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Laser Eye Surgery Risks

The great majority of patients who undergo refractive surgery are very pleased with the results. However, just as with any other surgical procedure, there are also some risks. This is why it’s necessary to be aware of the possible complications, effects and laser eye surgery risks.

In that spirit, and to help you full understand what’s at stake, we’ve listed some of the most common laser eye surgery risks that you might encounter.

Vision Loss

After the procedure, a small percentage of patients experience a vision loss which cannot be corrected with glasses, contacts or a second surgery. This is a very rare, but a very serious laser eye surgery risk.

Debilitating Visual Symptoms

A few patients experience halos, glare or double vision after surgery, which can create serious night vision problems. Even though these patients may have a good vision on the vision chart, they still might not see well at night, in the fog or in other situations with low contrast. They may even see worse in these situations than they did before treatment.

Under Treatment / Over Treatment

This is a frequent laser eye surgery risk. Only a small percentage of patients obtain 20/20 vision after surgery without glasses or contacts. You may need additional treatment to enhance your vision, though this isn’t always possible. If you used to wear weak prescription glasses before the treatment, you might still need glasses or contact lenses afterwards. If you used to wear reading glasses before, you might still need them after surgery.

Severe Dry Eye Syndrome

Dry eye syndrome is another laser eye surgery risk. After surgery, your eyes might not be able to produce enough tears to maintain proper moisture. This not only produces discomfort, but can also reduce quality of your vision with permanent blurring and other problems. It’s usually treated with intensive eye drop therapy, though there are other procedures that have been found to be helpful.

Disappointing Results

Be realistic about your laser eye surgery. While the procedure can dramatically improve your vision, it may not solve all your vision problems. Ask your doctor if there’s a good chance you’ll still need to wear glasses or contact lenses after the surgery.

Results Diminishing With Age

Another laser eye surgery risk, or at least a likely reality, is the likeihood that your results will gradually diminish over time, especially for those patients who are farsighted. If your manifest refraction (an exam with lenses before using dilating drops) differs from your cyclopegic refraction (another exam with lenses after applying dilating drops), the chances of facing this side effect are generally higher.

For the newest procedures, there’s too little research data available to determine all the possible laser eye surgery risks. These procedures have been developed over the last few years, and therefore their long-term effectiveness and safety are still being investigated. Even though these procedures may be far in advance of what’s currently available, they may still have unknown long-term side effects.

Laser Eye Surgery: What Are The Potential Side Effects?

With the ever-growing popularity of laser eye surgery and the continual advancements in the procedures and technology, the primary concern of many people considering the surgery is this: what are the potential side effects?

The good news is that both PRK (photorefractive keratectomy laser eye surgery designed to correct mild myopia and astigmatism) and Lasik procedures involve few risks. In fact, serious vision-threatening complications are minimal. However, as with any form of surgery, there can be potential side effects. Here are the most common side effects that can result from laser eye surgery:

Infection And Delayed Healing

Approximately one-tenth of one percent of all patients suffer from a corneal infection after undergoing PRK. Slightly fewer face an infection after Lasik. A cornea infection will not result in any long-term effects, however there generally is some additional discomfort and the healing process is slower.

Under Correction/Overcorrection

Even though tremendous advances have been made in laser eye surgery, a surgeon cannot predict precisely how your eyes will respond to the procedure. In some cases, you might need to continue to wear corrective lenses after surgery. If the results are particularly unsatisfactory, you do have the option to undergo a second surgical procedure to improve your vision.

Decrease In Best-Corrected Vision

After laser eye surgery, a few patients find that their best-corrected vision with contact lenses is actually worse than it was before the surgery. This is a rare occurrence, but can occur if there’s been irregular tissue removal or if a corneal haze has developed.

Excessive Corneal Haze

Corneal haze is not unusual. In fact, it’s part of the normal recovery process after refractive surgery. Generally, it won’t affect your final vision, and will only be evident to an ophthalmologist using a microscope. However, in some cases, excessive corneal haze does interfere with your final vision. In such a case, it can often be corrected with a second surgery. Also worth noting, the risk of encountering excessive corneal haze is much lower with Lasik eye surgery than with PRK.

Regression

Regression is exactly as it sounds: for some patients, after a period of several they find their vision returning to its pre-surgery state. In other words, they find the surgery to be ineffective. A second surgical procedure is usually possible in such cases.

