However, despite all the brilliant things about LASIK, there are some issues that occasionally cause problems. For example, if the patient is a boxer or does contact sports such as rugby, they are at risk of a direct blow to the eye which could potentially tear open the LASIK flap, even 20 to 30 years down the line.
The worst case of this that I’ve seen, is someone who was involved in a road traffic accident. The airbag went off and hit their face, compressing both the eyes and causing both laser flaps to be torn clear off – even 20 years after their original treatment. So, although it’s very rare, it’s a worry for some people.
A second issue with LASIK is that when we make this flap we actually cause quite a bit of damage to the nerves in the cornea. The nerves recover, but it can take between six and twelve months for them to fully recover. As they’re recovering we occasionally see severe dryness of the cornea, because these nerves are critical in telling your eye it needs to make more tears. But if they’re damaged, your eye doesn’t know it needs to water.
Interviewer: Are there any other issues with LASIK such as problems with night vision or halos?
Alex Shortt: These are issues that are very much historical now. In the early days, when we were doing laser treatment we used to create a 4 mm or 5 mm treatment zone in the middle of the eye. In doing this, there was a sharp boundary between the treated part of the cornea and the edge. What would happen, is the light would bounce off the edge of the treatment zone making it harder to see at night. So very simply, we just made the treatment zone bigger and added an extra zone – what we now call the blend zone – where we very carefully smooth the transition between treated and non-treated cornea together. Since we’ve done that, I can’t remember the last time I’ve seen a single patient who has had a single problem with night vision. However, we still need to tell patients about this as it’s out there in the literature.
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