Laser eye surgery has a generally high success rate and is considered the safest elective surgical procedure in the world today.  Laser eye surgery itself does not hurt but with any other surgical procedure, there are certain risks associated that you should be aware of, even though the probability of them occurring are very low.

The average complication rate across clinics in the UK is 5% but some clinics can have much higher rates so you need to do your research and ask the clinics. You should be aware complications do not mean the surgery failed, some complications could just be temporary issues that cause some discomfort (see below).

When Laser Eye Surgery Goes Wrong

There are a number of complications that can arise from laser eye surgery.  Fortunately, the chances of complications developing from laser eye surgery are extremely low.

Partial loss of vision

Description: The patient loses part of their vision permanently. This is manifested by their inability to read a few lines on the eye chart.

Occurrence: This occurs in 1% of laser eye surgery patients and is the result of erroneous reshaping of the cornea or damage to the eye from the laser. It can also be caused by an allergic reaction to the anaesthetic eyedrops used during the procedure.

Remedy: Unfortunately, there is no remedy for this.

Higher-Order Aberrations

Description: These visual impairments are characterised by decreased vision in low light. The patient sees a glow around light sources or light radiating from them. This makes driving at night dangerous for the patient.

Occurrence: This occurs in o.5 to 1% of patients, particularly among those with larger pupils.

Remedy: This is a temporary condition, but can last up to six months.

Ptosis

Description: This is a condition where the upper eyelid droops.

Occurrence: This is extremely rare. It may be caused by the pressure applied to the eye during the procedure.

Remedy: This problem resolves itself after a couple of weeks. There are very rare cases of the condition persisting; if this happens, corrective surgery might be necessary.

Infection

Description: The patient might suffer from corneal infection after the surgery.

Occurrence: This is very rare, but can be brought on by the cornea being vulnerable to infection after the flap is created.  A study by the National Institute of Clinical Excellence (NICE) found only 1 in 5000 (0.02%) people suffered from infection.

Remedy: The patient will be given steroid eyedrops or antibiotics to treat the infection.

Corneal Haze

Description: Corneal haze refers to cloudy vision.

Occurrence: A mild degree of corneal haze is quite common and it happens because the cornea is still healing.  More severe occurrences of haziness are rare and a study by the National Institute of Clinical Excellence (NICE) found only 2% of people experienced this after refractive surgery.

Remedy: The haze disappears quickly on its own, but sometimes the patient is given eyedrops to speed up the healing process of the cornea.

Dryness of the eye

Description: The treated eye might have difficulty producing tears, which makes the eyes dry, red and itchy. This will also make the eye prone to infection.

Occurrence: This is a common occurrence and is due to the nerves on the surface of the eye having been cut.

Remedy: Dryness of the eye is temporary, but can be relieved by using lubricant eyedrops that will help the eye produce artificial tears.

Astigmatism

Description: Astigmatism is a condition caused by irregularities in the corneal shape which make the patient lose focus in parts of their vision.

Occurrence: This complication rarely happens and is caused by reshaping errors on the cornea.

Remedy: If the patient’s cornea is thick enough, corrective laser eye surgery can be done on it. If not, the patient will have to wear corrective lenses or glasses.

Sub-Conjunctival Haemorrhage

Description: The patient’s eye turns red, indicating bleeding.

Occurrence: This is another rare complication, and stems from the pressure from the suction when the corneal flap is created. The blood vessels get damaged and the blood flows into the space between the sclera—the white part of the eye–and the conjunctiva, the lining of the sclera. This makes the eye red.

Remedy: This usually resolves itself within a few weeks.

Corneal Estasia

Description: The cornea bulges out and flattens out. This could eventually lead to blindness, if left untreated.

Occurrence: The probability of this happening to a laser eye surgery patient is less than 0.2%. It results from too much tissue having been removed from the cornea, rendering it extremely weak.

Remedy: The patient will be given rigid contact lenses to help strengthen the cornea. In extreme cases, a corneal transplant might be necessary.

How to minimise the risks of laser eye surgery

As a laser eye surgery patient, there are certain steps you can take to make sure that your procedure will be successful and that your chances of suffering from any complications are kept at a minimum.

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Research as much as you can into your procedure.

Find out how it will be carried out, what you should expect with every step of the process, and what risks are associated with it, as well as what you can do to lower those risks.

Choose a clinic with a solid reputation.

Ask each clinic that you look into for its success rate as well as its complication rate. The national average complication rate following laser eye surgery is less than 5%, so make sure that the clinic rate you go won’t have a complication rate higher than this figure. A clinic that’s unwilling to disclose its complication rate wouldn’t be worth your time and consideration.

Another way to assess the competence of a clinic is reading patients’ reviews in independent sites. Look at what patients who have undergone the same procedure you’re about to have say about the clinic—how they were treated not just by the surgeon, but by other members of the staff as well. What level of aftercare did they get? If they had complications, did the clinic do anything to correct these?

Choose a highly qualified and experienced surgeon.

When you see your surgeon, ask them as much you can about the procedure as well as their experience and qualifications. Here are some questions you can ask to ascertain whether your surgeon is right for the job:

  1. How much training have you had in laser eye surgery? The Royal College of Ophthalmologists recommends a minimum of three months’ formal training in laser eye surgery for surgeons.
  2. How many procedures do you perform every years? The more surgeries your laser eye surgeon performs, the more competent they are. According to the Royal College of Ophthalmologists, a laser eye surgeon should perform at least 500 procedures a year.
  3. What is your success rate in the procedure I’m about to undergo? A good laser eye surgeon will have a minimum success rate of 75%.
  4. Do you have a Certificate of Competence from the Royal College of Ophthalmologists? The Certificate of Competence  is the only independent assessment of a surgeon’s skills in laser eye surgery and a surgeon who has earned this will be subject to yearly appraisals and receive continuing professional development.

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