Laser Eye Surgery

Laser eye surgery is becoming increasingly popular, but if you are seriously considering it, also consider the risks and read the consent forms carefully. Designed to protect doctors from lawsuits, they usually provide a detailed list of possible complications, although they do not estimate the risk of side-effects.

Although many benefit from this surgery, most, if not all, will experience some short-term adverse effects, including pain, light sensitivity, dry eyes and vision abnormalities. Patients are generally prepared for this and the symptoms usually resolve quickly.

But what they may not be prepared for are the more serious complications. For a small but significant fraction of people who undergo the surgery, eyesight is not much improved and even worsened. The US Food and Drug administration performs some monitoring of these surgical techniques and notes that, after surgery, about five percent of patients will continue to need glasses all the time and 15 percent will need them occasionally. The FDA even accepts as safe and effective trials in which up to five per cent of the eyes operated on worsen by more than two lines on a visual chart.

Many also experience a haze (slight blurring of vision) and various annoying visual artifacts such as glare, halos or starbursts around light sources. These usually resolve within a few months, but impairment of night vision may be permanent.

Surgery generally targets the cornea, the transparent layer that covers the eye and plays an important role in focusing light. Mistakes can sometimes damage the cornea, reducing the ability of the eye to focus and see. At best, this can require a second surgery if not enough material was removed. If too much material was removed, however, additional surgery is not likely to be effective and may not even be possible.

One of the most serious risks is infection, particularly with fungus or bacteria. To reduce this risk, antibiotics are usually required, and this introduces the risk of drug reactions in patients. If infections are not brought under control quickly, serious eye damage can result. Drug reactions can also occur because of sedatives or other prescribed medications.

Even when surgery is successful, eyes continue to change over time, and freedom from glasses may not last. Eyes may be structurally weakened by surgery, making the consequence of a later eye injury more serious. The long-term effects are not known because the current techniques have only been in use for a few years and are still changing frequently.

The benefits of successful eye surgery will be greatest in people with the most serious vision disorders; however, the risk of complications is also greater because of the greater amount of material that must be removed. Before you sign on the dotted line, weigh the small possibility of serious adverse effects against the likely (but not certain) benefits.