During consideration of having LASIK - Laser Vision Correction, each
patient must weigh the benefits and risks of having such a procedure. It
is essential that patients understand potential risks associated with
the LASIK procedure. Although, it has received FDA approval and is
considered to be safe, there is risk of having a serious
vision-threatening complication. While approximately 1% of patients have
complications with their LASIK procedure, even fewer experience a
serious flap related complication. LASIK is an extremely effective
procedure that is suitable for high, moderate or low prescriptions.
Complications
can occur due to the Laser component of the procedure or the
Keratectomy step of the procedure. There have been no reported cases of
blindness following either PRK or LASIK, anywhere around the world.
Undercorrection, is when the intended amount of laser correction
is not obtained during the primary procedure. In extreme cases of
undercorrection, after stabilization, an enhancement may be necessary to
obtain optimum results. Undercorrection can result from a number of
factors: the healing response of the eye, the hydration of the cornea
during treatment, the laser's calibration, or temperature and humidity.
Often time undercorrection is deliberately induced to create a
monovision effect.
Overcorrection occurs when the desired
treatment is exceeded, this causes an eye to become farsighted. Often
this condition will correct itself, as the cornea tends to bounce back
somewhat towards its original shape following the procedure. However,
should the patient remain hyperopic (farsighted), it is possible to
perform an enhancement to obtain the desired correction.
Corneal
haze occurs in the normal healing process of the cornea; however for
most patients (95% +) it does not affect their vision. The haze is
actually caused by a collagen protein that has developed on the surface
of the eye. For those patients who do develop haze, it usually clears
gradually over many months following the procedure.
People may
experience poor night vision, night glare, haloes and starbursts even
before having vision correction by laser. Night glare is common
immediately following the LASIK procedure and typically last for a short
period of time; however, it is important that you discuss your pupil
size with your physician. Patients with large pupils when dilated are at
a higher risk of having decreased night vision.
Although the risk
of infection is rare, it is probably the greatest risk during the first
48 to 72 hours following LASIK. Because of the potential dangers
resulting from infection, antibiotic drops are dispensed both before and
after the procedure.
Another complication involves a
non-infectious infiltrate developing beneath the flap. A cloudy
accumulation of inflammatory cells gives the appearance of swirling sand
and has been dubbed "Sands of the Sahara". The cause is unclear;
however, it can be successfully treated by the use of topical steroid
eye drops or lifting the flap to remove the debris.
Some patients find their best vision after LASIK
not as good as with their glasses or contacts. This is called a loss of
best corrected visual acuity. The final result depends not only the
procedure but how a patient heals. Healing determines the speed of
visual recovery, the sharpness of vision and the need for enhancement.
As the degree of correction increases, the importance of healing to the
final visual outcome also increases.
Blindness is the number one
concern of all patients considering LASIK. In surgery, as in life,
anything is possible; however, there has not been a reported case of
permanent blindness occurring after LASIK surgery.
A major component of LASIK surgery
is the creation of the corneal flap (keratectomy). The first
complication associated with the keratectomy is an incomplete flap,
which can be caused by an obstructed microkeratome. Second is a thin
flap, which occurs if there is a loss of suction. These types of
complications will not affect the final outcome; however, it can prolong
the recovery process sometimes leading to a secondary procedure to
complete the correction.
Another complication resulting from the
keratectomy is a "free cap". A free cap occurs when the flap is cut
completely across the cornea leaving no connecting tissue. Although this
is considered a complication, LASIK was originally performed without a
hinge. This condition is manageable by the surgeon, and excellent vision
can still be achieved.
LASIK dramatically reduces your recovery
time and decreases the chance of many of the procedural risks, as
opposed to RK. The procedure takes only a few minutes to complete and
entails minimal discomfort. LASIK requires more technical skill and
training than other laser procedures.
The number of people
considering refractive surgery is at an all time high and LASIK is
considered by virtually all refractive surgeons to be the procedure of
choice today.
Experience has shown us that vision correction using
the excimer laser has been overwhelmingly successful in reducing
myopia, hyperopia and astigmatism. While vision improves following the
procedure, the degree of improvement may vary with each individual.
Overall, 98% of typical patients achieve 20/40 vision or better after
one procedure allowing them to drive legally, play sports, and join the
police or fire departments. Patients may receive a second enhancement
procedure to further improve their results if their vision is below
legal driving levels. Generally, there is a 10% chance that a patient
will require an enhancement procedure. This chance is less in patients
with mild myopia (approximately 5% chance) and greater in patients with
extreme myopia (approximately 20% chance).
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