LASIK and PRK surgery can possibly cause loss of vision or loss of best-corrected vision. This can be due to infection, irregular scarring, or other causes and unless successfully controlled by antibiotics, steroids, or other necessary treatment could even result in loss of the eye involved. Vision loss can also be due to the cornea healing irregularly, which could add astigmatism and make wearing contacts lenses necessary. Useful vision or night vision could be lost. It is also possible that you may not be able to successfully wear contacts after LASIK or PRK.

Refractive surgery is not right for you if you want a guarantee of a perfect outcome. Although our goal is to reduce or even eliminate myopia or hyperopia, with or without astigmatism, your outcome cannot be guaranteed. If you were nearsighted, overcorrection could result in farsightedness. If you are farsighted, over-correction could result in Nearsightedness. Overcorrections often diminish over time but could be permanent. It is possible that your initial favorable results could regress over time. Due to the normal healing process, small overcorrections and undercorrections may occur. If after the procedure you are overcorrected or undercorrected, it may be possible or necessary to have an additional surgery to fine-tune or enhance the initial result. However, small overcorrections or undercorrections are usually tolerated well by patients and do not require additional treatment.

You may experience a “starburst” or “halo effect” around lights at nighttime. If you have high myopia, high astigmatism, or dry eyes, you may be more likely to have night-glare issues. Your overall vision at night may not be as sharp as during the day, and you may experience increased sensitivity to light or glare.

This condition would become evident in the weeks or months following surgery. PRK has a small risk of haze, which is difficult to treat and may result in loss of best-corrected visual acuity and permanent loss of visual sharpness or clarity. Measures will be taken and medications employed to minimize this risk.

The duration and intensity can vary widely from person to person. You may experience dry eyes following the procedure, causing mild to severe irritation, discomfort, and blurring of vision. If this occurs, you may need to use certain over-the-counter or prescription medication for an indefinite period of time. This condition may be permanent. Post-menopausal women or patients taking certain medications may be at a higher risk of developing dry eyes.

LASIK and PRK do not correct presbyopia, which occurs in most people around the age of 40 and may require them to wear reading glasses for close-up work. People over 40 that have their nearsightedness corrected will find that they need reading glasses for clear, up-close vision.  The exception to this may be if monovision is attempted; however, monovision is not a guarantee that near vision will be clear without glasses or contact lenses. If you are over 40 years of age and decide to have laser vision correction to correct both eyes for distance vision, you may need reading glasses to see objects at approximately three feet or closer. If you are over 40 years, be sure you understand monovision, which corrects one eye for near vision and one eye for distance.

As part of the normal aging process, the lens of our eye becomes less flexible, which is the reason why reading glasses, bifocals, or removing distance glasses become necessary to see up close in our mid-40s and beyond. Monovision is one treatment for presbyopia. While laser vision correction cannot currently cure presbyopia, it can make it possible for these patients to see close without reading glasses. Monovision is a process of providing both distance and near vision by focusing one eye on distant objects and one eye on near objects. It can be more difficult to see at night with monovision. You understand that adapting to monovision can take 12 weeks or more and that it may never occur to your total satisfaction. Monovision can sometimes be reversed, if you decide that it doesn’t work for you.

Nearly everyone develops cataracts with age. This is still true after laser vision correction. Some patients may have mild cataracts at the time of laser vision correction that are not yet visually significant. If this is true for you, laser vision correction will not prevent this condition from worsening as your cataracts advance. If the cataracts advance to the point laser vision correction cannot help correct your vision, you will need standard cataract management practices.

You may develop a rare corneal condition called corneal ectasia in which the cornea progressively thins and blurs vision. This condition can be difficult to diagnose in its early stages, and laser vision correction may accelerate this degeneration. LASIK patients are at higher risk for developing ectasia than patients who have PRK.

You understand that you could develop keratoconus. Keratoconus is a degenerative corneal disease affecting vision that occurs in approximately 1/2000 people in the general population. While there are several tests that suggest which patients might be at risk, this condition can develop in patients who have normal preoperative topography (a map of the cornea obtained before surgery) and pachymetry (a corneal thickness measurement). Since keratoconus may occur on its own, there is no absolute test that will ensure a patient will not develop keratoconus following LASIK or PRK. Severe keratoconus may need to be treated with a corneal transplant while mild keratoconus can be corrected by contact lenses or glasses.

You may develop a corneal flap complication that could require your procedure be postponed either temporarily or indefinitely. If you develop certain complications with your corneal flap following surgery- including, but not limited to, striae (wrinkles), epithelial ingrowth, or inflammation- your flap may need to be re-lifted, which can cause additional complications. The equipment used in the procedure may also malfunction. Depending on the circumstances, these complications could cause loss of vision.

During pregnancy, your vision measurements can fluctuate and could influence your results. If you know you are pregnant, or are attempting to become pregnant within the next three months, it is important you advise your doctor right away.

With the recommendation of your doctor, the laser can be used to perform laser vision correction outside of the FDA guidelines, including when treatment may otherwise be contraindicated. If you are choosing to have laser vision correction and have a prescription outside of the approved ranges or have contraindications, you understand and accept the risks of doing so. In addition, following PRK laser vision correction, an anti-cancer medication known as Mitomycin-C (MMC) is applied to the cornea as an off-label use to reduce the potential for corneal haze.

You understand that there are situations in which treatment may be contraindicated, including, but not limited to: unstable refraction, abnormalities of the cornea, uncontrolled disease, history of severe or active eye infection, glaucoma, certain systemic medications, poorly controlled diabetes, pregnancy or lactation, and prior incisional or lamellar keratorefractive surgery. Therefore, it is important that you provide your complete medical history.

You should also be aware that there are other complications that could occur that have not yet been reported before the creation of this consent form, as LASIK and PRK surgeries have been performed only since the 1990’s and longer-term results may reveal additional risks and complications.

You are aware of the alternatives to laser vision correction, which include eyeglasses, contact lenses, and other types of refractive surgery or refractive lens implants. When tolerated well, glasses and contacts are a good alternative to LASIK or PRK. In addition, refractive surgery is continually evolving, and other refractive procedures may be available as an alternative to LASIK or PRK. You should also be aware that having any refractive procedure could potentially disqualify you from some professions, including the military, certain law enforcement agencies, and aviation occupations, among others. We strongly encourage you to check with any profession of interest for specific regulations.

After the procedure you should avoid rubbing your eyes. Your eyes may be more susceptible to traumatic injury after LASIK or PRK. Protective eyewear for all contact and racquet sports, or in any other situation where a direct blow to the eye could occur, should be worn. Additionally, you will be given medications and instructions to help prevent infection and regulate healing. It is imperative that you follow ALL instructions exactly as they are given to you. It is also imperative that all follow-up visits be kept as directed.