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It
is impossible to list all the risks and complications that may result
from laser vision correction. Your surgeon will review a list of
possible risks that you will have to consider before signing a consent
form.
Overcorrection
Initially the eye is over-corrected since the cornea has a tendency to regress to its
original state of refractive error. The regression generally stabilizes after 1-3 months
and permanently over-correction is uncommon. If you
are permanently over-corrected, you'll need glasses for reading and any close up work.
Undercorrection
If it is severe, the procedure can be repeated. Steroid drops are believed to control regression and are
used for several weeks after the procedure to avoid
under-correction.
In this situation the patient is unable to see as well with glasses
after the surgery as he or she could see with glasses before the
surgery. Sometimes contact lenses can be fit to help remedy this
situation.
Two images appear when looking through one eye at a time.
Headlight glare when driving at night.
This is a tendency for eyes to become more nearsighted at night,
leading to blurry vision. This can be corrected by wearing glasses
with minus lenses in the dark
This occurs when the pupil enlarges beyond the treated area at nighttime.
This is when images appear blurrier after the refractive
surgery than before.
The flap begins to disintegrate and may require surgical intervention.
This is a condition in which the corneal
flap is not in proper alignment in the corneal bed. This is treated
with surgical intervention.
A major or minor flap dislocation produces flap wrinkles. This
is treated with surgical intervention.
Lines noted in the flap are termed flap striae. There are various
types of striae and treatment depends upon the type and the patient's
symptoms. Treatment and cause of striae is currently somewhat controversial.
If vision is threatened, then surgical intervention is indicated.
This is a condition in which an island of corneal tissue remains
in the visual axis following excimer laser treatment. This is less
common with the new generation of lasers that have been modified
with programs to prevent this complication. This can cause undercorrection
and visual blurring or distortion. Most central islands disappear
spontaneously post-operatively without additional treatment.
Occurs when the microkeratome creates a flap without a hinge
because the microkeratome blade cuts the hinge. This is more likely
to occur with the ACS type microkeratome and is quite uncommon.
The flap will need to be replaced carefully, and reoriented to its
original position after the laser treatment is completed.
Could create serious healing and vision problems. Physical loss
of the flap following an incident of a free flap.
Creation of an incomplete flap is usually due to a microkeratome malfunction.
The procedure will usually need to be aborted and rescheduled at
a later date.
A disturbance in the top layer of the cornea (epithelium) caused
by the normal action of the microkeratome moving across the cornea.
Some corneas are more susceptible to corneal abrasion. Corneal abrasions
can be treated using a soft contact lens as a type of bandage, or
by patching or taping the eyelids to keep them closed.
This complication is uncommon in the newer generation lasers.
Corneal healing difficulties can produce a pseudo-decentered ablation
especially with PRK. Usually caused by either poor patient fixation
on the laser fixation light, poor patient head positioning, or poor
centering of the laser beam by the surgeon.
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