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Laser Eye Treatment Failures
by Isobel Washington
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Overview
Laser eye treatment is an FDA-approved, highly effective solution for vision deficiency in the form of nearsightedness, farsightedness and astigmatism. The success rates for laser eye surgery are extremely high; for example, Lasik-Review.com reports that patient satisfaction for LASIK surgery (the most common type of eye surgery) is 92 to 98 percent. However, no surgical procedure is 100-percent risk free, and no surgeon, despite skill and experience can guarantee no complications.
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Occurrence
A number of sources testify that laser eye treatment failures are extremely rare, including AllAboutVision.com, which reports that fewer than 1 percent of laser eye surgery patients experience serious vision problems because of some failure of the treatment. The Eye Surgery Education Council (ESEC) reports that less than 1 percent of laser surgery patients experience serious post-procedure problems if proper screening is performed, and the surgeon is skilled and experienced, and 3 percent to 5 percent of laser surgery patients experience less serious problems that are correctable. AllAboutVision.com also reports that complications and risks are still decreasing with improvements in technology and technique, and that there have been absolutely no cases of blindness reported after laser eye surgery.
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Flap Failure
In LASIK surgery, the aim is always to reshape the cornea tissue (the clear front window tissue of the eye) to achieve enhanced vision. This procedure, then, requires that a flap be made on the front of the cornea, which is flipped up during surgery to work with the corneal tissue beneath. Once the corneal tissue is adjusted, the surgeon closes this flap and the surgery is complete. Most failures during laser eye treatment are related to the making of this flap, and how it closes over the eye at the end of the surgical procedure. It may not adhere correctly, might be too thin or thick or might begin to wrinkle.
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Irregular Astigmatism
Irregular astigmatism is one result of a poorly made flap during laser eye treatment. It is the result of a corneal surface that is not smooth and has an abnormal texture. Laser treatment that fails to center properly on the eye is another cause. Symptoms include double vision (diplopia) and "ghost images," which means that the images are surrounded by white, "glowing" fuzz. This can be treated with another laser surgery procedure.
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Keratoconus
Keratoconus is also caused by some erroneous flap-making or flap-closing. This is the bulging of the eye's surface that occurs if a flap is cut too deeply into the eye tissue, and when too much corneal tissue is removed during the laser treatment. The main symptom is distorted vision, according to AllAboutVision.com. Correction can be made with an additional laser eye procedure, a corneal implant or a special type of contact lens. There is also a newer treatment that involves riboflavin eye drops that are activated by ultraviolet light.
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Diffuse Lamellar Keratitis
Diffuse Lamellar Keratitis (DLK) is also called "Sands of the Sahara," and is excessive inflammation under the corneal flap created during surgery. This inflammation can interfere with healing, and can sometimes cause vision loss. The flap is treated by rinsing the cells beneath it to prevent infection and tissue damage. The doctor typically prescribes antibiotics. This condition affects vision, causing haziness and blur.
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Incomplete Corrections
In some cases, the patient's vision may be undercorrected, or there may be a residual astigmatism. This is usually caused by the surgeon not removing enough corneal tissue (much safer than removing too much corneal tissue). In these cases, patients might experience blurriness and less-than-perfect vision. In some cases, patients see improvement, though it doesn't achieve initial objectives, and another identical enhancement procedure is performed.
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Prevention
AllAboutVision.com, DocShop.com and The-Lasik-Directory.com say that the most important step in preventing complications from laser eye surgery is to carefully choose a highly skilled surgeon with extensive experience in performing laser eye procedures. The-Lasik-Directory.com suggests that other ways to prevent complications are to throw away pre-surgery makeup, carefully follow post-surgery instructions, avoid strenuous exercise as well as swimming for a week, avoid rubbing eyes for a minimum of two weeks and take vitamin C daily.
