The risks of laser surgery

We wish to openly explain the risks associated with refractive error surgery, even if their appearance is very rare these days. The FemtoLasik® and Smile methods have reduced the already minimal number of risks associated with laser surgery. These days it’s easy to say that with FemtoLasik® laser surgery, getting rid of spectacles is a very safe procedure!

1. Drying of the eyes

Drying of the eyes after FemtoLasik® laser surgery is due to the fact that in surgery it is always necessary to damage, to some extent, the nerves affecting tear production. For this reason, it is recommended that moisture drops are applied to the operated eyes for a three- to six-month period. Most patients report, however, that they no longer need moisture drops for more than a month or two after surgery. About 10–15% require moisture drops for a period longer than three months. Since the eye is part of the skin, it requires moisture care the same way as skin otherwise – so drops are good for the health of the eye.

With the Smile procedure, eye nerves are less damaged, so the risk of drying is even smaller.

2. Decreased night vision

Currently a larger surgical area can be made, so that the risk of weakening night vision is smaller than previously. During the preliminary examination, the size of the pupil is measured, on the basis of which the extent of the surgical area is planned and the best operating procedure is determined.

Night vision may decrease temporarily (for 3–6 months), but those who experience it as a longer term problem remain fewer than 1% of those operated. The majority see better in the dark after laser surgery than they ever did wearing spectacles.

3. Over- and under-correction

Laser surgery-related side effects may be over- and under-correction. Over-correction means that in correcting the vision we go from minus to the plus side, which nevertheless generally evens out with time. In correcting age-related sight impairment (presbyopia or ‘aging eye’), under-correction is intentionally sought, since the one eye is operated on to see a short distance and the other one far. The need for a repeat operation within a year occurs in the case of approx. 2% of those operated. Our operation warranty guarantees free-of-charge corrective surgery for a year’s time if the target value has not been reached.

4. Sensitivity to light

Sensitivity to light appears these days quite rarely. It may be said that from two to six hours after surgery, the eye has recovered almost entirely from the strain of the procedure.

5. Protrusion of the cornea (keratoconus)

Modern laser surgery technology has enabled the correction of ever larger refractive errors with complete safety. For this reason, it has been possible to minimize the risk of cornea distention. The risk is considerably smaller than with a mechanical razor, i.e. a cutting blade applied in the operation. Due to the current technology, the risk is, as a consequence, practically non-existent. The more precise preliminary examinations have also raised safety to a whole new level – and have already enabled the detection of keratoconus at an early stage. Keratoconus can currently be treated successfully by means of, for instance, the CCL and ICRS methods.

6. Retinal damage

In the FemtoLasik® and Smile methods, eye pressure does not need to be raised anywhere near the level required when using a mechanical razor. For this reason, damage to the retina is very rare indeed.

7. Growing epithelium under the flap

About one month after the operation, there is an additional check to see if an epithelium – i.e. surface layer on the eye – has grown under the flap. The removal of an epithelium has to be performed these days to fewer than one in one thousand of those operated. In repeated operations, the risk of epithelial growth is slighter greater (approx. 3–5%).

With the Smile procedure, the opening lasered into the cornea is only a few millimetres in size, so epithelium growth is even less likely.

8. Incomplete flap

Previously, one-third of all side effects caused by laser surgery resulted from the incomplete, mechanically performed shaving of the flap. If the flap was not instantly completed with no problems, it was necessary to wait three to four months for a repeat operation. ??The femtosecond laser utilized by the FemtoLasik® method has enabled a boost in safety to a whole new level in this area as well. If for some reason the flap is made in an incomplete manner, a new one can be made immediately.

9. Infections

The speed of the FemtoLasik® and Smile procedures has minimized the risk of infection. The flap made in the eye with a femtosecond laser is open for a very short time, thereby reducing the risk of infection. The quick procedure and highly developed equipment maintenance ensure the infection-free character of the FemtoLasik® operation. We are currently using more and more disposable surgical implements as well.

10. Technical supervision

Before FemtoLasik® and Smile surgery is performed, a total of 14 mathematical values are taken of the eye. In order to avoid mistakes, a technician is present during the operation who monitors the laser technique and related equipment, ensuring that the mathematical values measured from the patient during the preliminary exam are correctly inputted into the laser’s computer. The technician operates and supervises the devices, thereby allowing the physician to personally concentrate on the operation and patient. Before surgery, the physician and technician further confirm together the values inputted.


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