When the first Photorefractive Keratectomy (PRK) laser vision correction surgery was performed in 1989, there were a lot of unknowns regarding the risks, effectiveness, and longevity of the surgery.
Back then, complications such as glare, blurred vision because of a residual prescription, haze, double vision and infections occurred much more frequently.
But fast forward over 30 years, to the present day, and the laser eye surgery techniques and equipment used are far more advanced, meaning the risks involved in having laser eye surgery are minimal and the outcome is far more precise.
Despite laser correction now being safer than it has ever been, with various complications being greatly reduced or even eliminated, laser eye surgery is still surgery and should always be treated as such – with due care and consideration.
How Dangerous is Laser Eye Surgery?
Vision loss due to complications from laser eye surgery is extremely rare, particularly with modern laser eye surgery techniques. However, certain side effects are common, and these symptoms generally resolve within a few weeks or months. The most common complications associated with eye surgery include:
- Dry Eyes
- Eye Infections
- Halos or Glare
Want To Find Out If You’re Suitable?
If you’re wondering whether laser eye treatment is the right choice for you, there are some key things to consider…
Can Laser Eye Surgery Go Wrong?
The chances of experiencing complications from laser eye surgery, including various minor ones, has been documented to be less than one per cent.
Most laser eye surgery complications actually arise when the patients treated are not good candidates for the procedure.
This ultimately comes down to the surgeon and clinical setting.
If it’s a high volume or sales-orientated environment where less time is spent on assessment and selection and more time is spent trying to get as many people as possible treated, laser eye surgery risks will rise.
Despite this, serious complications with LASEK / PRK or LASIK eye surgery are actually rare, providing the patient is suitable and known risks have been reduced e.g. from pre-treatment of any dry eye to improve post-operative healing and recovery.
But while laser eye surgery might seem risky, all vision correction options have an element of risk. For example, it is well known that there is a higher risk of infection if you wear contact lenses long-term than from LASIK eye surgery.
Providing you are deemed a suitable candidate and the surgeon is reputable and experienced, laser eye surgery risks are extremely rare and the procedure is incredibly safe.
What Are the Risks of Laser Eye Surgery?
Although you may not think it, the biggest risk in the laser eye surgery process arises at the consultation stage.
Laser eye surgery safety is primarily about only operating on suitable candidates.
PRK and LASIK eye surgery outcomes are almost always favourable for those who don’t have any indications of increased risk and are suitable to proceed; however, not everyone is deemed a suitable candidate.
A good indication of the success of any clinic is the percentage of patients who require a second ‘top-up’ procedure to enhance the result, known as an enhancement or re-treatment.
These enhancements or retreatments can be caused by over- or under-correction, which is where too little or too much tissue is removed from the corneal tissue during the procedure.
The LASIK protocols created and followed at Focus Clinic have led to a remarkably low re-treatment rate, at less than 1% of typically short-sighted cases (2014 data), compared to between 3% and 9% in published studies.
Primary laser eye surgery treatments, even for high levels of myopia, remain consistently accurate and relatively risk-free.
As with any medical intervention, there are possible risks and side effects that can occur.
All of these will be discussed at your consultation. It’s important that you are aware of the potential issues before you go ahead with the surgery and discuss any concerns you have at your consultation.
Most Common Laser Eye Surgery Side-Effects
While the laser surgery process is incredibly safe, there is still a chance that patients can develop some side effects. Your eye surgeon should discuss potential risks with you and explain why the procedure selected will be an effective treatment in your circumstances.
The most common risks for laser surgery patients are:
- Dry Eyes
- Eye Infections
- Halos or Glare
Read more about laser eye treatment side effects here.
Dry Eyes
The most prevalent complication reported after this surgical procedure is persistent dry eyes (a gritty sensation, redness and fluctuating vision). Published studies show rates of up to 20-50% of patients.
Dry eyes before treatment can increase the risks of persistent, increased dry eyes after laser eye surgery, so it is highly recommended that if you suffer from dry eyes, you get this condition treated before laser eye surgery is performed.
At Focus Clinic, pre-treatment of any existing dry eye symptoms using lubricating eye drops has dramatically improved these rates, dropping the post-op incidence to less than 1% of our laser eye surgery patients.
If your eyes are very dry beforehand, your risks are increased, and it is likely better to avoid laser vision surgery. Another option for selected short-sighted patients is an ICL (implantable contact lens) with far less risk of induced dryness.
If you aren’t sure if you suffer from any pre-existing eye conditions, like dry eyes, you can speak to a consultant ophthalmic surgeon prior to any surgical procedures taking place.
Eye Infections
Other, more rare complications of laser eye surgery include infections which can occur in roughly 1 in 10,000 cases.
That figure is much less common than an eye infection leading to vision loss from contact lenses, which occurs in roughly 1 in 2,000 cases.
