Laser Eye Surgery Problems

The Food and Drug Administration first approved laser eye surgery in 1995, and demand has grown ever since. There are two types of FDA-approved laser eye surgery: photorefractive keratectomy (PRK) and laser-assisted in situ Keratomileusis (LASIK). Despite widely touted benefits, laser eye surgery does come with risks and is not a perfect solution for all vision problems or all people. After undergoing laser eye surgery, about 5 percent of people have worse vision than they did beforehand, and about 15 percent still need to use glasses at least occasionally, such as while driving, according to the FDA.

Infection

There is a tiny (0.1 percent) chance of infection of the cornea after PRK, and a smaller chance of this after LASIK. Although the infection will add to your discomfort following surgery and delay healing, it won't have long-term negative effects, according to the FDA.

Undercorrection or overcorrection

Laser eye surgery is not a guarantee that you'll never again need glasses or contacts. If you don't have perfect (or nearly perfect) vision after the surgery, you may be able to have a follow-up procedure to adjust the result and improve the outcome. A problem similar to undercorrection is regression: Occasionally the vision improvement from laser eye surgery gradually goes away, according to the FDA, but retreatment may be possible.

Haze, glare and halo effect

A mild haze, glare around lights and a "halo effect" that can complicate night driving are common after-effects of laser eye surgery. These conditions are related to normal healing of the eye, and they improve or disappear altogether within six months of the surgery for most patients, according to the FDA. There have been cases of excessive corneal haze that interferes with vision, which often can be treated with an additional laser procedure. This risk is greater with PRK than with LASIK.

Flap damage or loss

In LASIK, a flap of tissue is supposed to hinge on the central cornea. There is a risk that this flap could come off; if it does, it may be replaced after the surgery, but it also could be damaged or lost, according to the FDA. The FDA further states that LASIK also carries the risk of abnormal healing of this flap, which could lead to a distorted corneal shape, "resulting in a decrease of best-corrected vision."

Special considerations

Even assuming your procedure will go without a hitch, there are certain things to be aware of when considering laser eye surgery. Older patients, for example, should know they will not be able to see well both up close and from far away without corrective lenses, even after surgery. And patients who are having one eye operated on at a time should consider that their eyes may not work well together between surgeries. If a contact lens can't be used on the untreated eye, everyday tasks like driving may be difficult or impossible until both eyes have been treated. Finally, consider how you'll pay for laser eye surgery, which is expensive and usually isn't covered by insurance.

Poor candidates

Not everyone is a good candidate for laser eye surgery. People with uncontrolled vascular diseases, autoimmune diseases or certain eye diseases probably should not have the surgery. Pregnant women shouldn't have laser eye surgery because pregnancy can affect the eye's refraction. In addition, people with thin or abnormally shaped corneas, or severe dry eye, probably are not good prospects for the surgery, according to Dr. Robert K. Maloney of Maloney Vision Institute in Los Angeles.

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