The Rewards and the Risks of Lasik (laser-assisted in situ keratomileusis)

According to Market Scope, around 10 million Americans have had LASIK surgery since it was first approved by the FDA in 1999. Around 700,000 LASIK surgeries are done each year, but that’s down from a peak of 1.4 million in 2000.

It remains one of the most popular elective surgeries in the country, and its satisfaction rating among patients who’ve had the procedure is remarkably high. Eric Donnenfeld, MD, a former president of the American Society of Cataract and Refractive Surgery, has successfully completed around 85,000 procedures over his 28-year career. He says that overall, 96% to 98% of LASIK patients end up with 20/20 vision. 40 to 50% end up with vision that is better than 20/20.

Sight-threatening complications such as significant loss of vision from LASIK surgery are extremely rare, and many side effects and laser eye surgery complications can be resolved with additional surgery or medical treatment. In most cases the side effects are temporary

The Rewards associated with Lasik:

  • Correction of nearsightedness (myopia)
  • Correction of farsightedness (hyperopia)
  • Correction of Astigmatism
  • No more vision correction devices like glasses or contacts

Like any surgery Lasik has its risks:

  • Dry eye
  • Glare
  • Halos
  • Double vision
  • Under /over corrections
  • Irregular astigmatism-This is caused by an unequally curved corneal surface. Irregular astigmatism also can occur from laser correction that is not centered properly on the eye or from irregular healing.
  • Flap problems- If the LASIK flap is not made correctly, it may fail to adhere properly to the eye’s surface
  • Vision Loss or Changes
  • Epithelial ingrowth- This is when cells from the outer layer of the cornea (epithelium) grow under the flap after LASIK surgery. In most cases, epithelial ingrowth is self-limiting and causes no problems. But in some cases (reported to be 1 to 2 percent of LASIK procedures), symptoms of discomfort and/or blurred visioncan occur, and additional surgery is needed to lift the flap and remove the epithelial cells.
  • Diffuse Lamellar Keratitis- Nicknamed “Sands of the Sahara,” this is inflammation under the LASIK flap that may have several causes. Some inflammation of the cornea after LASIK surgery is normal. But if it is uncontrolled, as in DLK, it can interfere with healing and cause vision loss. If DLK occurs, it usually responds to therapies such as antibiotics and topical steroids. Also, the flap might need to be lifted and cleaned for removal of inflammatory cells and to prevent tissue damage.

There are also health conditions which carry an even higher risks to patients in Lasik

  • Autoimmune disorders such as Rheumatoid arthritis
  • A weakened immune system caused by immunosuppressive medications or HIV
  • Persistent dry eyes
  • Unstable vision due to medications, hormonal changes, pregnancy, breast feeding or age
  • Keratitis, Uveitis, herpes simplex affecting the eye area, glaucoma, cataracts, eye injury or lid disorders.
  • Too thin or irregular corneas
  • Large Pupils

As a patient having had Lasik myself back in 2001 and I am still very happy with the results, but be wary Lasik is still a surgery with risks and rewards weigh all of the options and chose a skilled eye surgeon to perform the procedure. Just because they advertise on television or will do the procedure cheap does not make them an expert. Do your research. People will spend hours on the internet shopping for a TV or camera, check out your doctor too.



All About Vision


The Mayo Clinic




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