LASIK Side Effects and Potential Complications
- Maria Cholakova
- 2 hours ago
- 6 min read
With a high success rate and quick recovery time, it’s easy to see why LASIK is one of the most popular vision correction procedures worldwide. However, like any surgical intervention, LASIK side effects and complications are possible. Here you will learn how to recognize them and weigh the risks.
It’s crucial to be fully informed about what can happen during and after the healing process. From temporary symptoms to rare but serious complications, understanding the full range of possible outcomes is essential for anyone considering the LASIK procedure.
Common LASIK Side Effects
Most discomforts from LASIK surgery are temporary and diminish over time. Dry eyes, halos and glare, light sensitivity, and vision fluctuations would not be considered side effects from LASIK. They are a part of the recovery process after the procedure.
If you experience those, you can use coping strategies like preservative-free artificial tears, wearing sunglasses, and avoiding screens. Steer clear of smoky or dusty environments. Don't drive. And of course, refrain from rubbing the eyes, as it can disrupt the healing process.
However, some patients report other, noteworthy LASIK side effects:
Ectasia
Corneal haze
Infection
Flap complications
Undercorrection
Overcorrection
Regression
Presbyopia progression
Ectasia
Risk Level: Low
Ectasia is a rare but serious LASIK surgery complication. It's where the cornea becomes progressively thinner and begins to bulge forward. The structural weakening can distort vision and may mimic keratoconus. Ectasia occurs most often in individuals with undiagnosed pre-existing corneal conditions.
Corneal topography and pachymetry are the best prevention techniques. Specialty contact lenses and corneal cross-linking are the most effective form of treatment. The best practice is to screen for potential risk factors for ectasia by performing a thorough preoperative assessment.
Corneal Haze
Risk Level: Low
Corneal haze is a temporary hazy layer that may form on the corneal surface. It results in blurred vision or glare, more prominent in low light. This LASIK side effect usually resolves within weeks to months. Anti-inflammatory eye drops are often effective for management. Severe cases may require further treatment.
Flap Complications
Risk Level: Low
The LASIK procedure involves creating a thin flap in the cornea. In rare cases, this flap can be incomplete, have irregular edges, epithelial ingrowth, holes, or develop issues during healing. If your eye surgeon is experienced, there is hardly anything to worry about.
If such a side effect occurs during the LASIK recovery period, contact your eye surgeon. They can perform lap repositioning or additional surgery. Sometimes, depending on the severity, all you may need is close monitoring.
Infection
Risk Level: Low
As with any surgical procedure, there is a risk of infection. Although this is extremely rare with LASIK eye surgery. Symptoms to watch out for are increased redness, pain, sensitivity to light, or discharge.
Preventing this complication during LASIK surgery recovery starts with strict adherence to post-op hygiene and using prescribed antibiotic drops. Prompt medical attention with antibiotics or other therapies is the highest form of treatment once the infection occurs.
Chronic Dry Eye Syndrome
Risk Level: Low
Transient dry eye is common post-LASIK. But sometimes, a subset of patients may develop chronic symptoms that don't seem to go away. Chronic LASIK side effects can affect the quality of life. Long-term use of lubricating eye drops, punctal plugs, or prescription medications like cyclosporine can manage the symptoms.
Undercorrection or Overcorrection
Risk Level: Low to Moderate
The laser may remove slightly too little (undercorrection) or too much (overcorrection) corneal tissue. The result? Less-than-optimal vision. In other words, you may still need glasses or contact lenses temporarily after the LASIK. Enhancement procedures, also known as “touch-ups”, are possible after full healing.
Regression
Risk Level: Low to Moderate
In some cases, the initial vision correction from LASIK fades over time. Part of the original prescription returns. We call this process regression. Regression usually occurs within the first year, but sometimes later. LASIK enhancement surgery may be an option if you are a suitable candidate. Regression after refractive surgery is common in the following conditions:
High preoperative myopia (e.g., greater than -6.00 D)
Young age at the time of surgery
Thin corneas or a large degree of treatment
Epithelial hyperplasia (thickening of the corneal epithelium post-op)
Dry eye syndrome
Presbyopia Progression
Risk Level: Inevitable with age
While not a side effect, LASIK does not prevent presbyopia. Presbyopia is the natural aging process of losing near vision after age 40.
