Side effects of Lasik eye surgery have prevented many a person from undergoing this sight improving procedure. Take for example a 37year old talent agent from Hollywood. He said he hated glasses and could not tolerate contact lenses. He even had the money to do the procedure. The only reason stopping him was his uncle had the procedure 20 years ago and had lot of side effects. This was food for thought. This was also a segway into how modern technology has decreased the incidence of side effects and how can a consumer prevent them.
I like to keep things simple and hence I have classified the side effects. The origin of side effects of Lasik eye surgery stem from causes before surgery, during the procedure and after the intervention. I explained to him once we understand the etiology; elimination becomes a matter of will and dedication.
Before Lasik Surgery is performed
Age of patient: The best age for Lasik eye surgery is from 21 years to 45 years. Younger patients can undergo laser vision correction but serial maps and number checks have to determine stability. Otherwise the effect of surgery will wear off.
Refractive Stability: It is very important that prescription of eyes have stabilized. It is very difficult to hit a moving target. That is the setting for poor outcomes. Minor variations are to be expected and is even allowed by FDA.
Ruling out Comorbidity: Diabetes, autoimmune diseases like thyroiditis may lead to increased side effects like delayed healing of surface layer.
Shape of Cornea: Shape as studied with corneal topography should be within normal ranges.
Thickness and Thinness map of Cornea: Thin and abnormal cornea can lead to bulging of the cornea if Lasik eye surgery is performed on them.
Dry Eye: This is present in a lot of individuals especially those living in warmer dry climates like southern California. Older individuals, postmenopausal women and those on multiple medicines are also predisposed to lack or poor quality of tears. Dry eyes must be resolved before Lasik is done.
During the Lasik procedure
Automated vs. manual data entry: Incorrect manual data entry was found to be the commonest source of error in one study. This has been eliminated with the newer automated wavescan systems.
Calibration and accuracy of laser: Choosing a doctor one can trust is paramount for it is difficult to analyze behind the scene actions. The best centers keep the laser well calibrated and under maintenance contract with the manufacturing company.
Sterility of equipment: This is a no brainer but neglected at greedy centers.
After Lasik has been performed
Immediate assessment of flap: Within an hour the surgeon needs to check the flap placement. Adjustments should be done to prevent long-term sequelae.
Checkup with in 24 to 48 hours for fall slip, inflammation, infection: This should not get neglected. It often gets omitted when the operating doctor is different from the one doing the postoperative check ups.
A good experienced Lasik eye surgeon avoids these to get safer predictable outcomes.