Halo Effect

The halo effect will generally go unnoticed except in situations where the light is dim. As the name implies, a second faded image is seen as the pupil enlarges. This image is produced by the untreated peripheral cornea. The danger here is that the halo effect can often interfere with your night driving.

Flap Damage or Loss

In some Lasik cases, instead of creating a hinged flap on the center of the cornea, the entire flap comes off. This can usually be replaced after the laser treatment. However, in some cases, the flap may be damaged or lost.

Distorted Flap

Also in reference to the Lasik procedure, if the healing of the corneal flap is irregular, then the shape of the cornea can become distorted. This will often result in your best-corrected vision being disappointing.

Other Side Effects of Laser Eye Surgery

Even when both the procedure and the healing process seem to go perfectly, there are some side effects that may still cause dissatisfaction. Older patients, for example, cannot have both distance and near vision in the same eye without wearing glasses or contact lenses. Patients suffering from myopia but who could still read without glasses may no longer be able to read without glasses after surgery. And finally, if both eyes are not treated at the same time, the eyes might work awkwardly together between the time of the first surgery and the second surgery.

Lasik Eye Surgery: Are You A Candidate?

The popularity of Lasik eye surgery has grown to such an extent that more than two million people are expected to undergo the procedure this year alone. By far, most of those who’ve had Lasik eye surgery have been pleased with the results, though the surgery is not always 100% effective, and the long term effects of the surgery are still unknown.

One of the aspects of Lasik eye surgery that makes it slightly more risky is the complexity of the procedure. Lasik eye surgery requires a surgeon, using a knife called a microkeratome, to cut a flap of corneal tissue, to remove the targeted tissue beneath it with a laser, and then replace the flap. Generally Lasik eye surgery involves fewer negative side effects and the eye heals faster. However, since it involves cutting part of the eye tissue, the risk of severe complications is greater.

In fact, not everyone is a candidate for Lasik.

Who might not be a candidate for Lasik eye surgery? Obviously, if you’re not in good overall health, elective surgery such as this is probably not in your best interests. If you’re a diabetics, it’s generally beleived that you would probably not be a good candidate for Lasik eye surgery. If you’re pregnant or nursing, it would be wise to wait until after your child has been born and your body is strong again before considering Lasik eye surgery.

You must be at least 18 years old and have had a prescription for glasses or contacts for no less than the previous two years. In addition, your cornea, the part of the eye that’s cut to make a flap so the laser can remove the targeted tissue, must to be at least 250 microns thick in order for the flap to be successfully cut. If an eye doctor reports that your cornea is too thin for Lasik eye surgery, heed his advise. Otherwise, you risk irreversible damage to the cornea if the incision doesn’t go right.

To make sure Lasik eye surgery is in your best interests, disclose your personal health history and any medications you’re taking to your eye surgeon. Steroids, as well as other drugs, tend to delay the healing process. There are certain diseases which can also delay the healing process. So make certain your eye surgeon has all the facts in order to make the proper determination about the procedure’s appropriateness for your situation.

Finally, be aware that there are some occupations you’ll no longer be able to pursue if you have Lasik eye surgery. Certain jobs within the armed forces, pilot, and those jobs that require frequent immersion in water are examples of occupations that affected by this surgery. Even if you’re not currently affiliated with one of these jobs, you’ll want to take into consideration your future pursuits.

A few considerations for after the Lasik eye surgery:

* Your vision will be blurry for at least a day or two after your surgery.
* Complications that can arise include continued blurry vision, halos around light and glare.
* You may have difficulty driving at night for some time.
* It could take several months for your vision to stabilize.
* Initially, you can expect some burning, itching, and even some minor pain.

Lasik eye surgery is the same as any surgery … you need to be well informed and have all the facts before you make the decision to proceed. If there’s anything you don’t understand, ask your surgeon to explain it. Make sure you’re a good candidate, and listen to the advise of your doctor.

What Is Laser Eye Surgery?

With the continued development of computers and lasers in the field of corrective eye surgery, patients have a greater palate of surgical procedure choices than ever before. So let’s take a look at some of the vision problems you may be experiencing and follow up with some of the newest procedures available to solve those problems.

For the most part, laser eye surgery is used to correct three types of eye problems:

* Myopia – near sightedness
* Hyperopia – far sightedness
* Astigmatism – distorting vision at any distance

These three conditions are the result of the patient’s inability to properly focus an image on the retina. This inability to focus is affect by three contributing factors: the distance from the back of the eye to the front, the shape of the cornea, and the shape of the lens. The cornea is the dome-shaped window of the eye that covers the iris and the pupil. It provides approximately two thirds of the eye’s ability to focus.

