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I'm thinking of getting LASIK next month, but I was reading a site called LASIK Problems and it had a massive list of potential complications. Has anyone experienced any? I'm scared and don't know what to do.
f you're considering LASIK, you've probably heard a lot about the supposed benefits of the surgery. But what about the risks and long-term consequences? Don't rely solely on a LASIK sales pitch for the facts. Before you risk your eyesight, read Top Ten Reasons Not to Have LASIK Surgery.
1. LASIK causes dry eye Dry eye is the most common complication of LASIK. Corneal nerves that are responsible for tear production are severed when the flap is cut. Medical studies have shown that these nerves never return to normal densities and patterns. Symptoms of dry eye include pain, burning, foreign body sensation, scratchiness, soreness and eyelid sticking to the eyeball. The FDA website warns that LASIK-induced dry eye may be permanent. Approximately 20% of patients in FDA clinical trials experienced "worse" or "significantly worse" dry eyes at six months after LASIK.(1)
2. LASIK results in loss of visual quality LASIK patients have more difficulty seeing detail in dim light (loss of contrast sensitivity) and experience an increase in visual distortion at night (multiple images, halos, and starbursts). A published review of data for FDA-approved lasers found that six months after LASIK, 17.5 percent of patients report halos, 19.7 percent report glare (starbursts), 19.3 percent report night-driving problems and 21 percent complain of eye dryness.(1) The FDA website warns that patients with large pupils may suffer from debilitating visual symptoms at night.
3. The cornea is incapable of complete healing after LASIK The flap never heals. Researchers found that the tensile strength of the LASIK flap is only 2.4% of normal cornea.(2) LASIK flaps can be surgically lifted or accidentally dislodged for the remainder of a patient’s life. The FDA website warns that patients who participate in contact sports are not good candidates for LASIK.
LASIK permanently weakens the cornea. Collagen bands of the cornea provide its form and strength. LASIK severs these collagen bands and thins the cornea.(3) The thinner, weaker post-LASIK cornea is more susceptible to forward bulging due to normal intraocular pressure, which may progress to a condition known as keratectasia and corneal failure, requiring corneal transplant.
4. There are long-term consequences of LASIK • LASIK affects the accuracy of intraocular pressure measurements,(4) exposing patients to risk of vision loss from undiagnosed glaucoma.
• Like the general population, LASIK patients will develop cataracts. Calculation of intraocular lens power for cataract surgery is inaccurate after LASIK.(5) This may result in poor vision following cataract surgery and exposes patients to increased risk of repeat surgeries. Ironically, steroid drops routinely prescribed after LASIK may hasten the onset of cataracts.
• Research demonstrates persistent decrease in corneal keratocyte density after LASIK.(6) These cells are vital to the function of the cornea. Ophthalmologists have speculated that this loss might lead to delayed post-LASIK ectasia.
5. Bilateral simultaneous LASIK is not in patients’ best interest In a 2003 survey of American Society of Cataract and Refractive Surgery (ASCRS) members,(7) 91% of surgeons who responded did not offer patients the choice of having one eye done at a time. Performing LASIK on both eyes in the same day places patients at risk of vision loss in both eyes, and denies patients informed consent for the second eye. The FDA website warns that having LASIK on both eyes at the same time is riskier than having two separate surgeries.
6. Serious complications of LASIK may emerge later The medical literature contains numerous reports of late-onset LASIK complications such as loss of the cornea due to biomechanical instability, inflammation resulting in corneal haze, flap dislocation, epithelial ingrowth, and retinal detachment.(8) The LASIK flap creates a permanent portal in the cornea for microorganisms to penetrate, exposing patients to lifelong increased risk of sight-threatening corneal infection.(9) Complications may emerge weeks, months, or years after seemingly successful LASIK.
7. LASIK does not eliminate the need for glasses Since LASIK does not eliminate the need for reading glasses after the age of 40 and studies show that visual outcomes of LASIK decline over time,(10) LASIK patients will likely end up back in glasses – sometimes sooner rather than later.
8. The true rate of LASIK complications is unknown There is no clearinghouse for reporting of LASIK complications. Moreover, there is no consensus among LASIK surgeons on the definition of a complication. The FDA allowed laser manufacturers to hide complications reported by LASIK patients in clinical trials by classifying dry eyes and night vision impairment as "symptoms" instead of complications.(1)
9. Rehabilitation options after LASIK are limited LASIK is irreversible, and treatment options for complications are extremely limited. Hard contact lenses may provide visual improvement if the patient can obtain a good fit and tolerate lenses. The post-LASIK contact lens fitting process can be time consuming, costly and ultimately unsuccessful. Many patients eventually give up on hard contacts and struggle to function with impaired vision. In extreme cases, a corneal transplant is the last resort and does not always result in improved vision.
