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Lasik Eye Surgery Failure: 8 Signs That Your Lasik Failed

Posted by EyeSight Hawaii

Usually, a healthy eye has a cornea that refracts light and focuses it onto the retina in the back

Lasik eye surgery is a popular and effective way to improve vision without the need for glasses or contact lenses. However, it is important to be aware of the Lasik surgery risks associated before undergoing it. 

LASIK, or Laser-assisted in situ keratomileuses, is a popular laser refractive procedure that can serve as an alternative to wearing corrective lenses. It’s used to correct vision problems.

In LASIK surgery, a precise laser is used to alter the curved transparent tissue at the front of the eye (cornea), in order to improve vision.

Typically, a healthy eye has a cornea that bends light and directs it to the retina at the back. However, having eyesight issues such as double vision, nearsightedness (myopia), farsightedness (hyperopia), and astigmatism causes light to bend incorrectly, resulting in blurry vision, or even vision loss.

While the success rate of Lasik surgery is high, there are still some potential complications that can occur. Knowing the signs of a failed Lasik surgery can help you make an informed decision and ensure that your vision remains healthy.


Primary LASIK procedures often result in under-correction, while overcorrection is more likely to occur following retreatment, so both of these factors are interconnected with the ablation algorithm, nomogram, age, and degree of refractive error.

Visual aberrations

Around 20% of patients may notice a visual change; flap creation alone may contribute to aberrations.

According to the FDA, some people who have undergone this procedure may experience glare, halo, or star-bursting patterns around lights, along with decreased contrast sensitivity and a hazy view. Visual changes usually stabilize three to six months after surgery.

Flap Fold or Striae

The risk factors for flap folds include:

  • Excessive irrigation of flap during LASIK,
  • Poor repositioning of the flap at the end of the procedure,
  • Thin flaps
  • Deep and highly myopic ablation with a flap-bed mismatch

Flap folds may be classified into macro- and microstriae:


Macrostriae is a full-thickness stromal fold that forms due to a misaligned flap or slippage.

Management: If discovered shortly after the procedure, it is essential to immediately raise the flap, irrigate and put it back in place. Your doctor may advise you to place a bandage contact lens.

If more than 24 hours have passed, macrostriae can be treated through refloating, de-epithelialization, hydration, stroking, and suturing.

Surgery may need to be done if folds are identified too late. But, if patients do not have any symptoms and are happy with their vision, they can simply be monitored instead.


Microstriae are thin, wavy lines in Bowman’s layer that usually go unnoticed, and result from the incompatibility between the flap and the new bed.

For management, observe and lubricate aggressively if visually significant. Then refloat, stroke and suture.

Flap Dislocation

Flap dislocation can occur years after LASIK

The risk factors are:

  • Presence of epithelial abrasion,
  • Poor intraoperative repositioning,
  • Eye rubbing
  • Excessive lid squeezing
  • Excessive dry eye
  • Excessive irrigation of flap

To prevent issues, make sure to check the flap’s adhesion after the procedure, caution the patient against rubbing and squeezing their eyes, and have them wear a shield for 24 hours and every night for one week.

Management: Move the flap back into position, stitch it in place if the fold won’t go away, and use ointments.

Dry Eye

60-70% of those undergoing LASIK experience dry eye as one of its side effects, due to nerve damage on the corneal surface caused by the flap creation process.

Preventative Actions: Prior to the operation, do a complete examination to search for any signs of dry eye and give intense treatment with the help of topical lubrication, cyclosporine A, as well as systemic therapy using oral tetracyclines and oral omega-3 fatty acids.

Management for mild dry eye syndrome includes frequent usage of non-preserved artificial tears and gels, whereas severe cases require utilizing topical cyclosporine A, topical corticosteroid, oral tetracyclines, omega-3 fatty acids, and punctual plugs.

One of the most common lasik surgery risks is dry eye, which can be treated with topical lubricants
Lasik surgery can sometimes lead to dry eye as a result of nerve damage on the corneal surface from the flap-making procedure

Diffuse Lamellar Keratitis (DLK)

DLK, or Diffuse Lamellar Keratitis, is an eye infection that can occur during and after Lasik eye surgery. It’s caused by the presence of inflammation in the corneal tissues and is more likely to occur if the flap created during the surgery wasn’t handled properly.

If you’ve undergone Lasik eye surgery and suffer from diffuse lamellar keratitis, you’ll notice several key symptoms. These include redness in your eyes, increased sensitivity to the light, blurry vision that fluctuates throughout the day,

It’s also important to note that DLK can cause further eye damage if left untreated. Immediate treatment will involve a prescription of antibiotics to reduce inflammation and help the healing process. Your doctor may also apply antibiotics or steroid eyedrops directly on your eyeball to alleviate some of the pain and discomfort associated with DLK.

