LASIK Complications & Success Rates: An Honest Assessment

LASIK is one of the most studied elective procedures in medicine. Over 40 million procedures have been performed worldwide, generating extensive safety data. Let's look at what the research actually shows.

Success Rate Statistics

A comprehensive meta-analysis published in the Journal of Cataract & Refractive Surgery analyzed 67 studies covering 53,731 eyes over 18 years. The findings:

• 88-92% of patients achieve 20/20 vision or better without correction
• 99%+ achieve 20/40 or better (legal driving vision in most states)
• 92.6-98.5% report satisfaction with outcomes
• 1-2% require enhancement (touch-up) procedures

These outcomes have improved significantly since LASIK's early days due to advances in wavefront-guided technology, femtosecond lasers, and better patient selection.

Common Side Effects (Usually Temporary)

These side effects are experienced by most patients but typically resolve within weeks to months:

Dry Eye (20-40% of patients)

The most common side effect. LASIK temporarily disrupts corneal nerves that stimulate tear production. Most patients experience some dry eye for 3-6 months. Usually manageable with artificial tears. Severe, persistent dry eye occurs in <1% of cases.

Glare, Halos, and Starbursts (10-20%)

Most noticeable when driving at night. More common with large pupils and older technology. Usually diminishes significantly within 3-6 months as the cornea heals. Modern wavefront-guided lasers with larger treatment zones have reduced this issue.

Light Sensitivity

Common in the first few days to weeks. Sunglasses help. Typically resolves completely.

Vision Fluctuation

Vision may be slightly better in the morning than evening, or vice versa, during healing. Stabilizes by 3-6 months.

Less Common Complications

Under-correction or Over-correction (2-5%)

Vision not fully corrected to target. Usually correctable with enhancement procedure after 3-6 months. More common with higher prescriptions.

Flap Complications (<1%)

Issues during or after flap creation: incomplete flap, buttonhole, free cap, or flap displacement. Modern femtosecond lasers have significantly reduced these risks. When they occur, most are manageable with proper treatment.

Infection (<0.1%)

Extremely rare with modern sterile techniques. Risk minimized by proper antibiotic protocols. When caught early, responds well to treatment.

Diffuse Lamellar Keratitis (DLK) (1-2%)

Inflammatory reaction under the flap ("Sands of Sahara"). Usually detected at follow-up appointments and treated with steroids. Rarely affects final vision when treated promptly.

Rare but Serious Complications

Ectasia (<0.04%)

Progressive corneal thinning and bulging after surgery. The most concerning potential complication. Risk factors include thin corneas, high prescriptions, and undiagnosed keratoconus. Proper screening effectively identifies at-risk patients. If it occurs, may require corneal cross-linking or eventually corneal transplant.

Chronic Dry Eye (<1%)

Some patients experience persistent dry eye beyond 12 months. May require ongoing treatment with prescription drops (Restasis, Xiidra), punctal plugs, or other therapies.

Persistent Visual Disturbances (<1%)

In rare cases, glare, halos, or starbursts persist beyond the normal healing period. May affect night driving. Can sometimes be improved with specialty contact lenses or additional procedures.

How to Minimize Your Risks

Who Should NOT Get LASIK

Proper patient selection is the most important factor in avoiding complications. LASIK is not appropriate for:

• Patients with keratoconus or suspicious corneal topography
• Corneas too thin to safely remove required tissue
• Unstable prescriptions (still changing)
• Severe dry eye syndrome
• Uncontrolled autoimmune diseases
• Pregnant or nursing women
• Unrealistic expectations

A reputable surgeon will decline to operate if you're not a good candidate — that's actually a sign of quality care.

The Bottom Line

LASIK has an excellent safety profile when performed on appropriate candidates by experienced surgeons using modern technology. The vast majority of patients achieve excellent vision with minimal side effects.

However, no surgery is risk-free. The key is understanding the realistic risks, ensuring you're a good candidate, choosing a qualified surgeon, and following post-operative care instructions carefully.