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Possible LASIK ComplicationsLASIK Vision Correction Complications Denver - Boulder - ColoradoSo, how bad can it get? Can you go blind from Laser Vision Correction? There has not been one case of blindness in any FDA Laser Vision study since the studies initially began in the early 1990's. In my practice, no patient that I am aware of, has had to give up any activity in their life because of a complication from Laser Vision Correction.
Over 95% of my patients are satisfied after Laser Vision Correction; however, Laser Vision Correction is NOT PERFECT! Dryness, hazy vision in dim light, and night glare occur initially after EVERY LASIK procedure. The dryness often requires the use of lubricating eye drops ("artificial tears") for weeks to months following LASIK, and usually resolves after three to six months. Rarely, patients have persistent dry eyes. The hazy vision in dim light usually resolves within a few weeks, although it may last longer in patients that had large amounts of nearsightedness treated with LASIK. The night glare ("halos" around headlights) usually resolves within a few weeks, although glare may be permanent after LASIK. I use a VISX Star 4 Excimer Laser which has a large optical and blend zone. These large zones on the VISX Laser significantly decrease the incidence of night glare. And to further decrease the incidence of glare and halos I would recommend that you consider CustomVue Wavefront and IntraLase Lasik. The IntraLase also adds significant safety to the Lasik procedure. Approximately 5-10% of patients require a retreatment after LASIK, usually performed about three months after the initial LASIK procedure. With the CustomVue Wavefront and IntraLase, the retreatment rate is much lower, approximately 2%. I do not consider retreatments a "complication". Retreatments are performed at no additional charge for 12 months after surgery or indefinitely, if you have annual routine exams by Dr. Levinson. For details, see our Lifetime Promise Agreement. Potentially serious complications...
2. FLAP WRINKLES - When I replace the corneal flap after performing the LASIK procedure, small folds in the flap are common, and are easy to identify and remove at the time of the LASIK by simply refloating the flap. However, small folds can occur rarely in the flap in the first few hours following the procedure. Wrinkles probably occur when the patient inadvertently squeezes the eye tightly shut. Visually significant wrinkles occur in less than 1% of cases. If wrinkles occur, I take the patient back to the Laser Center, anesthetize the eye with an eye drop, relift the flap and smooth out the flap to remove the wrinkles. This usually removes the wrinkles successfully. If this does not, I repeat the retreatment procedure a second time. 3. CENTRAL CORNEAL ISLANDS - Although the configuration of the Laser beam is highly homogeneous, small central surface irregularities, called "central islands", can occur in less than 1% of cases. These usually resolve without treatment. In a very small percentage of cases, the central islands may persist, requiring a "touch up" with the Laser. I have not had a patient lose vision from a central island. 4. EPITHELIAL INGROWTH - Small cells from the corneal epithelium, the "clear skin" that covers the cornea, can become embedded under the LASIK flap. This occurs in less than 1% of LASIK cases. The cells can start to grow and form a thin sheet of epithelium under the flap. This will affect the vision. The epithelial cells are usually easy to remove by anesthetizing the eye with eye drops, painlessly lifting the flap, and irrigating or mechanically removing the aberrant epithelial cells. I have had two patients with epithelial ingrowth; both were very successfully treated and have had no further problems. 5. HAZE UNDER THE FLAP (DLK) - Usually, the corneal tissue under the LASIK flap remains clear. However, the tissue under the flap can become hazy. The haze can look like small pieces of sand (this condition has been called "Sands of the Sahara"). This haze is very uncommon, but has been reported to occur to the point where vision has been affected. The cause of the haze is unknown, and usually responds to steroid eye drops. I have had two patients whose vision has been permanently affected by this haze with loss of best-corrected vision 6. DISLOCATED CORNEAL FLAP- The corneal flap is remarkably stable after LASIK, but I have had one patient's flap dislocate after surgery. The patient had an uneventful LASIK procedure. However, when I saw her the day after surgery, her flap had come loose, and was tucked up under the upper eye lid. It was still attached at its base to the cornea. The patient had experienced significant non-LASIK emotional distress three hours after her LASIK procedure, and had sobbed heavily for approximately five minutes. This probably caused the flap to dislocate. I brought the patient back to the Laser Center and easily repositioned the flap. Fortunately, the flap remained in position and the patient had 20/20 vision 48 hours after the flap was repositioned. 