Pressure-induced Stromal Keratitis (PISK)

One sign of Lasik surgery failure is pressure-induced stromal keratitis (PISK). PISK is an inflammatory reaction caused by the instruments used during the procedure that can erode the corneal stroma. This condition can occur within days or sometimes even years after the surgery.

Symptoms of PISK include severe eye pain, blurry vision, redness, and sensitivity to light. If left untreated, this condition may cause scarring or further damage to corneal nerves, resulting in a permanent loss of visual acuity. In some cases, PISK can be treated with steroids or anti-inflammatory agents. But due to the complexity of its treatment, it often requires a period of several visits for regular follow-ups and treatments.

When caught early on, your doctor may be able to treat PISK with medication and other therapies to reduce discomfort and restore vision clarity and stability—saving you from more serious and costly interventions down the line. Don’t wait for things to get worse; contact your doctor right away if you believe your laser eye surgery failed due to pressure-induced stromal keratitis.

Infectious Keratitis

One of the most worrying signs of Lasik eye surgery failure is infection. Infectious keratitis, or corneal infection, is an inflammation of the cornea caused by a bacterial, fungal, or viral infection. It’s important to note that this type of infection can happen right after the surgery or up to several months later.

The symptoms of infectious keratitis can range from mild irritation and redness to severe pain and swollen eyes. You might also notice your vision becoming more and more blurry as time passes. Left untreated, infectious keratitis can cause permanent damage to your eyesight! That’s why it’s so important to see an eye doctor immediately if you experience any of these symptoms post-Lasik surgery.

If your doctor does diagnose you with an eye infection, he will likely prescribe antibiotics, antivirals, or antifungals depending on the cause of the infection. If this doesn’t help improve symptoms, other medical treatments such as laser therapy may be necessary. Remember that treating an infected eye quickly is key for avoiding potential damage and preserving your eyesight!

Epithelial Ingrowth

Epithelial ingrowth is a common complication of flap surgery, with an incidence reported between 1% and 20%. It typically presents weeks to months after the procedure. Poor adhesion of the flap edges, epithelial abrasions at the flap margin, buttonhole flaps, and free caps are all potential causes of this condition.

Epithelial ingrowth occurs when cells from the surface of the eye migrate into the interface between the cornea and its surrounding tissue. This can cause inflammation, scarring, and decreased vision. In some cases, it may require additional surgery to remove these cells. Fortunately, this complication is less common in flaps created with femtosecond lasers than those created with manual techniques.

Treatment option for this epithelial defect often involves topical steroids or antibiotics to reduce inflammation and promote healing. If necessary, a second procedure may be performed to remove any remaining epithelial cells from the interface.

Rare LASIK Surgery Risks

In less than 0.1% of cases, LASIK can result in complications such as:

  • Ischemic optic neuropathy
  • Retinal detachment
  • Vitreous hemorrhage, and
  • Posterior vitreous detachment

What is the failure rate of LASIK surgery? Should I be concerned?

Absolutely not. If there were a significant drawback to LASIK, it would be widely known by now since numerous studies have been conducted in the past two decades. Such research should’ve revealed abundant clinical evidence indicating an excessively high LASIK complication rate. However, it hasn’t. No such data exists.

Despite many people having an unfounded fear of going blind from LASIK, this has never actually happened – in no cases was blindness caused primarily by LASIK.

Studies have found that a staggering 96 percent of patients are happy with the results of LASIK surgery, which shows its huge success rate.

If you’re thinking about getting this laser eye surgery, it’s important to do your research and get accurate information – both the risks and benefits of the procedure.

Not all people are suitable for LASIK surgery. Eye conditions and health issues may deter a successful outcome, which is why consulting an eye surgeon and offering a full medical history is so important. Fortunately, there are other corrective procedures like SMILE, PRK, or ICL which your doctor can decide on if LASIK isn’t not a suitable option for you.

A phenomenal 96 percent of LASIK patients report satisfaction with the outcome, revealing its immense success
Before considering LASIK surgery, it is important to consult a specialist and provide a full medical history as eye conditions or health issues may make the procedure unsuitable.

Ready for a consultation?

If you would like to learn more about this non-surgical procedure and how it can help you have excellent vision without the aid of glasses or contact lenses, schedule an initial consultation with our experienced surgeons at EyeSight Hawaii in Honolulu, HI, and Maui, HI. Make an appointment online or call our office to schedule a consultation for LASIK Surgery Hawaii today!