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What are the risks of laser eye surgery?

Dr Abi Tenen

18/10/2018

Female doctor consulting with young patient

For more than 30 years, laser eye surgery has been performed around the world to correct refractive errors, including short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism. During this time, numerous clinical studies have shown laser eye surgery to be a safe elective procedure.

However, all medical and surgical procedures carry some degree of risk, so it’s extremely important to choose a skilled surgeon and a clinic equipped with the latest technology to reduce your chances of complications.

The risk of complications and side-effects are low

Most of the complications and side-effects from laser eye surgery are temporary and they generally resolve on their own or with follow-up treatment.

Potential issues to be aware of include:

  • Over- or under-correction of your refractive error: this means that the focusing power of your eye is slightly outside the target range after surgery. It is uncommon and can almost always be corrected with an enhancement procedure to further refine the shape of your cornea. The rate of enhancement procedures is approximately 1–2% worldwide. Vision Eye Institute offers free enhancement procedures within two years of your initial surgery if required.
  • Loss of visual sharpness: this is when your vision fluctuates and may not be as clear as it was immediately after the procedure. It occurs uncommonly while the patient’s vision is stabilising after surgery and normally resolves within 6 months.
  • Dry eye: this is a common side-effect for a few weeks or months after surgery but tends not to be an ongoing issue. If it persists, there are usually other underlying issues. Dry eye is more likely after LASIK, so ASLA/PRK may be recommended instead if you have a history of this condition.
  • Problem with the flap: this can occur when the corneal flap created during LASIK is moved out of place prior to healing. You can help prevent this by following post-operative instructions and not rubbing your eyes, swimming or returning to sports too soon.

No patient in Australia has become blind from laser eye surgery

For some patients considering laser eye surgery, their biggest fear is becoming blind as a result of the procedure. Blindness is always listed as a potential side-effect of any eye surgery, but this would usually only result from serious complications inside the eye (e.g. an infection). The reality is that no patient has ever become blind after undergoing laser eye surgery in Australia.

One of the reasons for this is that laser eye surgery is a very superficial and precisely controlled procedure, meaning that the laser only comes into contact with the surface of your eye. In the unlikely event that an infection or damage was to occur, the chance of your inner eye being affected is extremely low.

Our clinic has been operating since 1991 and we are very proud of the fact that we have zero infections on record as a result of laser eye surgery.

Laser eye surgery is considered safe for eligible patients

During your pre-operative appointment, we take a full medical history, thoroughly examine your eyes, and encourage you to discuss your specific visual goals and any concerns. You will need to allow around 1.5 hours for this appointment and you will have the opportunity to ask as many questions as you like.

If you meet the eligibility criteria, and laser eye surgery is the most suitable treatment, your options include:

  • LASIK: this procedure involves creating a thin flap in the surface of your cornea using the ALCON femtosecond laser; you will remain on the same bed while your cornea is then reshaped with the SCHWIND AMARIS excimer laser.
  • PRK (ASLA): after application of topical eye drops to soften your cornea, the top layer of epithelial cells is removed manually before being treated with the SCHWIND AMARIS excimer laser.
  • TransPRK: also known as ‘no touch’ PRK, this procedure involves removing the top layer of your cornea with the SCHWIND AMARIS excimer laser (rather than manual removal). The laser is then used to reshape the underlying corneal tissue.

A lot of my patients are familiar with LASIK, as this is the most commonly performed procedure. In general, this is because LASIK has a shorter recovery time – not because one procedure is ‘better’ than the other. All produce excellent results and have comparable safety profiles.

However, in some situations, one procedure may be recommended over the others based on factors such as your lifestyle, visual goals, general eye health, and the thickness and symmetry of your corneas.

Choose a reputable clinic with the latest technology

Our clinic is home to a state-of-the-art laser suite, fitted with a SCHWIND AMARIS 1050RS excimer laser and the ALCON LenSx femtosecond laser. The 1050RS excimer laser has the fastest and most accurate eye tracking available to date. This sophisticated technology translates into excellent visual results and improved safety for our patients.

Laser eye surgery is not ‘one size fits all’

There is no standard solution for correcting refractive errors, so laser eye surgery may not be the most suitable treatment for everyone. For some of my patients, laser eye surgery is recommended in combination with another treatment for a better outcome, or to treat more than one eye condition at the same time. For others, laser eye surgery may not be recommended at all.

The decision is tailored to each patient’s individual circumstances, suitability and needs.

Find out more about laser eye surgery

Dr Abi Tenen is a highly experienced and well respected refractive and cataract surgeon. Her expertise in a broad range of procedures means she can offer customised care plans for each patient. Dr Tenen practises at Vision Eye Institute Melbourne (St Kilda Rd) and Vision Eye Institute Blackburn South.

References

  1. Choice. A guide to laser eye surgery. NSW, 11 August 2020. Available at https://www.choice.com.au/health-and-body/optical-and-hearing/optical/articles/guide-to-laser-eye-surgery [Accessed 6 January 2021].
  2. Healthdirect. Laser eye surgery. NSW, 2019. Available at https://www.healthdirect.gov.au/laser-eye-surgery [Accessed 6 January 2021].
  3. Lawless M. Refractive Laser Surgery: Who’s Interested Now? mivision 2019;141:33–37.
  4. Wilkinson JM, Cozine EW, Kahn AR. Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK. Am Fam Physician 2017;95(10):637–44.
  5. Murueta-Goyena A, Cañadas P. Visual outcomes and management after corneal refractive surgery: A review. J Optom 2018;11(2):121–29.
  6. Shortt  AJ, Allan  BDS, Evans  JR. Laser‐assisted in‐situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia. Cochrane Database Syst Rev 2013; 1: CD005135.
  7. Doane JF, Cauble JE, Rickstrew JJ, Tuckfield JQ. Small Incision Lenticule Extraction SMILE – The Future of Refractive Surgery is Here. Mo Med 2018;115(1):82–4.
  8. Stonecipher M, Stonecipher K. Influences on Enhancement Rates in Laser Vision Correction. US Ophthalmic Review 2016;9:107–09.
  9. Chua D, Htoon HM, Lim L et al. Eighteen-year prospective audit of LASIK outcomes for myopia in 53 731 eyes. Br J Ophthalmol 2019;103:1228–34.
  10. Mimouni M, Vainer I, Shapira Y, Levartovsky S, Sela T, Munzer G, Kaiserman I. Factors Predicting the Need for Retreatment After Laser Refractive Surgery. Cornea 2016;35(5):607–12.
  11. Somani SN, Moshirfar M, Patel BC. Photorefractive Keratectomy. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2020.
  12. SCHWIND eye-tech-solutions. Frequently asked questions from patients. Germany, 2020. Available at https://www.eye-tech-solutions.com/en/patients/faq [Accessed 6 January 2021].

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The information on this page is general in nature. All medical and surgical procedures have potential benefits and risks. Consult your ophthalmologist for specific medical advice.

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