Dr. Jeffery J. Machat: Hello! I am Dr. Jeff Machat, Medical Director of Crystal Clear Vision. Today I am going to discuss the possible risks of having a LASIK procedure. The greatest risk for any surgical eye procedure is simple, blindness. It is quite possible that catastrophic infection could occur, much in the same way that contact lenses have resulted in blindness. Most LASIK complications however do not result in blindness; in fact, this outcome is incredibly rare, by most accounts, far less than one in a million. In addition to blindness, LASIK can result in surgical corneal flap complications or healing problems, producing corneal irregularities or scarring, reducing the sharpness, crispness, and clarity of your vision. Regardless of the exact cause, these irregularities medically grouped under the term irregular astigmatism can affect the quality of your vision. The best way to understand irregular astigmatism is to think of a fresh sheet of aluminum foil. Then imagine how a flashlight will cleanly bounce a light beam off of it. Then imagine crunching that piece of foil into a ball, and then spreading it open again. It would be all crinkly. Imagine now bouncing that same flashlight beam off of that surface, it would scatter light rays everywhere. Irregular astigmatism has many causes, most of which are related to uneven or irregular healing. This problem occurs in about 1% of patients. More common with older technologies and techniques and less often with new or mover advanced LASIK procedures. There are two other important potential complications with LASIK; dry eyes and ectasia. While people who have had dry eyes before LASIK are at greatest risk, patients with no history of dry eyes or any risk factors have developed painful dry eyes following LASIK, while others with dry eyes preoperatively actually gain relief from surgery. So it's not simple. LASIK affects the neural pathways and the normal lubrication pattern of the eyes. Dry eyes is the most common complaint following LASIK and one of the most difficult to manage, even if patients see perfectly.
Furthermore, dry eyes worsen with age, with or without LASIK. Although rare, corneal ectasia is a bulging or weakening of the cornea, much like the bulging that occurs when there is a weak area on a tire. It can produce a worsening of nearsightedness, development of astigmatism, including irregular astigmatism, a reduction in the quality of vision, the loss of best corrective vision, and may even necessitate a corneal transplant. So those are some of the risks to consider before moving forward with the LASIK procedure.