Side Effect of LASIK

LASIK procedures have been performed for a number of years with varying degrees of success. Many patients have been freed from having to wear glasses and are very happy with the results. Others still need eye glasses for certain activities.

Common side effects include post surgical dry eyes, light sensitivity, fluctuating vision and halos around lights. As the procedure has evolved some of the side effects have been reduced while others have started. Development of the Femtosecond laser resulted in a neater, sharper flap that heals faster and better then when the lathe is used.
However, this new laser has resulted in a new side effect in some post surgical individuals

Transient Light Sensitivity Syndromern(TLSS) occurs in some patients that have had LASIK when the Femtosecond laser is used. According to Dr William Miller, this occurs in less then 1% of the patients employing the Femtosecond laser. However, as they say “if it is in the chair, it ain’t rare.” So we must all be aware of this condition and how to treat it.

While DLK and epithelial cell in growth under the flap are not uncommon side effects, neither one will cause the symptoms of TLSS.
TLSS patients will complain of moderate to very severe light sensitivity, but will show no other clinical signs. Many of these patients will even keep their sunglasses on while in the examining room.

Current theories as to the etiology of TLSS include the increased energy levels employed by the Femtosecond laser causing elimination of the gases located in the intrastromal space. These “bubbles” relocate to the peripheral cornea and episclera resulting in a secondary irritation of the cilliary body. It should be noted that this is only a theory.

Treatment of TLSS includes prednisolone acetate drops with varying frequency depending on the severity of the photophobia. Their use may last between a week to more then a month, always tapering their use to prevent a rebound reaction. Recently, the use of cyclosporine in addition to the Pred has shown a positive effect in remediating the condition.

In short, post LASIK patients require careful follow up and for the doctor to be aware of the entire possible short and long term complications and how to best treat them.