During laser eye surgery, the surgeon changes the shape of the cornea using a device called Excimer Laser. This produces a laser beam that vaporizes the tissue. It’s also referred to as a “cold” laser because it removes targeted areas of the eye tissue without harming the surrounding areas.

Laser Procedures

The most common types of laser eye surgery are PRK (Photo-Refractive Keractomy), available since early ’90s and Lasik (Laser Assisted in situ Keratomileusis), first introduced in the mid-’90s.

PRK – This is an outpatient procedure generally performed with local anesthetic eye drops. This type of refractive surgery gently reshapes the cornea by removing microscopic amounts of tissue from the outer surface with a cool, computer-controlled ultraviolet beam of light. The procedure itself takes only a few minutes, and patients are typically back to daily routines in one to three days.

After PRK laser eye surgery, the patient may have blurry vision throughout the healing process. However, this generally will clear up in time. Another possible outcome is referred to as “regression,” which means the eye will return to its original state within about six months. When this happens, you’ll either require a second procedure or you’ll have to go back to wearing glasses or contact lenses.

Lasik – This is a more complex procedure, generally performed for degrees of nearsightedness. Unlike PRK, which is performed by a machine, Lasik eye surgery requires a surgeon, using a knife called a microkeratome, to cut a flap of corneal tissue, to remove the targeted tissue beneath it with a laser, and then replace the flap.

Lasik surgery generally involves fewer negative side effects and the eye heals faster. However, since it involves cutting part of the eye tissue, the risk of severe complications is greater.

Benefits and Risks

Laser eye surgery is always performed by highly skilled and well-prepared specialists. For most patients, the results are positive and their lives are significantly improved. They no longer have to wear glasses or contact lenses.

However, laser eye surgery is not the solution to all vision problems, so it’s important to keep realistic expectations. Patients over 40 may still have to continue wearing reading glasses. And the eye will continue to change after the surgery, meaning you may still end up wearing prescription glasses or lenses at some point in your life. You might also require a second procedure if your first laser eye surgery proves less than entirely successful.

Types of Corrective Eye Surgery

While Lasik is the most popular type of corrective eye surgery, it’s not the only option patients have. All of the following types of corrective eye surgery use lasers, yet they each differ slightly. Remember: it’s always best to thoroughly research your options before you undertake any form of surgery.

Lasek

Similar to Lasik, Lasek (Laser assisted seu-epithelial keratectomy) surgery is most used to treat patients with a thin cornea. In Lasek eye surgery only the outer layer of the cornea is cut, resulting in the removal of a smaller percentage of the cornea. Corneal nerve regeneration is quicker. However, patients may be required to use drops for an extended period after the surgery and vision tends to remain blurry for a couple of weeks. This eye surgery is still relatively new and is most commonly used to treat astigmatism, nearsightedness and farsightedness.

Epi-Lasik

Epi-Lasik eye surgery uses neither a blade nor alcohol to cut through the cornea. Instead a plastic separator is used to separate the epithelial sheet from the eye. The same excimer laser used in Lasik is used in Epi-Lasik to reshape the corneal tissue. After this corrective eye surgery, a special contact lens is used to keep the epithelial flap in place until it reattaches itself. People can usually see well enough to drive after about a week, however, it may take up to six months before the patient experiences the best results from this surgery.

Bladeless Lasik

Bladeless Lasik, also known as IntraLase eye surgery, is similar to regular Lasik eye surgery except that, as the name implies, no blade is used to create the flap. The obvious advantage is that IntraLase (by using laser energy instead of a microkeratome, the metal blade used in traditional Lasik procedures) appears to enhance the safety of corrective eye surgery.

Photorefractive Keratectomy (PRK)

With PRK corrective eye surgery, no flap is made in the cornea at all. Instead, the surgeon skips right to the next step and uses an excimer laser to reshape the cornea. If you’re nearsighted, the surgeon will attempt to flatten the cornea, which is too steep. If you’re farsighted, the surgeon will attempt to make the cornea steeper.

Although the success rates for these types of surgeries are impressive, no corrective eye surgery is one hundred percent safe or successful. Always do your homework and get the facts when considering laser eye surgery. An informed decision will dramatically increase your odds of a successful surgery.

