What are the presbyopic laser eye surgery risks?

The risks of presbyopic laser eye surgery are the risks of any corneal laser refractive surgical procedure, and fortunately, the risks are very low and occur infrequently.

Most Common Risk

The most common risk that occurs – it’s not really a risk, but fairly typical – is a period of the eyes feeling dry. So in the presbyopic age group, which is, the late 40s, 50s, our eyes are drier as we get older. And if you perform any surgical procedure on the eye, be that cataract surgery, glaucoma surgery, or corneal laser refractive surgery, you will induce some dryness of the eye.

Duration of Presbyopic Symptoms

The symptoms recover over a month or two, but one can tell that the eye is dry for maybe up to six months, so many patients will need to use ocular lubricating drops, dry eye drops, or artificial tears, to help the eyes feel more comfortable during the healing process.

With presbyopic eye surgery, one essentially performs LASIK, that is flap based corneal laser refractive surgery where one laser creates a thin flap, and a second laser reshapes the cornea to address the presbyopia.

Taking Care of Oneself After Surgery and Avoiding Complications

It’s important that patients are very mindful that they can’t rub their eyes, particularly for the first week. I tell patients that for the first week they need to be extremely careful, and they need to be careful for a month. For the first week, we ask patients to wear shields over their eyes at night, and, if they’re, for example, outdoors running after surgery in the first month, I like them to wear protective eyewear so that they don’t get dust in their eyes. The risk is that if the eyes are rubbed too vigorously, that the flap can move or shift slightly.

I’ve seen that on half a dozen occasions in the last 20 years, all of them related to trauma in the first week. One, for example, was a dad playing rough and tumble with his baby. Another was a lady who instead of putting the drops in the eye put the bottle in the eye. Another was a child who scratched their mother’s eye. All of them did extremely well. You can fix it. It’s just a nuisance and a hassle. So that’s why patients have a responsibility to really look after their eyes for the first month, but particularly in the first week.

The most serious complication would be an infection but bear in mind that infections from corneal laser refractive surgery are extremely rare. I’ve seen one in over 20 years of carrying out corneal laser refractive surgery. That patient presented the following day after surgery with a slightly sticky eye. I treated him intensively with drops, and he made a full recovery. But I’ve seen hundreds of patients who wear contact lenses with corneal infections, and many of those patients don’t do so well. So the risk of an infection, which is the most serious complication, is hugely greater if you’re a contact lens wearer, as opposed to having corneal laser refractive surgery.