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Complications of Refractive Surgery

All refractive surgical procedures are associated with a risk of complications. Fortunately, serious sight threatening complications are rare (<1%).

Under and over-correction are the most common; this is why the ability to touch up or enhance the initial result is so important. Undercorrections are common with LASIK, and between 10-20% of patients may require an enhancement. Enhancement involves surgically lifting the previously created flap and performing additional laser correction. LASIK is relatively easy to enhance.


Infection is very rare with RK, PRK and LASIK. However, late infections (many months to years) have been reported with incisional techniques such as RK. Corneal haze and scarring in the area of the cornea treated by the laser is more common with PRK and rare with LASIK. Glare and haloes or starburst light patterns occur commonly in the early post-operative period following any refractive procedure. As the cornea heals, these night vision problems generally fade or disappear altogether (1-2months). Irregular surface (irregular astigmatism) can result from an initial irregular ablation pattern, a laser pattern not centered over the cornea, or poor healing. Contact lens wear may be necessary to visually correct the problem, although fitting a contact can be more difficult following refractive procedures due to the altered shape of the cornea.

Most serious complications of LASIK are associated with creation of the corneal flap. A thin or bad flap can occasionally occur. When this happens, the flap is repositioned and allowed to heal for several months. Most patients can then be retreated, however permanent corneal scarring can result. The flap occasionally becomes displaced (usually in the first 48 hours) and then must be repositioned. Folds can occur in the flap, making it necessary to "iron" them out. Other complications have been reported and discussion of the potential risks of surgery with your surgeon is an important part of your consultation visit.