LASIK Complications & Risks

LASIK eye surgery is considered an effective and safe procedure with a high success rate. However, like all surgeries, LASIK has some potential risks and complications.

Understanding these risks can help you make a confident, informed decision about LASIK.

How Risky Is LASIK?

All surgeries carry risks, but the absolute risk of serious complications with LASIK is extremely low at approximately 0.3%.  

Modern LASIK technology, combined with highly experienced surgeons, has dramatically reduced complication rates compared to LASIK performed in the 1990s. Today’s procedures are safer and yield higher satisfaction rates.

What Are the Potential LASIK Complications?

After the procedure, you may experience some mild side effects. This typically includes dry eyes or visual disturbances.

Your vision may even be over- or under-corrected. Fortunately, most of these side effects subside after some time, and visual inaccuracies can be corrected with LASIK enhancement. 

However, there are also risks for rare or severe complications, such as:

• Regression. Your vision may regress to your former prescription or worsen after surgery. This requires LASIK enhancement treatment.
• Irregular astigmatism. An unequal curvature of your cornea causes visual distortions like glare, halos, and shadows around images.
• Decentration. Occurs when the laser isn’t centered correctly on the eye during surgery, resulting in irregular astigmatism. 
• Flap wrinkles or folds. A flap that doesn't lie smoothly after surgery can affect your vision. These often improve with time; if not, minor adjustments can be made.
• Epithelial ingrowth. This happens when surface cells from the cornea grow under the flap, which may need to be removed for optimal vision.
• Corneal ectasia. A rare complication that results in corneal thinning.
• Diffuse Lamellar Keratitis (DLK). A type of inflammation that occurs under the LASIK flap; it typically occurs within the first week post-surgery.
• Infection. It may occur if bacteria enter the surgical site or if the flap heals improperly. Symptoms include pain, redness, and light sensitivity.

If you experience chronic severe pain, debilitating dry eye, or persistent visual issues, contact your doctor immediately.

What Increases the Risk of Complications?

While LASIK is generally safe, your risk of complications can vary based on certain factors. These include:

• Thin or irregularly shaped corneas
• Higher eye prescriptions that require deeper laser treatment, which can reduce structural support
• Pre-existing dry eye disease or poor tear production
• Conditions like rheumatoid arthritis or diabetes can impact healing, potentially complicating recovery

There are also concerns about large pupils, but modern lasers can effectively address large pupils, reducing the risk of complications.

What to Do if a Complication Occurs

If you start experiencing severe dry eye, consider using lubricating eye drops. Persistent cases may require prescription anti-inflammatory medications, punctal plugs, or specialized therapies like serum tears or scleral lenses.

For over- or under-correction, enhancement surgeries are usually considered after 3 to 6 months. Especially if significant residual refractive errors persist and sufficient corneal thickness remains.

Treatments like corneal collagen cross-linking (CXL) can help improve vision for rare cases of corneal ectasia. Specialty lenses, like rigid gas permeable or scleral lenses, can also improve vision.

How to Prepare for LASIK

One of the best ways to avoid complications during LASIK is to know how to prepare for the procedure. Here are our tips to prepare for the procedure:

• Talk to your surgeon about your overall health and medical history
• Avoid wearing contacts for at least 1 to 3 weeks to allow your corneas to return to their natural shape
• Avoid wearing makeup, perfume, cologne, or scented products on the day of surgery
• Have someone drive you home after the procedure

Your surgeon will conduct a thorough eye examination to assess your overall eye health and ensure you’re not taking any medications or experiencing any conditions that may affect the procedure or the healing process.

How to Recover From LASIK Eye Surgery

Another way to prevent complications is by following your doctor’s specific post-op instructions. These include using eye drops, pain relief medication, and avoiding activities that can impact your eyes (swimming, working, and sports).

After the procedure, you should rest and give your eyes a break. During this time, you can expect some blurry vision and light sensitivity. 

While healing, try to stay hydrated and eat healthy foods; your body will need nutrients to heal. Avoid smoking, and make sure to attend your follow-up appointments so your doctor can monitor your progress.

Your eyes will fully recover in 6 months. However, your recovery might take longer if you have a higher eye prescription before surgery.

Are You a Good Candidate for LASIK Eye Surgery?

To be a good candidate for LASIK, you must have an eye prescription within a treatable range. Generally, this includes up to -12.00 diopters for nearsightedness, +6.00 diopters for farsightedness, and up to 6.00 diopters for astigmatism.

Other criteria required to get LASIK include:

• At least 18 years old, preferably 21 or older
• Stable prescription for at least 1-2 years
• Adequate corneal thickness
• No eye diseases, infections, or severe dry eye syndrome
• No uncontrolled autoimmune disease or poorly-controlled diabetes
• Not pregnant or nursing
• No history of certain eye conditions such as keratoconus, severe cataracts, or glaucoma