So when you go for the procedure young, you may still need reading glasses for close-up work when you get older. That's even if your distance vision is perfect after the procedure and you go through LASIK surgery recovery without complications.
Rare and Serious LASIK Complications
While LASIK is a highly successful and safe procedure for most patients, complications are possible.
As we get deeper into what could go wrong, these are not meant to discourage potential candidates. We want to ensure informed consent and awareness.
LASIK risks are preventable or manageable with early detection, proper surgical technique, and diligent follow-up care.
Diffuse Lamellar Keratitis (DLK)
Risk Level: Rare
One rare complication is Diffuse Lamellar Keratitis (DLK). It's sometimes referred to as “Sands of the Sahara.” The inflammatory reaction occurs beneath the LASIK flap, usually within the first few days after surgery.
Untreated DLK may affect vision, but when detected early, it often responds well to corticosteroid eye drops. In severe cases, the flap may need to be lifted and irrigated.
Epithelial Ingrowth
Risk Level: Rare
Epithelial ingrowth is another potential LASIK issue, where surface cells migrate underneath the corneal flap. Mild cases may not affect vision and can be observed. But if the cells cause visual disturbances or flap melting, they need to be surgically removed.
This complication is more common in enhancement procedures than in primary LASIK.
Flap Dislocation
Risk Level: Very Rare
Although uncommon, flap dislocation can occur due to trauma to the eye. The earlier in the healing period, the bigger the concern. In simple words, postoperative trauma can dislodge the corneal flap created during LASIK, even years after the procedure.
Avoid activities that involve the risk of eye injury and use protective eyewear when appropriate to prevent this LASIK side effect. If it happens anyway, the flap must be repositioned by a surgeon as soon as possible.
Central Toxic Keratopathy (CTK)
Risk Level: Very Rare
A very rare complication known as Central Toxic Keratopathy (CTK) may also develop as a LASIK side effect. CTK is characterized by central corneal clouding, tissue thinning, and farsightedness. Currently, there is no definitive treatment for this complication. The condition often stabilizes over time with supportive care.
Pressure-Induced Stromal Keratitis (PISK)
Risk Level: Very Rare
Another infrequent issue is Pressure-Induced Stromal Keratitis. PISK resembles DLK but is associated with elevated intraocular pressure, leading to corneal edema and vision changes. The onset is often due to overuse of steroid eye drops.
Unlike DLK, PISK requires pressure-lowering medications and cessation of steroids rather than anti-inflammatory treatment.
Retinal Complications
Risk Level: Extremely Rare
Although the procedure focuses on the cornea, retinal complications and retinal detachment have been reported in very rare cases. This LASIK side effect occurs particularly in patients with high myopia.
Retinal issues aren't a direct consequence of the LASIK procedure itself, but are more related to the anatomical predisposition of the eye. The only form of management is surgical repair via vitrectomy or scleral buckling.
Vision Loss
Risk Level: Extremely Rare
Though exceedingly rare, permanent vision loss is the most severe potential LASIK complication. It can occur due to severe LASIK side effects, like untreated infection or corneal ectasia.
Vision loss after LASIK surgery is largely preventable with proper care and experienced surgical hands. On-time management may include corneal transplantation or other advanced interventions, depending on the cause.
RELATED: Is Laser Eye Surgery Painful?
LASIK Side Effects and Complications: What to Have in Mind?
LASIK surgery has a high success rate and patient satisfaction. Patients have to be vigilant of LASIK side effects and potential rare complications, but we urge you not to overthink it if you've recently had the procedure. Unless you have terrible discomfort, the last thing you need is to worry about what could go wrong during your recovery period.
Thorough preoperative screening, choosing an experienced surgeon, and adhering to postoperative care guidelines significantly mitigate these risks! In case you have any concerns, discuss them with your ophthalmologist!
External resources:
Facts About LASIK Complications, American Academy of Ophthalmology
✅ Medically reviewed
Checked by Atanas Bogoev, MD.
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