8. PERMANENT UNCORRECTABLE BLURRY VISION OR "GHOST IMAGES" - Rarely, a patient may have corneal irregularity after LASIK that causes blurry vision or "ghost images". "Ghost images" are similar to a TV picture with poor reception; overlapping the main image is an identical, but dim second image. A retreatment may not be able to treat a post-LASIK corneal irregularity. 9. RETINAL HEMORRHAGE OR DAMAGE TO THE OPTIC NERVE - In making the LASIK flap, I put a suction device on the eye which increases the pressure in the eye for approximately 20 seconds. Very rarely, this elevated pressure could cause bleeding in the retina or damage to the optic nerve. Both of these complications could cause permanent vision loss. I have never had either of these complications occur. 10. INFECTION - In any surgical procedure, infection can occur. An infection after LASIK could potentially cause scarring of the cornea, with permanent vision loss. Fortunately, however, infection is extremely rare after LASIK. In fact, I have not had an infection occur in any patient after LASIK. 11. CORNEAL ECTASIA - Cutting a corneal flap for LASIK can cause structural weakening of the cornea. Although LASIK has been performed since 1996 in the USA, the cutting of corneal flaps has been performed worldwide since 1959 for treating corneal diseases and refractive errors. I have learned that if I cut too deep of a flap or remove too much corneal tissue with LASIK, I can structurally compromise corneal integrity, resulting in a "weakened" cornea that may "bulge" months to years after LASIK. This is called "ectasia" and can cause significant regression of the LASIK treatment, resulting in the recurrence of significant nearsightedness and/or astigmatism. Retreatment is not possible and would even make the regression worse. In the rare case of extreme ectasia, a corneal transplant would be necessary to regain useful vision. I have a 1/1000 incidence of corneal ectasia and I have had one patient require a corneal transplant after LASIK. To minimize the risk of ectasia, I do corneal topography and measure the corneal thickness (pachymetry) of every LASIK patient prior to LASIK to identify patients that are at risk for developing ectasia. I will not perform LASIK on any patient that I think is at risk for developing ectasia. Approximately 2% of LASIK candidates that I examine are at risk for ectasia and cannot be safely treated. 12. HUMAN ERROR - To err is human but..... No matter how thorough, meticulous, conscientious, etc., I, or any surgeon, am, the possibility of human error exists. All the above listed complications are inherently potential risks of Laser Vision Surgery but human error, theoretically, should never occur. Human error, for me is the scariest of all complications because, theoretically, at least, I should never make an error. I am comfortable claiming that I am 99+% "perfect". Regrettably, I have had one patient for whom I put a wrong number in the computer that controls the Excimer Laser, in 1999. The patient did see 20/40 in the eye after being incorrectly Lasered by me, and could have been retreated and corrected to 20/20. Understandably, she was not that interested in having me ever Laser her again. The above complications are all rare and can usually be successfully treated. However, treatment may not completely correct these, or other problems, and the patient could, rarely, experience a permanent, non-treatable decrease in their best-corrected vision after LASIK. The chance of "going completely blind" from LASIK is probably zero. In the "worst case" scenario, which is extremely rare (approximately 1 in 2000 cases) a patient would require a corneal transplant to correct a LASIK complication. Phone
(303)393-0347
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The Levinson Eye Clinic, in Denver Colorado, and its laser vision correction surgeon, Dr. Richard A. Levinson, M.D., provide the latest technology in eye care and Lasik vision correction surgery for Custom Wavefront Lasik in the Denver and Boulder Metro area. Dr. Levinson and his refractive eye surgery staff use the Visx Star S4 excimer laser for Lasik or PRK refractive eye surgery with Customvue Wavefront Lasik. Contact Dr. Levinson and his Denver, Colorado laser vision correction staff for more information or to schedule a complimentary Custom Lasik vision correction consultation.
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