Laser Complications:
This includes decentrations of the laser treatment, central island formation, or seriously irregular ablation patterns. Mild degrees cause little trouble, but more serious situations require sophisticated retreatment procedures.
Laser complications are less common with
modern, top-of-the-line lasers such as
the VISX Star S4.
Inflammation (DLK, SOS):
Inflammation is a normal reaction in any surgery, and the
postoperative medications typically handle this response very easily. However, if this reaction is exaggerated, it can require more extensive therapy and rarely can affect the visual outcome.
Diffuse
Lamellar Keratitis (DLK), which has also
been termed the "Sands of the
Sahara" (SOS), due to its sandy
appearance under the microscope, refers
to inflammation underneath a flap. As
such, it is only found after LASIK.
Reported incidence: 1% non-severe, 0.02% severe (2-4) Our rate: 0.02% all mild
Overcorrection:
It is possible for the eye to over-respond to the calculated laser treatment. Mild cases are typically visually
insignificant. However, significant overcorrection can be bothersome and require a
retreatment procedure to correct the situation.
Reported incidence: 1% (5-7) Our rate: 0.57%
Keratome/Flap Complications:
Creation of the corneal flap in LASIK is a crucial element in the overall process. Flap complications can include small flaps, irregularly
shaped flaps, very thin flaps, button-hole flaps and
an irregular treatment surface. If the abnormality is serious enough, the case must be cancelled without performing the laser treatment. After a 3-6 month healing period, a satisfactory flap can usually be created in a second attempt.
Reported incidence: 0.7-11.8% (5,6,8,9) Our rate: 0.18% over 8600 cases
Epithelial Ingrowth:
This is a condition in which the surface epithelial cells manage to migrate beneath the edge of the LASIK flap and invade the area known as the "interface". This is rare on primary cases and most commonly associated with
retreatment procedures. Mild cases are of no significance, but more aggressive intrusions can cause discomfort,
a decrease in vision or threaten the health of the flap itself. In these more serious cases, it may be necessary to
re-lift the flap and remove the cells. This is usually very successful and has no serious visual consequences.
Infection:
One of the serious complications of any surgical procedure is infection. This can lead to serious loss of vision.
Reported incidence: <0.1% Our rate: 0%
in 8600 cases
Corneal Distortion or Thinning Requiring Corneal Transplant:
Reported incidence: 0.01% Our rate: 0%
in 8600 cases
Corneal Perforation:
Certain keratome technology can allow the flap cut to penetrate
the eye, often leading to very serious consequences. Most of this technology has been replaced.
Reported incidence: <.01% Our rate: 0% in
8600 cases
References:
(1) Montes M, Chayet A, Gomez L, Magallanes R, Robledo N. J Refract Surg. 1999: 15: 106-110.
(2) Steinert RF, McColgin AZ, White A, Horeburgh GM. Am J Ophthalmology. 2000; 129: 380-381.
(3) Yeoh J, Moshegov CN. Clin Experiment Ophthalmology. 2001; 29: 435-437.
(4) Chang-Godinich A, Steinert RF, Wu HK. Arch Ophthalmology. 2001; 119: 1074-1076.
(5) Ambrosio, R, Jr., Wislon SE. J Refract Surgery. 2001; 17: 350-79.
(6) Stulting RD, Carr JD, Thompson KP, Waring GO, Wiley WM, Walker JG. Ophthalomology. 1999; 106: 13-20.
(7) Kawesch GM, Kezerian GM. Ophthalmolgy. 2000; 107: 653-61.
(8) Tham VM, Maloney RK. Ophthalmology. 2000; 107: 920-924.
(9) Lin RT, Maloney RK. Am J Ophthalmology. 1999; 127: 129-136.
(10)Knorz, MC, Jendritza B, Hugger P, Liermann A. Ophthalmologe. 1999; 96: 503-508.
Please
note: The above section summarizes many
of the most common patient concerns. It
does not, however, attempt to list every
possible concern.
