5 Possible Side Effects of Laser Eye Surgery

Side Effects of Laser Eye Surgery

5 Possible Side Effects of Laser Eye Surgery

May 12, 2021, 2:09:11 PM Life and Styles

Laser eye surgery provides permanent solutions to many eye conditions. But like every surgical procedure, there are some risks involved. However, these risks can be eliminated or minimised. You can only do this by seeking an experienced surgeon's services with an excellent track record.

The surgeon to perform the surgery should be the one that examines you during the consultation. Also, ensure that the operating centre has all the needed diagnostic technology, methodologies and well-trained staff to ensure that the tests are carried out at the best standard.

Also, you need to learn about the related risks of the surgery and how they can be eliminated or minimised.

1.     Dry eye

Patients usually experience dry eye temporarily after a laser eye surgery, but if the patient was not adequately examined before the procedure, it could become a long term problem.

After Lasik and prk, the nerve ending on the cornea's surface will take some time to regenerate and heal. Because of this, the cornea will become numb and will not have the needed sensation to trigger the production of tears. The eye becomes dry as a result of this.

Also, the nerve endings are responsible for producing chemical messengers called 'cytokines' which trigger growth that aids interaction between the surface cells. The nerves take 6 to 12 weeks to regenerate, and until they do, the eye is prone to getting dry.

Long-term dryness can occur if the patients have an underlying undiagnosed and untreated condition before the procedure.

Symptoms of dry eye

  • Grittiness
  • Burning
  • Fluctuating vision
  • Eye pain

How to prevent it

a)     Ensure your operating centres carry out the following dry eye tests:

  • Schirmer's test for tear production
  • Tear break-up time (tbut)

Ensure that your operating surgeon is knowledgeable and experienced in the treatment of the dry eye.

b)     Let your surgeon examine you for meibomian gland disease. The meibomian glands are in the eyelids and produce the oil that prevents your tears from evaporating too quickly.

c)     Take re-esterified omega-3 supplements in advance of your laser eye surgery to boost your meibomian gland function.

d)    Frequently use preservative eye drops after your surgery.

e)     Take breaks from computer monitors after using them for 20 minutes. Close your eye for 20 seconds, and look out the window for another 20 seconds before getting back to work.

2.     Halos and glare

Every patient experiences halos for a few days to a few weeks after the laser eye surgery (be it LASIK and surface ablation). It happens because the fluids around the treated cornea make light scatter. When the fluids clear up, the halos will disappear. However, some patients with halos may realise that the symptoms worsen at night (left-hand image) due to the aberrations induced from lasers that deliver smaller diameter correction zones or the older treatments that do not have an aspheric profile.

The good thing is that this problem will not happen every time because patients are now correctly chosen for the procedure, and treatments are now customised to suit each eye in a perfectly delivered way. This problem can also happen when the treatment is not centred correctly.

How to prevent it

  • Ensure that the surgeon understands high order aberrations and is highly experienced in laser eye surgery.
  • Ensure the doctor properly measures your pupil size in dark/dim light.
  • Ask the doctor if he/she will give you an aspheric treatment profile on your cornea. There are usually "aspheric" lenses on good cameras and spectacles for good vision. You need to ensure that your surgeon will make your cornea aspheric.
  • Ensure that there is up-to-date and well-maintained laser technology in the treatment operating centre.

3.     Infection

There is a risk for infection with laser eye surgery, just like there are for other surgeries. Lasek, PRK, blade-Lasik, and IntraLASIK rank highest to lowest in the risk of infection, but the lowest of all is femtosecond laser.

After an IntraLASIK procedure, the risk for infection is 1 in 10,000, but this is only applicable to good eye centres.

How to prevent it

  • Only get treatment from a centre with Care Quality Commission (CQC) rating
  • Find out if the HEPA is filtered in the environment of the surgery and how often. The minimum required is 10 per hour, but many good centres use 15 per hour.
  • Know the type of antibiotics that are used both in preoperative preparation and during the surgery. It is best to use a 4th generation fluoroquinolone like gatifloxacin or moxifloxacin. They are very potent against a wide range of bacteria.

4.     Ectasia

When the cornea becomes more elastic than usual, it becomes unstable after laser eye surgery. The cornea will bulge out and get thin with time. It will cause some changes in vision and make it necessary to wear glasses for a while. Astigmatism can worsen and lead to other problems.

Ectasia is common after both Lasik and PRK/LASEK surgeries. They usually show signs on the cornea that can be detected through corneal mapping, biomechanic checks, and corneal epithelial thickness mapping.

How to prevent it

  • Find a specialised corneal surgeon who is experienced with keratoconus (a condition that makes the cornea elastic and bulge out) to check whether you are at risk or not.
  • Ask your doctor to use a dimensional tomography device like the pentacam to evaluate your cornea.
  • Find out if the centre uses biomechanical checks to evaluate corneal elasticity.

5.     Flap complications

Partial flaps, buttonholes, irregular fragmented flaps and other flap complications may occur after a microkeratome blade has been used to create the flap during a Lasik laser eye surgery. However, this complication is rare due to the introduction of IntraLase femtosecond laser for creating flaps. Also, the microkeratome blade is no longer in use.

How to prevent it

  • Ask if the centre will use an IntraLase laser to create the corneal flap during the Lasik procedure.
  • Find out how long your surgeon has been doing Lasik and how long they have used intraLase.

Laser eye surgery is revolutionary and liberating; however, you must choose the most suitable one for you. You need to learn as much as is necessary about the procedure. The tip lies in finding an excellent eye centre with a good surgeon. You can visit at thelasik.co.uk for more about laser eye surgery.

Published by Scott Stevens

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