Although highly successful, refractive surgery can have adverse effects. Possible vision complications of refractive cornea surgery include:

• Over/under correction
• Irregular astigmatism
• Best corrected visual acuity worse than before surgery (BCVA)
• Glare, arcs, starbursts and halos (GASH) especially at night
• Increase of higher aberations
• Decreased contrast sensitivity (i.e., the ability to detect subtle differences of light and shadow)
• Need for reading glasses

Possible medical complications of refractive cornea surgery include:

• Scar or haze in the cornea
• Corneal inflammation
• Retinal detachment
• Weakness and bulging of the cornea
• Cataracts
• Glaucoma

• Optic neuropathy
• Corneal denervation
• Droopy eyelid
• Recurrent corneal erosion
• Wrinkling of LASIK flap
• Loss of vision at high altitudes

• Dry eye symptoms
• Allergic eye disease
• Contact lens intolerance
• Tear film abnormality

Post-surgical Rehabilitation Options

Other than enhancing an undercorrection, additional surgeries are only occasionally helpful in reducing the optical aberrations following refractive surgery. Of these surgical treatments, using a small beam laser to enlarge the optical zone is the most successful when the chief problem is due to large pupils. Otherwise, surgical treatments for irregular astigmatism and other problems are not yet reliable.

The customary treatment for surgically-induced aberrations is still the contact lens. Contact lenses provide a number of functions for the post-refractive surgery eye, including:

• Corrections of residual ametropias, i.e. nearsightedness, farsightedness, and astigmatism.
• Correction of induced aberrations, such as flap-wrinkles or striae, central islands, small ablation zones, and other surface complications.
• Functioning as a bandage lens to protect the cornea from exposure in severe dry eye, and to facilitate re-epithelialization of the cornea after PRK and after LASIK-related epithelial sloughing.
• Based on the patient’s complications and surgical history, Dr. Gemoules custom designs contact lenses that will significantly improve vision, comfort, and wearing time, with a minimum of post-wear complications. Dr. Gemoules has consulted to patients and professionals from throughout the U.S.A., South America, Canada, and Europe. He has been interviewed and quoted in numerous local and international publications and has published original research in this field. Dr. Gemoules is the one to see for a candid pre- or post-refractive surgery consultation and assessment.