10. Safer alternatives to LASIK exist Some leading surgeons have already abandoned LASIK for surface treatments, such as PRK, which do not involve cutting a corneal flap. It is important to remember that LASIK is elective surgery. There is no sound medical reason to risk vision loss from unnecessary surgery. Glasses and contact lenses are the safest alternatives.
[size=50]I like to separate post operative difficulties, whether after Laser Vision Correction(Lasik or PRK) or cataract surgery with the use of advanced technology intraocular lenses, into two columns. The first, and mildest, are what I call the "nuisance" issues and consist of short term dry eye, glare and halo when driving at night and occasional light sensitivity. These all resolve on their own, but, sometime, I use eyedrops to speed the process along. The second group I term "doomsday" scenarios and these are very rare, but very serious. In my opinion, the most significant doomsday scenario in either Lasik or cataract surgery is the risk of infection and, even if it were to occur, either the surgeon or the patient(or usually both) would have to have made some pretty bad choices to allow an infection to get ahead of us. Examples of this are poor surgical technique(I do not allow this to happen). Another is poor compliance by the patient when it comes to taking the pre and postoperative eyedrops(one of which is an antibiotic). A third would be missed appointments by the patient that would allow an early, easily treatable infection, to become a nasty, fast moving, damaging infection. Just let me say that if you have either Lasik, PRK, Phakic ICL, clear lens exchange or cataract surgery in my practice, and you don't show up for one of your post op visits(especially day one) then we are going to find you!
In the end, most serious risks of any surgery can be avoided by good surgical technique and adherence to postop instructions. As long as a good relationship exists between the patient and surgeon, then the risks of grave complications are very low and controllable. Lasik and cataract surgery are two of the safest surgical procedures on the planet and we intend to keep it that way!
LASIK and other types of LASER vision correction are some of the most successful procedures that exist. When using the best technologies and best techniques, the safety and accuracy of LASIK and Laser Vision Correction are excellent. However, like any other surgery, there are some risks associated with LASIK. These risks are usually different from person to person. Certain individuals are very good, low-risk, candidates for LASIK and others are not.
I agree with Dr. Kameen in that you need to have a skilled, experienced, ethical, and meticulous doctor to help avoid LASIK complications. Also, I agree with him in that most concerning LASIK complications can be managed well if caught quickly and treated. I suggest, first of all, that you see a LASIK specialist in your area that has a reputation for high ethical standards and consult with them about whether or not you are a safe LASIK candidate. This requires some high-tech imaging of the surface of your eyes as well as a careful ocular examination.
I also agree with lexifoxy that PRK and surface ablation techniques are excellent alternatives to LASIK which can be done safely with similar results. You can also find detailed descriptions of these different procedures on our website above under PRK, Epi-LASIK, and LASEK.
Another important thing to think about is that the risks of LASIK need to be viewed in perspective of how you are correcting your vision at this time and whether or not it is already exposing you to some risk. Certainly, having glasses is the way of correcting vision that is least likely to cause any complications. That being said, however, even with glasses there are certain safety issues such as incidents that may cause them to break and damage the ocular surface (I have operated on a patient who suffered a ruptured eye from this). Also, high-prescription glasses usually do not provide good peripheral vision potentially making it difficult to notice things in the periphery while driving or riding a bike. Most individuals who are interested in LASIK wear contact lenses. In my career, I have seen countless complications of contact lenses that have caused irreversible damage to certain patients' vision. This risk is compounded when contacts are worn by many people (against medical advice) to participate in water sports such as swimming and surfing. The use of contact lenses in water is directly related to acanthoamoeba infection of the eyes, which is a severe and painful infection that there is essentially no good treatment for. In my personal experience, I have seen many more concerning, irreversible complications of contact lenses than LASIK or Laser Vision Correction.
In summary, there are certainly risks with LASIK. There are certain individuals that are not good LASIK candidates. There are also practices of LASIK that do not have the highest ethical standards. The best way to find out whether or not LASIK is for you is to get an eye examination by an ethical ophthalmologist and obtain as much information as you can. I have tried to the best of my ability to answer all LASIK questions and concerns on my san diego websitehttp://www.sandiegolaservision.com in as much of an unbiased fashion as I can and I hope that it can be helpful to you. Please do not hesitate to contact me with any questions.
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