LASIK Risks: potential downside and side effects with LASIK

With more than 40 million LASIK procedures performed worldwide over 30 years—and over 15 million in the United States alone—this LASIK procedure has evolved into a highly safe and precise option for vision correction. It is FDA-approved and backed by decades of experience and technological advancement.

That said, like any procedure, LASIK is not completely risk-free. The most common side effects are temporary dry eyes and some night vision symptoms, such as glare or halos, especially early in the recovery period. These typically improve over time. Serious complications are very rare, and a thorough screening at a reputable center can greatly reduce problems. A good surgeon will carefully evaluate your corneal thickness and shape, your prescription stability, your tear quality, and the overall health of your eyes. This helps ensure that LASIK is both safe and appropriate for you. In fact, if a doctor tells you that you’re not a candidate, that’s actually a sign of a careful and responsible practice!

From a patient perspective, it’s completely normal to feel cautious about LASIK. It’s an elective procedure involving your eyes, so people often focus on “what could go wrong.” A good way to approach this is to clearly explain both the real risks and how often they actually happen, along with what’s done to minimize them.

Many patients experience temporary dryness after LASIK. This can cause irritation, a burning sensation, or fluctuating blurry vision. Symptoms typically improve over time, with most patients returning to their baseline tear function within 3–6 months.

Why it happens: LASIK temporarily affects the corneal nerves that help regulate tear production.

What to do about it: Using preservative-free artificial tears several times a day can help keep the eyes comfortable. Nutritional supplements such as flaxseed oil or fish oil may also support tear function. In addition, gently cleaning the eyelids and eyelashes twice daily with warm water and a mild cleanser (such as diluted baby shampoo) can help maintain healthy tear film and reduce irritation while healing occurs.

Many patients notice halos, glare, or starbursts around lights—especially at night during the first week after LASIK. These symptoms usually improve gradually and often fade over the first 1–3 months. Patients who have never worn contact lenses may be more aware of these effects, while contact lens wearers are often more accustomed to similar visual sensations.

Why it happens: During the early healing period, the edge of the flap and treated area of the cornea can be slightly elevated, which can affect how light enters the eye.

What to do about it: For most patients, these symptoms improve naturally over time. In fact, patients are significantly more likely to notice an improvement in their night vision than a worsening. If halos or glare persist, your doctor may prescribe medications such as Brimonidine to use in the evening, which can help reduce these symptoms while healing continues.

In some cases, vision may not be perfectly corrected after the initial LASIK procedure, and a small number of patients may benefit from a “touch-up,” also called an enhancement.

Why it happens: Although modern laser technology is very precise, each person’s eyes can heal and respond slightly differently, which can affect the final outcome.

What to do about it: Nationally, about 8% of nearsighted (myopic) patients may require an enhancement. With advanced technologies such as CustomVision LASIK and refined nomograms (formulas), outcomes can be improved significantly. At Stahl Vision, over 99% of patients achieve 20/20 vision or better after their initial treatment.

For those who do need an enhancement, it is typically a straightforward procedure. Many practices, including Stahl Vision, offer this at no additional cost within the first year.

LASIK involves creating a thin flap in the cornea, which is carefully repositioned at the end of the procedure. In rare cases (about 1 in 100), the surface cells (epithelium) can become loose. Even more rarely (about 1 in 5,000), the flap may not sit perfectly smooth. Rubbing the eyes or applying pressure in the first few days can also cause small wrinkles in the flap (called striae).

Why it happens: The surface cells of the cornea can be naturally looser in some individuals—particularly in patients over age 50, post-menopausal patients, or those with conditions like Map-dot-fingerprint dystrophy.

What to do about it: Most small areas of epithelial loosening heal on their own within a day. If the area is larger, a temporary bandage contact lens can be placed to support healing. If the flap is not smooth enough during the procedure, it is safest to postpone treatment and consider an alternative such as PRK (Photorefractive Keratectomy) at a later time.

The likelihood of these complications decreases significantly with an experienced surgeon. Wrinkles in the flap are largely preventable—patients should avoid rubbing their eyes, keep them well-lubricated, and wear protective goggles during the day immediately after surgery and while sleeping for the first week.

As with any surgery, there is a very small risk of infection—about 1 in 10,000 cases.

Why it happens: Bacteria from the eyelashes or surrounding skin can occasionally enter beneath the corneal flap during or shortly after the procedure.

How we reduce the risk: Careful preparation significantly lowers this risk. Patients are asked to thoroughly clean their eyelashes and use prescribed antibiotic drops the night before and the morning of surgery. Surgeons also follow strict sterile techniques throughout the procedure.

At experienced centers, infections are extremely uncommon. For example, at Stahl Vision, more than 50,000 procedures have been performed without a single reported infection—reflecting a strong focus on prevention and patient safety.

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