Cost of Laser Eye Surgery

The cost of laser eye surgery varies widely from one clinic to another, and generally takes into consideration several determining factors. The only consistent standard is that providers almost always quote the cost of laser eye surgery for a single eye and not the pair.

Although, you may come across advertisements that offer Lasik eye surgery for as little as $500 per eye, this price is generally not available for most people and can often require extensive correction and treatment after surgery. In fact, only about three percent of all Lasik providers offer their laser eye surgery at cost below that of $1000 per eye. So be wise. If you come across an eye surgery center offer their services at bargain prices, thoroughly investigate the fine print for any hidden costs, and take the time to check out as many references from past customers as you can.

Lasik Laser Eye Surgery Cost

The cost of Lasik laser eye surgery has been steadily increased over the past several years. To give you a general idea of the increases, here’s what the refractive industry has reported as the average price of this type of procedure:

* In 2002, the average Lasik laser eye surgery cost ranged between $1,550 and $1,600.
* By October 2003, it had already increased to approximately $1,710.
* At the end of 2004, Lasik laser eye surgery cost rose above $1,800.
* In the first half of 2005, the average price was $1,965.

These figures reflect several types of businesses, from individual surgeons who use rented equipment to those who own their own equipment, and from regional eye surgery centers to nationwide eye surgery networks.

For example, TLC Laser Eye Centers, a leading Lasik provider, had an average price of $1,800 in 2002. By the end of 2004, the average Lasik laser eye surgery cost had risen to $1,957, and at the beginning of 2005 the price was $1,983.

Lasik Plus, another famous nationwide provider, reported an average price of $1,344 per eye in 2005, which is slightly lower than the $1,351 price it was quoting at the end of 2004, but much higher than the $1,173 at the beginning of 2003.

Prices for Other Types of Eye Surgery

The cost of other eye surgery procedures also tends to vary dramatically, depending on such factors as individual prescriptions, the surgeon you choose, and the area where you reside. Here are the average prices, per eye, for other common eye surgery procedures:

* Corneal inserts: $2,800 to $3,800
* CK (Conductive Keratoplasty): $1,200 to $2,500
* PRK (Photorefractive Keratectomy): $1,000 to $1,800
* LASEK: approximately the same prices as for Lasik

New Technology Laser Eye Surgery Cost

Laser eye surgery procedures that use newer technologies are generally more expensive. In Lasik with IntraLase, the surgeon cuts a flap from the cornea with a laser, not a microkeratome. The price is generally higher than for regular Lasik procedure, increasing by $250 – $500 per eye. The increase is partly justified by the fact that the surgeon has to cover the cost for the system. Patients paying for this procedure are said to have fewer flap complications, require fewer treatments after surgery and have a better chance to achieve an acuity of 20/20 or higher.

Generally, you’ll find that financing is available to help you with the cost or your laser eye surgery. There are a number of lenders that specialize in elective procedures and offer plans with long-term payments and fixed rates. Many laser eye surgery centers and private surgeons work with lenders they’ve found to be reliable in the past to provide affordable financing plans for their patients.

The Average Cost of Lasik Eye Surgery

Considering Lasik eye surgery? Beyond all the other considerations (such as its safety, if it’s the right procedure for your eyes, its compplications and its benefits), there’s the consideration of cost. Though Lasik eye surgery is not cosmetic surgery, it is considered elective surgery. Therefore, most insurance companies will not cover the procedure. In most cases, neither will Medicare. Still, it’s wise to first check with your health insurance provider.

If you aren’t covered for the procedure, then it’s time to do your homework.

You’ll quickly discover that the cost of Lasik eye surgery can vary dramatically. Prices can be influenced by the area in which you live, your health and ability to pay, even the level of competition. Primarily, you’ll want to make sure you thoroughly understand everything that’s included in any quote you obtain from a local practice. For instance, does it include pre-operative and post-operative visits?

LASIK Price Increase

In the past few years prices have been rising. On the one hand, this has been due to new procedures that customize the procedure, making it more expensive than traditional Lasik surgery. On the other hand, new developments such as IntraLase technology, have also brought about an increase in the cost of the procedure.

In 2002 the average cost of Lasik eye surgery was between $1,550 and $1,600. However, by October 2003 the average had risen to $1,710. At the end of 2004, the average cost of Lasik eye surgery was a little over $1,800, and in 2005 it was $1,965.

