From the Guidelines
LASIK is generally considered safe for most eligible candidates, with a high success rate and patient satisfaction, as reported in the most recent study from 2023 1. The procedure involves reshaping the cornea with a laser to correct vision problems like nearsightedness, farsightedness, and astigmatism. Serious complications are rare, occurring in less than 1% of cases, as noted in the refractive surgery preferred practice pattern 1. However, like any surgery, LASIK carries some risks including dry eyes, glare, halos, and rarely, vision loss. Not everyone is a good candidate for LASIK; those with thin corneas, certain autoimmune diseases, severe dry eye, or unstable vision prescriptions may be advised against it, as highlighted in the special considerations for evaluating patients for LASIK 1. The procedure is quick (about 15 minutes per eye) and recovery is relatively fast, with most patients seeing clearly within 24-48 hours. Most side effects like mild discomfort and blurry vision resolve within a few days to weeks. For best results, patients should follow all pre-operative and post-operative instructions, including using prescribed antibiotic and anti-inflammatory eye drops. A thorough pre-operative evaluation by an experienced ophthalmologist is essential to determine candidacy and reduce risks, as emphasized in the refractive surgery preferred practice pattern 1.
Some key points to consider when evaluating the safety of LASIK include:
- The importance of preoperative evaluation to identify potential risks and contraindications, such as abnormal corneal topography or insufficient residual stromal bed thickness 1.
- The potential for complications, such as dry eye, glare, and halos, and the need for proper management and treatment 1.
- The importance of patient selection and the need to carefully evaluate patients with certain conditions, such as keratoconus or significant dry eye, to determine the best course of treatment 1.
- The need for ongoing follow-up and care after the procedure to monitor for potential complications and ensure optimal outcomes, as noted in the refractive surgery preferred practice pattern 1.
Overall, while LASIK is generally considered safe, it is essential to carefully evaluate each patient's individual needs and risks to ensure the best possible outcome, as emphasized in the most recent study from 2023 1.
From the Research
Safety of LASIK
- LASIK is considered a safe procedure for correcting myopia and myopic astigmatism, as long as inclusion and exclusion criteria are strictly respected 2.
- A 5-year study found that LASIK surgery is effective and safe, with minimal regression occurring during the investigative period 2.
- However, a small number of patients may suffer serious complications that can even lead to visual loss, emphasizing the importance of careful performance by qualified surgeons 3.
Potential Complications
- Common complications of LASIK include dry eye, infections, stromal-interface related problems, and corneal flap complications 3, 4, 5, 6.
- Dry eye is a nearly universal problem after LASIK, but can be managed with artificial tears, punctal plugs, or botulinum toxin injection 4, 5.
- Other complications, such as epithelial ingrowth, corneal ectasia, and infectious keratitis, can occur, but are relatively rare 3, 6.
Management and Prevention
- Identifying and treating pre-existing dry eye before surgery is crucial to prevent symptomatic postoperative dry eye 5.
- Intra- and post-operative management techniques, such as the use of artificial tears and punctal plugs, can help minimize complications and maximize the stability of the ocular surface 4, 5.
- Reporting outcomes and mishaps of LASIK surgery can help refine the approach to the management of emerging complications 6.