While LASIK usually heals very well with out incident there are situations that may complicate the process resulting in serious issues that may alter the final results. To best illustrate this I have 2 case histories that will explain different problems. The first is caused buy the patient, the second in no one’s fault.

A 25 year old man had LASIK with out incident on a Friday and came in for his first post op visit on Saturday. All was normal as his vision was 20/20 in each eye and aside from a little redness he was fine. He was advised to avoid situations that may result in ocular trauma, rubbing of the eyes or any place that may have windy conditions. He was of course also told to wear his sunglasses outside and sleep with his shield at night.

On Sunday he went to the beach to play in a Volleyball tournament. After fighting off multiple spike attempts, one of them did manage to hit him square in the face resulting in eye trauma. He then fell to the ground landing face first in the sand. On Monday he came in with red, painful eyes and blurry vision. Examination revealed that the flap on the cornea had shifted out of place and there was sand under it. Both of those are emergencies and required bringing him back into surgery to lift the flap and clean under it. He was seen on Tuesday and he was not as happy as the first post op visit. He had more redness, discomfort and his vision was only 20/40. He had to use the steroid drops for 2 weeks until the swelling resolved and his vision returned to 20/20. He was very fortunate that the problem that he caused was able to be corrected. Had the flap been completely taken off during the volley ball game or a lot of sand got under the flap, the results could have been devastating. He ultimately did achieve 20/20 in each eye and was happy with the results. He did have more glare then the average patient because the juncture where the flap was made scarred a little resulting in diffraction of light. It will fade over time, but may not completely resolve itself.

The second patient was 100% compliant, but had bad luck. She was a 38 year old woman who underwent LASIK and was perfect for the first week following surgery. She returned 10 days after the procedure complaining of pain, decreased vision and redness in both eyes. An examination revealed both flaps were milky white and the edges were slightly lifted up. She stated that she was avoiding all the things that she was supposed to and even visited her ailing friend in the hospital. The significance of the hospital visit is that she had apparently been exposed to an infectious agent that was attacking the corneal flaps. There was no additional surgery required, but aggressive medical treatment was needed. She was put on several very strong antibiotic eye drops, steroids and even an oral antibiotic to kill the infectious agent. She was followed up on a daily basis and after 1 week she began to show signs of improvement. The corneal flaps did reattach at the edges and became almost perfectly clear. Her best vision was 20/25- in each eye and her eyes were healthy.

The first patient was foolish and caused his problem, the second did nothing wrong, but had bad luck. The bottom line is that when undergoing refractive surgery one must always do as instructed, and hope for the best with factors that can not be controlled.