More Reasons Why Prices Vary

Another contributing factor to the wide range of prices is the level of pre-operative testing conducted by your Lasik practioner. Because there can be such a difference of care from one practioner to another, you need to fully understand what’s included in any price that’s quoted to you.

As an extension, you’ll want to know what procedures and surgical equipment are being used. Is the practiioner up to date on the latest techniques and equipment? Technologies for tear film analysis, eye tracking, and measurements of corneal thickness, the laser and corneal topography and pupil size can dramatically influence the cost of your procedure.

What Are You Paying For?

Refractive surgery fees generally cover a variety of costs such as lease or purchase and maintenance of the laser, corneal ring segments, microkeratome and/or other devices used. The excimer laser manufacturer receives a royalty fee of $100 to $150 per eye to develop the machine. If it’s a custom procedure the royalty fee per eye can rise to between $145 and $250, depending on the laser manufacturer.

The cost of Lasik surgery will generally include masks, gloves, gowns and other items used to make sure the operation is kept sterile as well. And then there’s the surgical solutions, medications and microkeratome blades used during the surgery; office and surgical staff benefits and salaries, office equipment, rent, and office administration; insurance, patient acquisition costs, which include seminars and advertising, and surgeon’s fees if he or she is not on staff.

While the cost of Lasik eye surgery is an important consideration, it’s vital that you don’t base your decision solely on cost. Ask your surgeon what’s included and what is not, what you’ll be required to pay if enhancement surgery becomes necessary or complications occur, if the newest techniques will be utilized, and how extensive his experience is with Lasik surgery. Remember: a good surgeon is well worth the extra expense.

Understanding Eye Surgery

Computer technology has been used on a large scale in medical science during latest years. Laser eye surgery has increased in popularity, while non-laser procedures have also been improved. Many people have only heard about LASIK as a refractive surgery. However, there are many various types of eye surgery to correct vision.

Laser Eye Surgery

For these procedures, the surgeon uses a laser beam for reshaping the cornea and improving the eye’s ability to focus. There are many different types of laser eye surgery, such as PRK, LASIK, Intralense or LASEK.

Laser-Assisted In Situ Keratomileusis (LASIK)

This laser eye surgery procedure is used for treating astigmatism, nearsightedness and farsightedness. It involves cutting a flap from the outer and middle layers of the cornea and then the use of an excimer laser to reshape tissue under this flap. This procedure usually takes about one minute per eye.

Laser Epithelial Keratomileusis (LASEK)

In LASEK eye surgery, the process is pretty much the same, except that the flap is cut only through the outer corneal layer (epithelium). It is used mostly for patients with thin corneas, for whom a LASIK procedure will be more risky. This type of eye surgery can have some side effects, such as a slightly longer healing period with more discomfort.

IntraLense

In this type of eye surgery, the surgeon cuts the flap using another laser instead of a microkeratome.

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Photorefractive Keratectomy (PRK)

This type of laser eye surgery is used to treat mild to moderate farsightedness, nearsightedness and astigmatism. The outer layer of the cornea is reshaped in order to correct vision. No flat needs to be cut in the cornea. The surgery generally lasts less than a minute.

Non-laser Eye Surgery

These types of eye surgery involve correcting vision reshaping the cornea by cutting into the outer layers of the eye or using low heat radio waves.

Astigmatic Keratotomy Incisions

This procedure is used for correcting mild astigmatism. Bulgy areas of the cornea are corrected with the use of a blade. This procedure is often performed in conjunction with other eye surgery procedures. However, it is now used less frequently than laser eye surgery.

Implantable Contact Lenses

These implantation lenses are used to treat serious farsightedness and nearsightedness. The lens is inserted behind the iris, in front of the eye’s natural lens. Unlike normal contact lenses, you cannot feel them and they don’t need maintenance. This type of eye surgery usually takes 6 to 20 minutes.

Intraocular Lenses (IOLs)

This procedure has been used for many decades now and the lenses are usually implanted in the eye during a cataract surgery for replacing the natural lens. Years ago, intraocular lenses could only distance vision and glasses were still required for close vision. However, the procedure has been improved and now corrects close and intermediate vision as well.

While many surgeons would always choose laser procedures and the most advanced technologies, some still advise a few patients with specific eye conditions to have a non-laser surgery instead. All eye surgeries have possible side effects and involve certain risks, so you should consult a physician to explain you the advantages and disadvantages of each procedure.