I'm one of the very few who had complications. Both eyes are good now, but I had a condition they called Diffuse Lamellar Keratitis (DLK). Thought I was going to end up being blind in both eyes. This was very very scary, especially when the doctor had a panic look on his face the day after my surgery!! Once they determined my problem, they put me on steroids which turned things around. I now have 20/20 so everything ended up good. My advice is to research all the possible complications, then ask specifically if you might be a candidate for these complications. With DLK, they didn't have any way of knowing that I'd get it, but afterwards, they told me that there seems to be a link between DLK and fair skin, allergies, and I can't remember the others. Ask yourself this: "Do the benefits outweigh the risks?"
I remember laying in bed at night for those several days wondering what kind of dog I'd get to guide me around.
DLK:
Diffuse Lamellar Keratitis (DLK)
Diffuse lamellar keratitis--also known as the "sands of the Sahara" syndrome--is a general inflammation that sometimes arises between the corneal flap and the underlying corneal stroma.
Diffuse lamellar keratitis (DLK) is an extremely rare inflammatory reaction that leaves small white deposits underneath the corneal flap after LASIK. The cause of this reaction is unknown. Depending on the amount of inflammation, you may have no symptoms or you may note some haziness in your vision.
Prevention requires maintaining a clean interface between these two areas. This is aided by meticulously draping the eyelids with sterile tape to keep the eyelashes out of the surgical field and by irrigating (rinsing) the cornea to remove any debris that may be in the tear film before making the microkeratome cut. When folding back the flap, it is important to try to prevent any unwanted debris from accumulating on the interface surface. Irrigating under the flap following the application of the laser may also help to assure a clean interface.
Despite meticulous surgical technique, sebaceous secretions from the patient's own eyelid border may collect beneath the flap. This is usually of no consequence. Occasionally, microfibers from the sterile drapes or swabs may appear. Airborne particulate fibers are also occasionally seen as well as an occasional metallic fragment from the high speed keratome blade. Fortunately, most particulate matter does not cause problems unless it is in the visual axis. By drying around the edges of the eye, the surgeon insures that when the corneal flap is folded back, it will not be sitting in a pool of dirty fluid.
Postoperatively, a topical corticosteroid (medicated drop applied to the surface of the eye) is used to suppress inflammation. The steroid is applied for one week because diffuse lamellar keratitis peaks two to five days after surgery. Likewise, a single drop of a nonsteroidal, anti-inflammatory eye drop at the conclusion of surgery is essential. It serves to dramatically reduce pain during the first six hours after surgery.
When present, most cases of diffuse lamellar keratitis respond to treatment with corticosteroid drops. More severe cases may require that the surgeon lift the corneal flap and irrigate beneath it to remove the inflammatory cells. When recognized and treated properly, DLK rarely affects the ultimate visual outcome; in rare cases, DLK will cause a loss of best corrected vision.
A different form of lamellar keratitis has recently been reported, central lamellar keratitis or CLK. CLK appears within the first twenty-four to forty-eight hours and results in a severe central collection of inflammatory debris. At times the underlying stroma is also involved. Treatment is similar to DLK. However, vision may be more often affected, resulting in the need for additional enhancements after recovery.
At the time of this writing, the exact causes of DLK and CLK are unknown. Speculation of causative factors include an inflammatory reaction related to the patient's own sebaceous secretions, reactions to methlycellulose drops, antigens from bacteria, and even immune reactions to byproducts of the laser treated cornea.