the services of the best and most experienced professional you can afford. They will inform you fully of the risks and answer all of your questions. As with any surgery there are risks of complication:
Dry eyes
This is by far the most widespread complication from laser eye surgery. Dry eyes (keratoconjunctivitis sicca) is thought to affect as many as 35% of patients after the conclusion of the standard six month recovery period. It is a disease that leads to an irritating feeling of grittiness in the eye (as if something is stuck there) which tends to worsen as the day progresses. Dryness and burning are both common, as are itchiness and tiredness. Generally the condition is mild, treatable and does not leave lasting effects, but in some cases it can cause permanent pain, eye damage or vision loss. The latter can reverse the success of laser surgery.
Vision problems
Problems such as double vision, glare, visual halos at night, or a drop in contrast sensitivity resulting in foggy vision, are largely dependent on the degree of ametropia the patient experienced before surgery. Ametropia describes refractive errors of nearsightedness, with emmetropia describing a lack of refractive error – and thus perfect vision – when viewing far objects. Patients with a very high degree of nearsightedness may be more at risk of the aforementioned complications, though other individual factors are always important. The surgeon will assess the risk potential of each specific patient.
Other possible visual complications include floaters, light sensitivity, fluctuation in visual acuity, astigmatism, corneal ectasia, posterior vitreous detachment, and undercorrection.
Flap complications
Issues can arise during surgery when the surgeon has to carefully cut and fold the corneal flap in order for the laser to reach its target. The likelihood of these complications has been shown to decrease when the surgeon is experienced. Many people also maintain that non-microkeratome approaches to cutting the flap reduce risk, though this is open to interpretation.
Approximately 0.2% of patients are expected to suffer from flap issues, such as a slipped flap which detaches from the rest of the cornea, necessary flap repositioning, epithelial ingrowth or diffuse lamellar keratitis. Slipped flips are guarded against with eye shields or other appropriate eyewear to prevent slippage during sleep.
Biggest risk factors
Most of the more serious complications are found in well under 1% of patients. However, some people do report ongoing visual problems or pain as a result of their laser eye surgery. Responsible clinics do all in their power to prevent such eventualities, with thorough eye exams and quality post-operative care. The biggest risk factors unrelated to clinic and surgeon are thought to be the severity of the initial complaint, astigmatism, and being an older aged patient. Retreatment can sometimes be necessary.