Hence, contact lenses are at least 5 times more likely to cause loss of vision from micro-organisms compared to LASIK surgery.
Halos or Glare
Some patients experience halos, which show as circles around bright lights, or glare after surgery. They are due to the cornea healing process as the reshaped cornea refracts light differently. As the eye heals, these symptoms can resolve without requiring further surgery.
Halos and glares can also be linked with the degree of prescription treated. It’s most commonly seen in high and extreme myopia cases, typically of -8.00 dioptres and higher. They can also occur following corneal transplants.
A better option for some patients with very high prescriptions is placing a contact-lens type implant inside the eye, known as an ICL. ICLs have been a major breakthrough for extreme myopia, with a much lower chance of night vision problems.
Another laser eye surgery treatment that has shown reduced symptoms like halos and glare is Ray-Tracing Guided LASIK. This creates a 3D model of your eye to conduct thousands of procedures prior to the physical surgery. This limits over correction, light sensitivity and refractive errors from occurring and gives the best results we’ve ever seen.
How To Reduce The Risks of LASIK?
Overall, the risk of a complication requiring further treatment, by laser or any other technique, is approximately 1 in 1000, and where there is no significant visual loss.
The chance of a more serious complication, which would affect vision in one eye or the other, or both, is 1 in 10,000.
There are two types of laser eye surgery (and other options for those not suitable for laser eye surgery). This gives surgeons the ability to choose the best procedure for the patient, significantly reducing the risks of problems occurring post-surgery.
Sometimes laser eye clinics list these as ‘optional extras’, but they are essential. Having the right surgery ensures you limit the possible complications and improve your eye health and vision as intended. Choosing the right surgery is vital for improved vision. Here are some questions you can ask at your consultation to help you make the right choice:
- How many procedures like mine have you performed?
- What is your enhancement rate?
- Am I a good candidate for laser eye surgery based on my prescription, corneal thickness, and eye health?
- Which type of laser eye surgery (LASIK, LASEK/PRK, SMILE) do you recommend for me and why?
- Are there any conditions or habits (e.g., dry eyes, contact lens wear, pregnancy, certain medications) that could make me unsuitable or affect healing?
- Will you be the surgeon on the day, or someone else?
- What equipment and technology do you use, and how recent is it?
There have also been several advancements in laser eye surgery that limit the risk of complications, including:
Wavefront Optics
Wavefront optics (often referred to just as ‘wavefront’) is an advanced laser treatment pattern that leaves a more natural shape to the curvature of the cornea after treatment.
Older non-wavefront laser treatments tended to flatten the central cornea without maintaining its so-called ‘aspheric’ shape. (This aspheric shape is found in high-quality camera lenses, and gives a sharper, crisper focus.)
You may see the terms ‘wavefront optimised’ and ‘wavefront-guided’, but there is no statistical difference in outcomes between the two, confirmed by multiple research studies.
Wavefront surgery has meant that a lot of the side effects previously associated with laser vision correction (such as halos and glare at night) are now much rarer than before.
The take-home message is always to choose the ‘wavefront’ option. At Focus Clinic, we only offer wavefront-based treatments, with Ray-Tracing Guided LASIK being the most advanced form of wave-light laser treatment.
Femtosecond Laser LASIK Procedure
Modern LASIK surgery uses two lasers. The first is a so-called ‘femtosecond’ laser which creates the flap in the top layers of the cornea, rather than using an old-fashioned blade system, called a microkeratome.
Microkeratome LASIK surgery is a cheaper alternative to using a more sophisticated laser, where the surgeon will use a scalpel to manually cut the corneal flap to allow the laser to correct the site.
However, you are more likely to experience adverse reactions to this type of surgery as a surgeon using a blade device will never be able to cut this flap as precisely and cleanly as a laser.
You are also at a greater risk of reduced corneal strength and persistent dry eyes, as the healing process is slower with potentially thicker flaps made by the blade, than when the corneal flap is created by a laser.
For this reason, Focus Clinic only offer laser-created flaps in our LASIK surgery.
The femtosecond laser is the first stage of the procedure, with the second stage involving a different laser to correct the curve of the cornea, thus correcting vision.
We provide you with a course of antibiotic eye drops following your surgery to help prevent any infections or inflammation and minimise any symptoms of dry eyes.
Are The Risks Worth It?
So, if you’re considering laser eye surgery, is it worth the risk?
Ultimately, that’s for you to decide, but the data shows that laser eye surgery is an incredibly safe and life-changing procedure.If you’re getting tired of wearing glasses or contact lenses and you’re considering refractive surgery then get in touch today and a member of our team will be happy to discuss your suitability and talk you through the different options available to you. If you would like to learn more about the cost of laser eye surgery click here.
