Surgical and Postoperative Complications of LASIK, LASEK, PRK
The following charts taken from two scientific review articles contain all surgical and postoperative complications associated with LASIK. Surface procedures like PRK, LASEK, Epi-LASIK do not lead to microkeratome-associated intraoperative complications but they have a higher risk of haze, scarring and postoperative pain. The IntraLASIK or so-called "All Laser LASIK" with femtosecond laser flap creation also doesn't lead to microkeratome-associated intraoperative complications but, like standard LASIK, they have a risk of postoperative flap complications. IntraLASIK is associated with a higher risk of Diffuse Lamellar Keratitis (DLK) and Transient Lightsensitivity Syndrome (TLS).
Keratome and flap complications
- Intraoperative complications (0.3 to 5.7%)
- Ectasia
- Flap striae (up to 10%)
- Flap dislocation (up to 2%)
Laser complications
Complications of healing / infection / inflammation
Other complications of LASIK
 Schallhorn SC, Amesbury EC, Tanzer DJ. Avoidance, Recognition, and Management of LASIK Complications. A, J Ophthalmol 2006;141:733-739.
1. Inadequate alignment with astigmatism axis
2. Irregular flap cuts
- Partial Flaps
- Thin Flaps
- Donut-shaped flaps
- Decentered flaps
- Free caps
3. Complications due to improper microkeratome assembly or defective blades
4. Intraoperative bleeding
5. Intersecting microkeratome cuts
- Input errors
- Decentered ablations
- Central Islands and peninsulas
7. Microkeratome-induced epithelial defects
9. Postoperative flap complications
10. Epithelial growth within the interface
11. Interface debris
14. Overcorrection
15. Undercorrection and regression
19. Infection
20. Retinal complications
Source: Ambrósio R, Wilson SE. Complications of Laser in situ Keratomileusis: Etiology, Prevention, and Treatment. J Refract Surg. 2001 May-Jun;17(3):350-79.
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