Glasses and contact lenses can be inconvenient – they fog up, fall off, slip down, need cleaning, need constant maintenance – for people highly dependent on optical correction, vision correction with laser eye surgery can be a tempting solution. But any sort of operation to the eye can be a daunting thought and before you go under the metaphorical knife, you really want to know is laser eye surgery safe and what are the risks?
Laser Eye Surgery
It helps to know what laser eye surgery actually is and how it achieves vision correction. Laser eye surgery refers to a group of refractive operations of varying techniques – surgical procedures designed to change the way light passes through the eye so that rays come to a clear focus on the retina to form sharp vision. Although not all refractive procedures actually involve a laser tool, those that do mostly concentrate on reshaping the front surface of the eye known as the cornea.
This reshaping process involves the removal of select areas of the cornea, literally changing its shape. The result is that light is bent along a different pathway as it passes through this tissue to come to a point at the back of the eye where we perceive vision as being clear, thereby providing vision correction without the need for external optical aids such as glasses or contacts.
As with any surgical procedure that involves an incision in the body, laser eye surgery does come with a degree of risk. Although certain techniques are associated with particular risks and complications that other methods may be able to ameliorate, surgical vision correction techniques are recommended to individuals on a case by case basis – which laser eye surgery method is safest for you and your eyes.
Is Laser Eye Surgery Safe?
Before any medical device or operation is approved for clinical application in Australia, it must first go through a strict process of approvals to ensure the safety of the public. Overall, laser eye surgery is considered to be a very safe procedure with a very low rate of complications; success rates are typically quoted around 98-99% in the developed world.
Complications from surgical vision correction resulting in a loss of more than one line on the visual acuity letter chart sit around 0.4% and more comfortingly, total loss of sight from laser surgery has never been reported in an Australian clinic. One of the most well-known, popular refractive techniques, LASIK is known to provide perfect 20/20 vision for over 90% of patients. Extensive studies into the safety of other refractive methods including PRK and SMILE® also tend to demonstrate that these techniques are comparable in safety and efficacy.
As mentioned earlier, when it comes to laser eye surgery each patient is assessed on a case by case basis by their ophthalmologist and clinical team. This determines the level of your risk of complication as well as guides your eye doctor in deciding which procedure is the best and safest for you. There are several factors your refractive specialist will take into consideration:
- Your prescription – Each laser vision correction method will have been assessed for effectiveness and safety within a certain prescription range. Although this parameter is not considered in isolation, there are general rules of thumb when it comes to the treatable prescription range for each refractive technique, whether it’s astigmatism, or short- or far-sightedness. For example, LASIK and SMILE® can often be used to treat degrees of short-sightedness even into the double digits.
- Your corneal thickness – Refractive techniques that require reshaping of the cornea rely on a minimum corneal thickness. As the reshaping process involves removal of tissue and the higher the script, the more tissue that needs to be removed, an adequate amount of tissue is needed to begin with in order to address the presenting prescription. In addition to this, there is a minimum residual corneal thickness that needs to remain after the reshaping process to maintain the mechanical integrity and stability of the eye. Compared to LASIK, PRK tends to be a safer option for patients with thinner corneas.
- Lifestyle factors – Certain laser surgery techniques tend to be recommended for different types of lifestyles. While one aspect of this relates to a person’s visual demands, such as whether they have presbyopia and need treatment for both distance and reading vision, certain hobbies and vocations can also exclude certain surgery methods on the basis of safety. An example of this is a patient who serves in the armed forces or who undertakes wrestling as a pastime – LASIK surgery involves the formation of a hinged corneal flap before the underlying cornea can be reshaped. Although rare, this corneal flap may become dislodged in the event of physical trauma, making LASIK an unsuitable solution for such a patient. Another technique such as PRK or SMILE® would be more appropriate.
- Pre-existing eye conditions – Some patients may be counselled against any type of laser eye surgery due to a pre-existing eye disease such as keratoconus or an active corneal infection. In many cases, manipulating the corneal tissue may exacerbate such conditions, which either need to first be treated and resolved, or may simply exclude the patient from refractive surgery altogether. Pre-existing dry eye, although not a complete contraindication to refractive surgery, may guide the surgeon to recommending a technique less likely to worsen the dryness, such as SMILE® instead of LASIK.
If you’ve been wondering ‘is laser eye surgery safe?’, the answer is yes. Of course, there are still risks involved but a discussion with your ophthalmologist will help to ensure you are counselled to the most appropriate technique for your situation. Call us now at (03) 9070 3580 for a consultation.