Associated
complications

Corneal debris under the flap
The development of corneal debris under the flap may occur following a LASIK or ReLEx SMILE procedure. Debris sometimes slips under the flap at the end of the procedure. The surgeon evaluates the consequences of this on the patient’s vision, and will decide to leave it if it does not affect the vision, or rinse the interface.

Inflammatory reaction or diffuse lamellar keratitis
Depending on the severity of the inflammation, the surgeon will decide whether treatment with drops or a revision procedure including ablation of the inflammatory membrane and rinsing of the interface is necessary

Corneal infection
A corneal infection is a rare complication, because the surgical procedure is performed in an operating room that strictly respects aseptic protocols and uses only disposable material. Nevertheless, if ever an infection is diagnosed, antibiotics will be prescribed.

Erosion or epithelial defect
Erosion or an epithelial defect may develop following a LASIK or ReLEx SMILE procedure. This event is much less frequent with the femtosecond laser and more often occurs in older patients. The epithelium can become detached in case of fragility and result in more or less severe erosion with irritation or pain. This is treated with a bandage contact lens

Dry eye
Dry eye may occur following the LASIK or PKR procedures and more rarely the ReLEx SMILE procedure. In most cases dry eye gradually resolves within a month or so. The surgeon will prescribe moisturizing and lubricating eye drops, or even punctal plugs in the tear ducts.

Nocturnal halos, starbursts
Usually temporary, the occurrence of nocturnal halos and starbursts has significantly decreased with the most recent excimer lasers. If they are severe, your surgeon will suggest an intervention to analyze the corneal aberrations with the Wavefront technique

Light sensitivity
Light sensitivity is usually temporary, and improves over time.

Fluctuating vision
Fluctuating vision is frequent and rarely uncomfortable, it usually stabilizes rapidly.

Under correction
Under correction may occur with the treatment of a severe vision disorder. In the presence of significant visual discomfort, a revision procedure is possible by once again lifting the corneal flap in the case of a LASIK procedure. Revision surgery is performed after the cornea has been reexamined to ensure, in particular, that it is not too thin. Following ReLEx SMILE procedures, several methods exist, in particular, transforming it into a LASIK or PKR procedure.

Over correction
Over correction is very rare, but if it occurs the therapeutic options are the same as for under correction.

Regression
A gradual decrease in the visual acuity obtained after surgery is sometimes due to a cicatricial reaction of the cornea. It is more frequent following the correction of severe vision disorders. Treatment is based on revision surgery following evaluation of the cornea.

Corneal clouding or «haze»
The cornea always has an inflammatory reaction after the PKR procedure due to the impact of the excimer laser. This normal reaction does not affect the vision and is treated by anti-inflammatory drops and resolves. In case of a severe reaction resulting in an opaque haze, treatment must sometimes be continued for several months. The risk of a « haze » increases with the severity of the myopia treated.

Epithelial Ingrowth
Epithelial ingrowth can occur following a LASIK or ReLEx SMILE procedure. This complication is due to the passage of the epithelial cells of the cornea into the corneal flap interface. This usually involves small, peripheral invasions in the periphery of the flap, that will regress, and do not affect the patient’s vision or flap adhesion to the subjacent stroma. The risk is linked to the growth of these cells, which can result in thinning of the flap creating an astigmatism and a loss of visual acuity. The treatment depends on the progression of the epithelial ingrowth and in case of progression and a risk in the stability of the corneal flap, revision surgery is performed to remove all of the invasive cells.

Corneal ectasia
This is a progressive corneal condition that is extremely rare following the LASIK procedure. It causes a loss in visual acuity and a significant and progressive increase in the corneal curve. This complication may be due to significant thinning of the cornea following treatment. The first treatment is prevention, based on an in depth preoperative examination to identify corneas that are too thin or irregular, which may be a sign of underlying disease that could decompensate after a LASIK procedure. These high risk corneas should not be surgically treated. However, despite these preoperative precautions, if this complication does occur, the final option is to perform a corneal graft to improve the patient’s eyesight.