LASIK Surgery for Vision Correction

Benefits Versus Risks for LASIK Eye Correction Surgery

Oct 19, 2009 Christine Redmond

LASIK eye correction surgery can improve vision dramatically; however, many risks are associated with the procedure that have to be weighed up against the benefits.

LASIK eye correction surgery has helped many throw away their glasses and lenses, improving vision dramatically. However, as with all surgical procedures, there are risks associated with LASIK, some of which are quite serious.

What is LASIK Eye Correction Surgery?

LASIK - Laser-Assisted In Situ Keratomileusis - is a surgical procedure used to improve one’s vision, whereby an eximer laser permanently changes the shape of the cornea, the clear covering on the front of the eye.

LASIK was first introduced in 1998 and is now a widely available technology that can be used to correct short-sightedness, far-sightedness and astigmatism.

The procedure is as follow:

• A device, called a kerotome, uses either a blade (mechanical microkeratome) or a laser (laser keratome) to cut the cornea and produce a flap that is still attached at one end.
• The corneal flap is then folded back to reveal the stroma, the middle section of the cornea.
• Laser beams are used to remove a portion of the stroma. These beams are delivered in pulses and are targeted to the desired area using a computer-controlled laser device, which also controls the amount of laser delivered to the eye.
• Once the LASIK treatment is complete, the corneal flap is replaced in position and an eye shield is placed on the treated eye, which should remain until the first postoperative visit by a doctor, usually within 12 to 48 hours following surgery.

Effectiveness of LASIK Eye Correction Surgery

Many patients may not achieve perfect vision following this technique; however, a dramatic change in the quality of their vision can be achieved, with LASIK eye correction surgery typically improving vision more precisely than corrective lenses can. For patients with low to mild myopia (short-sightedness), which represents the majority of patients that undergo LASIK eye surgery, data has shown that the procedure results in around 95% of patients achieving 20/40 vision or better and 67% achieving 20/20 or better vision.

It must be noted, however, for those patients who present with a large refractive error, results achieved from LASIK treatment are generally not as good as for those who have a lower refractive error. In addition, for some farsighted patients, the vision correction achieved with LASIK may deteriorate with age, with many patients requiring corrective lenses at some stage following the procedure.

Risks Associated with LASIK Vision Correction Surgery

As with all surgical procedures, there are many risks associated with LASIK eye correction surgery. The risk of developing complications following LASIK is reported to be around 1%, with this figure having improved over time as technologies have also improved.

The most common problems associated with the procedure include flap complications. This includes;

• Possible abrasion when using a microkeratome to cut the flap, which can be treated and healed within a few days
• Diffuse Lamellar Keratitis (DLK), which occurs when dead cells become lodged beneath the corneal flap, and the cornea then initiates an inflammatory response against the dead cells. This can affect 2-3% of patients and can result in scarring or permanent loss of vision if treatment is not initiated quickly.

Other common problems include:

• Induced astigmatism, which may result when the corneal surface is not smooth or if the surgery is not performed correctly. This can result in double vision or blurred vision and is typically treated with further surgery to correct the problem.
• Dry eye, which can contribute to inflammation and infection; most of the time this is resolved using eye drops
• Infection of the eye, which can result in corneal scarring that may reduce the sharpness of vision; antibiotics are usually prescribed following surgery to prevent infection.
• Over or undercorrection of refractive error, which can result in blurry vision or visual disturbances. As such, many patients have to continue to wear contact lenses or glasses. Some patients can be re-treated with eye correction surgery.

More Severe Complication Associated With LASIK Eye Correction Surgery

More severe complications that may occur include the following:

• Night vision problems, which are more common with traditional LASIK procedures or when the eye surgeon treats too small an area surrounding the pupil. Sometimes these symptoms are debilitating, with patients experiencing glare, halos, and/or double vision, which can permanently affect their night-time vision.
• Loss of vision that cannot be corrected through the use of corrective lenses or surgery. This may occur when a patient experiences keratectasia, also known as corneal ectasia, Keratectasia results when the corneal flap is cut too deeply or too much tissue is removed during surgery, thus weakening the cornea and causing it to bulge forward in an irregular fashion. This complication may not be seen until months or even years after the procedure is carried out, and can cause increasing astigmatism and permanent distortion of vision.
• Severe dry eye, which causes discomfort and also visual problems due to intermittent blurring. This condition may be permanent, but can be treated with intensive drop therapy and the use of punctal plugs, which help keep moisture on the eye by preventing tears from draining too quickly.

In addition to the above complications, there is no long-term data related to the safety and effectiveness of this procedure as yet.

Since the first availability of LASIK eye correction surgery in 1998, the technology behind this procedure has improved and the incidence of side effects related to LASIK have declined as a result. While some people considering LASIK will wait until further improvements are made to the technology, others will have to weigh up the risks versus the benefits of this procedure before embarking down the road to hopefully a life free of glasses or lenses.

Readers may also be interested in the following article: Quality of Life After LASIK Eye Surgery

Sources:

FDA Website: LASIK – What should I expect before, during, and after surgery?, last updated 19th August 2009, viewed October 19th, 2009

LasikEyeSurgeryCorrection Website: Risks of LASIK Surgery, viewed October 19th, 2009

Sakimoto et al., “Laser eye surgery for refractive errors”, Lancet, 367: pp. 1432-1447

The copyright of the article LASIK Surgery for Vision Correction in Health Field is owned by Christine Redmond. Permission to republish LASIK Surgery for Vision Correction in print or online must be granted by the author in writing.

LASIK Eye Correction Surgery

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