No laser refractive procedure is completely free of risk. It is not possible to list every complication that can occur.
There is about a 0.1% chance of the cornea becoming infected after SmartSurfACE. Generally this means added discomfort and a delay in healing, with no long-term effect.
It is not possible to predict perfectly how your eye will respond to the laser procedure. As a result, you may still need corrective lenses after the procedure to obtain good vision because of residual myopia, hyperopia, or astigmatism. In many cases, but not all, a second procedure can be done to improve the result. At Pacific Laser Eye Centre, we are meticulous about updating our algorithms. We collect data from all our past patients to create a treatment algorithm. Using this treatment algorithm, our retreatment rate is extremely low (at less than 0.5%).
Corneal haze occurs as part of the normal healing process after the procedure. In most cases, it has little or no effect on the final vision and can only be seen by an eye doctor with a microscope. However, there are some cases of excessive haze which interferes with vision. As with undercorrections, this can often be dealt with by means of an additional laser treatment
In some patients, the effect of laser refractive procedures are gradually lost over several months. This is like an undercorrection, and a retreatment is often feasible.
The halo effect is an optical effect that is noticed in dim light. As the pupil enlarges, a second faded image is produced by the untreated peripheral cornea. For some patients who have undergone PRK, this effect can interfere with night driving. However, new technology has greatly decreased or eliminated this problem.
The fluid pressure inside the eye increases in some patients as a result of the steroid drops, which are used for two months after SmartSurfACE. With regular postoperative checkups during the time when steroids are being taken, such a pressure increase can be monitored by a simple measurement and controlled by an adjustment to the patient’s medications. At Pacific Laser Eye Centre, we reduce the risk of raised eye pressure after the procedure by giving patient a prophylactic eye drops which lower eye pressure in the first month while on steroids. This preventative therapy results in almost no risk of raised eye pressure after the procedure.
Even when everything goes perfectly, there are effects that might cause some dissatisfaction. Older patients should be aware that you can’t have both good distance vision and good near vision in the same eye without corrective lenses. Some myopic patients rely on their myopia (by taking off their glasses, or by wearing a weaker prescription) to allow them to read. Such a patient may need reading glasses after the myopia is corrected with the laser.
Another consideration is the delay between eyes. If one eye is being done at a time, then the eyes may not work well together during the time between treatments. If a contact lens is not tolerated on the unoperated eye, work and driving may be awkward or difficult until the second eye has been treated.