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Is laser eye surgery safe?

Dr Patrick Versace


This is the most common question I am asked by patients who are considering laser eye surgery. And for good reason. Your sight is precious and any procedure involving your eyes may seem daunting.

You can be reassured that laser eye surgery is one of the safest elective surgical procedures available today. Different forms of laser eye surgery have been performed for over 30 years and the procedure is very well established. Over the years, LASIK, ASLA and SMILE® have been studied extensively and there is a wealth of clinical evidence showing that each vision correction procedure is safe and effective for people who qualify. Being the right candidate for laser eye surgery is a really important point that I will come back to later. But for now, the best way to illustrate how safe laser eye surgery is to look at some of the data.

Over 16 million people have had LASIK

Because LASIK is the most commonly performed laser eye surgery procedure, there have been thousands of studies analysing its safety and how well it can correct refractive errors (e.g. short-sightedness, long-sightedness or astigmatism), which is referred to as its ‘efficacy’. A recent review article took 97 of the best-designed LASIK studies, which included 67,893 LASIK-treated eyes, and analysed their results together to understand the worldwide outcomes. They found that:

SMILE and ASLA are as safe and effective as LASIK

LASIK is not suitable for all eyes – different laser eye procedures work best on different refractive errors or corneal features. ASLA is suited to people who have thin corneas, because those patients are at increased risk of complications if they have LASIK. ASLA has actually been around longer than LASIK, but it is used for fewer patients because it has a longer recovery time. The good news is that studies have shown that patients who have ASLA can expect safety and outcomes comparable to LASIK.2

A more recently developed vision correction procedure is SMILE, which was introduced 10 years ago for people with short-sightedness and astigmatism. Many patients prefer SMILE because it is keyhole surgery, so there is no disturbance to the surface of the eye. One million eyes have been corrected using this type of laser eye surgery, and there is a growing body of clinical evidence to show how safe and effective SMILE is, including many studies comparing it to LASIK. A recent review article analysed data from more than 100 of these comparison studies and showed that SMILE was at least equal to LASIK for safety and efficacy.3

The risks of side-effects and complications are low

Most issues that can arise after laser eye surgery resolve in the short term. However, it’s important to have a good understanding of the potential risks before going ahead with the surgery. These include:

Serious complications are very rare

Most people’s biggest fear associated with laser eye surgery is going blind. But you can be reassured by the fact that blindness as a result of laser eye surgery has never occurred in Australia. Many people think that the laser itself could cause blindness, but in fact an eye infection contracted during or after surgery could cause severe visual impairment (if not treated or managed properly). That’s why it is incredibly important that you choose an experienced surgeon from a reputable clinic for laser eye surgery. This will greatly reduce your chances of any serious complications.

As the technology used in laser eye surgery continues to develop, the risks of other complications continue to decrease. For example, it is now standard practice to use a laser (rather than a blade) to create the flap in LASIK, which reduces the risk of inflammation in the eye. If you choose a modern clinic that uses the latest technology, you’ll further reduce your risk of complications.

Be sure that laser eye surgery is safe for you

At the beginning of this article I said that laser eye surgery is safe and effective for the people who qualify for each procedure. If your eyes are not suited to a procedure, the results may be less effective and you may be at greater risk of post-operative complications. An experienced surgeon will undertake a comprehensive evaluation to understand everything about your eyes – from the thickness and shape of your cornea to your general eye health – before advising whether you are eligible for laser eye surgery and which procedure best suits your eyes. If you are told you are not a suitable candidate for laser eye surgery, take that recommendation seriously.

And if you are told you are a good candidate for laser eye surgery, you can join the millions of people worldwide who are living their life free from glasses and contact lenses. Read more about the cost of laser eye surgery.

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  1. Sandoval HP, Donnenfeld ED, Kohnen T et al. Modern laser in situ keratomileusis outcomes.
 J Cataract Refract Surg. 2016;42(8):1224-1234.
  2. O’Bart D. Excimer laser surface ablation: a review of recent literature. Clin Exp Optom. 2014;97:12–17.
  3. Zhang Y, Shen Q, Jia Y et al. Clinical Outcomes of SMILE and FS-LASIK Used to Treat Myopia: A Meta-analysis. J Refract Surg. 2016;32(4):256–265.


This article is not a substitute for a consultation with your surgeon. Before choosing to proceed with laser eye surgery your surgeon will have a detailed discussion with you about the potential complications of your procedure.

SMILE® is a registered trademark of Carl Zeiss Meditec

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