All surgical procedures, including LASIK & PRK can involve risk of unsuccessful results, complications or infection. Although it is not possible to list every potential risk or complication that may result from the procedure, we wish to inform any potential patient of some of the possible risks for consideration. It is important to note that complications are rare, are treatable and occur only 1% of the time.
Possible risks specific to LASIK:
- Epithelial ingrowth – This is uncommon but can usually be treated by re-lifting the flap and gently irrigating the problem cells. This is much more common in a re-treatment than in a primary treatment. Usually it does not occur within a year of the primary treatment, but can occur more frequently with increasing length of time from the primary procedure. We generally won't perform a flap-lift after 18 months from the original surgery and will instead perform PRK on the flap because of this potential complication. It is also more prevalent in patients who require a far-sighted (hyperopia) re-treatment.
- Infection – Happens in rare cases but is generally successfully treated with a topical antibiotic medication. Rarely the flap has to be removed or a partial thickness or full thickness corneal transplant is required.
- Free Cap – This involves creating a cap free from the corneal bed. The laser procedure is completed, the cap fitted into place and allowed to heal naturally. A contact lens may be temporarily used. Visual outcome is usually the same. We have never had a free cap here at Coal Harbour Eye Centre and these are virtually non-existent with modern technology.
- Diffuse Lamellar Keratitis (DLK) – inflammation under the flap, treated with a topical or oral steroid medication. If severe, requires flap lift and irrigation.
- Epithelial abrasion – Not usually a problem. If significant complete the procedure and delay treatment in the second eye, or treat second eye with PRK as significant abrasions are usually indicative of corneal surface disease.
- Thin flap, incomplete flap, and irregular flap – Reposition flap on cornea, allow to heal for 3-4 months then perform procedure either LASIK or PRK, depending on the findings at that time. The outcome is usually good.
Side effects are minimal with the LASIK procedure and most patients achieve their best-corrected vision within 24 - 72 hours. Patients can experience light sensitivity, dryness and glare for a few days. Full stabilization may take up to a few weeks to achieve.
Possible risks specific to PRK:
- Infection – Can be treated with a topical antibiotic medication
- Under/Over Correction – A re-treatment may be necessary to achieve best corrected vision
- Off-Center Ablations, Irregular Ablations - These risks are very limited with the advent of new technology
- Haze - Usually treatable with topical steroidal medication or can be removed by laser if necessary
The healing process for PRK patients is more involved and lengthy than for LASIK patients. The following side effects are temporary and may last from a few weeks to a few months, but do not occur in all cases: light sensitivity, poor visual acuity, dry eyes, glare & halo effects, blurred vision, tired eyes, pain.
The final outcomes of LASIK & PRK are very similar, however the healing time varies.
In the hands of Dr. Kirzner, the final outcomes for PRK is slightly better. At Coal Harbour Eye Centre the retreatment rate for LASIK is approximately 6-7% and for PRK the retreatment rate is 2-3% (based on retreatment rates within 18 months of primary surgery). We treat much higher prescriptions and more astigmatism with PRK than with LASIK.
