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- Irregular
Astigmatism
Irregular astigmatism can result from irregular healing or
complications from the use of a microkeratome following
any kind of refractive surgery. A contact lens might help
the eye see well and wearing a contact lens might be a
solution to seeing well if you should have irregular
astigmatism following surgery. In our experience, once the
initial healing period is complete (usually about three
months), irregular astigmatism is quite uncommon following
LASIK. It is our experience that when
present it tends to improve with time, but there could be
cases in which it remains. Today,
Custom Excimer Ablations utilizing Corneal Topography can
eliminate this complication
(Autonomous
Ladar (tm))
- Epithelial
Cell In
growth or
Abnormality The
surface of the normal cornea is covered by a layer of
epithelial cells, that regenerate easily and grow quickly
so that they rapidly cover areas of scratches, abrasions,
and incisions. The negative aspect is that they can
sometimes grow where they are not wanted, such as beneath
a corneal flap as is used in LASIK. These cells can occur
as either "isolated pockets or nests" which can
come from a little "nest" of cells inadvertently
left beneath the flap or from cells which grow in under
the edge of the flap if any part of it is not sealed down
well at the end of the procedure. We take great care to
try to avoid both of these situations, but small groups of
cells are impossible to see (until they grow larger) and
small areas of poor sealing of the flap edge are at best
difficult to identify. As a result in about 1 case in 400,
we see a significant area of cells present beneath the
flap. Fortunately, most of these are fairly easy to
eliminate successfully, but it is possible that they could
damage the flap or cause enough permanent haze or scarring
that the flap would have to be removed and/or replaced by
a donor flap. This could conceivably result in permanent
visual loss or the attempts at treatment of it could
result in serious complications (such as infection) with
bad results.
- Retinal
Detachment Although
retinal detachment is not usually considered a specific
complication of LASIK surgery, it is at least a
possibility in high myopes. It seems conceivable that
manipulation and pressure changes in the eye related to
the use of the microkeratome could contribute to a retinal
detachment in a high risk eye. While the law only requires
that we exercise the skill and judgment of a
"reasonable practitioner" at the "standards
of the community"; we expend considerable time,
energy, and resources to try to always do better than
that. In spite of our very best efforts and in spite of
using the best technology available and the best
techniques known, there will be some results that are less
than ideal
and some patients who are dissatisfied or unhappy with
their results. As with many of life's choices and
activities, you must make a decision based upon the best
information available whether or not the potential
benefits of your contemplated surgery outweigh the risks.
- Infection
Infection of the cornea or of parts of the eye behind the
cornea is a rare, but a serious possible complication of
any type of refractive surgery. Although most infections
respond well to antibiotic treatment, there are occasional
exceptions and it is possible to have a very serious loss
of vision or even blindness as a result of infection.
- “Sands
of Sahara”This
condition occurs a few days after surgery and presents as
fine granules under the LASIK flap. These disappear with
topical steroid drops in most cases.
Pain
Postoperative irritation occurs, but frank pain is unusual
and often means that your flap has been rubbed off. This
is easily repaired by replacing the flap in its original
position.
- Glare,
Starbursts or Haloes
Today we pay attention to the size of your pupil. The
laser lens we create may be smaller than your pupil in the
dark , and as a result you may see around the edges of
this lens creating these sensations. We sometimes use eye
drops to correct this.
- Flap
Complications
– It is common for the surgeon, to note fine wrinkles in
the flap, but these rarely cause any problems. Rubbing
your flap off can occur, but we provide plastic eye
shields immediately after surgery. That is why we
emphasize that you don’t rub your eyes after surgery for
5 days if possible.
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