Common LASIK Side Effects and How to Manage Them

1. Dry Eye (Most Common)

Frequency: 60-95% in first month, 5-8% beyond 1 year

Why it happens: LASIK temporarily disrupts corneal nerves that signal tear production. Healing takes 3-6 months for most patients.

Symptoms: Burning, gritty sensation, intermittent blurred vision that improves with blinking, watering (paradoxical).

Management: - Preservative-free artificial tears 4-6 times daily - Warm compresses for 10 minutes daily - Omega-3 supplements (1-2g daily) - Avoid AC blowing directly on face - Humidifier at home/office - Limit screen time, take frequent breaks - For persistent cases: prescription drops (cyclosporine, lifitegrast), punctal plugs, IPL therapy

Resolves: Most patients fully recover in 3-6 months.

2. Halos, Glare, Starbursts at Night

Frequency: 30-50% in first month, 5-10% beyond 6 months

Why it happens: Healing cornea and slight pupil-reshape interaction with light at night. More common with higher prescriptions and large pupils.

Symptoms: Bright halos around streetlights, oncoming headlights causing starbursts, ghosting at night.

Management: - Time — most cases resolve within 1-3 months as the brain adapts - Lubricating drops at night - Avoid night driving for first 2-3 weeks - Wavefront-guided LASIK and Contoura Vision have lower rates than standard LASIK - For persistent cases: night-driving prescription glasses, low-dose pilocarpine drops

Resolves: 80-90% within 3 months, almost all by 6-12 months.

3. Light Sensitivity

Frequency: 30-50% in first 1-2 weeks

Why it happens: Healing corneal surface temporarily more sensitive to bright light.

Management: - Wear sunglasses outdoors - Avoid bright fluorescent lights - Dim screen brightness - Lubricating drops

Resolves: Within 1-3 weeks for most patients.

4. Under-correction or Over-correction

Frequency: 1-3% of patients

Why it happens: Individual healing variation can sometimes leave residual prescription.

Symptoms: Vision not as sharp as expected at distance or near.

Management: - Wait 3-6 months for full healing before assessing - Mild residual prescription often improves over time - For persistent residual error: free enhancement procedure (touch-up LASIK) — usually included in original surgery cost - Reading glasses may be needed for residual minor near-vision needs

Resolves: Most patients are fully corrected after enhancement. Final outcome typically 20/20-20/25.

5. Regression

Frequency: 2-5% over 5 years, slightly higher for high prescriptions

Why it happens: Cornea slowly returns toward original shape. More common in high prescriptions (above -8 D), young patients (under 25), or those with continued near-work strain.

Management: - Annual eye exams catch regression early - Mild regression may not need treatment - Significant regression: enhancement LASIK can correct it (often free within 1-2 years) - Lifestyle factors (excessive near work, eye strain) may contribute

Resolves: Usually correctable with enhancement if it occurs.

Rare but Serious Side Effects

Less than 1% combined:

• Flap dislocation: Rare, usually from trauma in first weeks. Surgical repositioning required.
• DLK (Diffuse Lamellar Keratitis): Inflammation under flap. Treated with steroid drops.
• Epithelial ingrowth: Cells growing under flap edge. May need minor surgical removal.
• Infection (microbial keratitis): Less than 1 in 5,000. Aggressive antibiotic treatment.
• Ectasia (corneal weakening): Less than 1 in 10,000. Treated with corneal cross-linking and ICL.

These rare complications are why proper screening (rejecting unsuitable candidates) and choosing an experienced surgeon matters so much.