Acuity
The Comprehensive Refractive Study (CRS)-USA LASIK
Study of 1,800 eyes examined 754 eyes that were not
treated for astigmatism. None lost two or more lines
of BCVA. One hundred six of these patients reported
having lost between one and two lines of vision at
some point during the 3 months between the operation
and the post-operative visit. Of the 106, 69 had regained
BCVA by the third month post-operatively without the
need for additional surgery. Many of the remaining
36 regained BCVA after enhancements.1
Risks More Prevalent in a Surgeon's First Cases
| Complications Noted
by Vidaurri-Leal (n= 5000) |
| |
First
Cases (n=200) |
Following
Cases (n=4,800) |
| Intra-operative
complications |
4.5% |
0.87% |
| Post-operative
complications |
38.8% |
7.98% |
| Loss of BCVA |
3.0% |
0.81% |
In 1998, Jésus S. Vidaurri-Leal, MD presented
"Complications in 5000 LASIK Procedures,"
a study that supports the existence of a learning
curve with LASIK, at the American Academy of Ophthalmology
Subspecialty Day. He broke his data into two categories:
his first 200 cases performed in 1995 and his 4800
following cases. Among the surgeon's later 4800 cases,
less than 1% experienced intra-operative complications.
Post-operatively, 7.98% of these cases experienced
complications, with a loss of best corrected visual
acuity in .81%. This compares with complications 4.5%
intra-operatively, 38.8% post-operatively, and a loss
of best corrected visual acuity in 3% of his first
200 cases.2
| Intra-operative
Complications Noted in the Lin & Maloney Study
(n=1,019) |
| First Cases(n=100)
|
Following Cases
(n=600) |
Last Cases (n=300) |
| 6.0% |
2.3% |
0.3% |
The February, 1999 study by Doctors Lin and Maloney
that considered 1,019 eyes also demonstrates a learning
curve with refractive surgeries utilizing a hinged
flap. This study noted a 6% intra-operative complication
rate in the first 100 eyes compared to a statistically
significantly lower 2.3% rate in the next 600 eyes.
In the last 300 eyes, the Intra-operative complication
rate dropped down to 0.3%.3
Other Risks
Other risks include corneal damage leading to permanent
corneal scarring or swelling, droopy eyelid, contact
lens intolerance and persistent discomfort. The majority
of complications recorded in early studies were intra-operative.
As microkeratome technology has improved, the incidence
of these LASIK complications has diminished. Researchers
expect further reductions as instrumentation becomes
more sophisticated.
Suggestions for Further Reading
Wherever possible, we have provided links to the
studies and articles we have cited. We encourage patients
to read them in full, but realize that these articles
have not been written for a lay audience.
1. CRS completes
LASIK study treatment for approved range. Ocular Surgery
News 1998; 11.
2. Vidaurri-Leal, JS. Complications in 5000 LASIK
procedures. Refractive Surgery 1998 Reshaping the
Future, a publication of American Academy of Ophthalmology
Subspecialty Day 1998 - Refractive Surgery; 61-64.
3. Lin RT, Maloney RK. Flap complications associated
with lamellar refractive surgery. American Journal
of Ophthalmology 1999: 127(2) 129-136.
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