Yes, while LASIK surgery is considered safe and effective, there is a slight possibility of developing keratitis as a post-operative complication. This condition, which involves inflammation of the cornea, can occur if proper hygiene, healing, or aftercare protocols are not followed.
LASIK aims to correct refractive errors and improve vision, yet like any surgical procedure, it carries potential risks. Understanding what keratitis is, why it might occur after LASIK, and how it can be addressed helps patients make informed decisions about their eye health. This blog explains the connection between LASIK and keratitis in detail, discussing causes, symptoms, risk factors, preventive measures, and treatment options.
What is Keratitis?
Keratitis refers to inflammation of the cornea, the clear, dome-shaped surface covering the front of the eye. It can result from infections, injuries, or other irritations. There are two primary types:
- Infectious Keratitis is caused by bacterial, viral, fungal, or parasitic pathogens.
- Non-infectious Keratitis arises from trauma, wearing contact lenses for extended periods, or dry eyes.
The cornea is crucial for focusing vision, so any condition affecting it—including keratitis—can impair eyesight if not treated promptly.
Can LASIK Increase the Risk of Keratitis?
Although rare, LASIK can sometimes lead to keratitis. This is due to the nature of the surgery, which involves creating a flap in the cornea. This temporary modification makes the eye more susceptible to inflammation or infection during the healing process.
Several factors can affect the likelihood of keratitis following LASIK, including:
- Environmental exposure to contaminants.
- Poor hygiene during or after surgery.
- Delayed healing in certain individuals.
- Conditions like chronic dry eyes that may predispose to post-operative inflammation.
It’s important to note that while keratitis is a recognised risk, it occurs in only a small percentage of cases due to modern surgical techniques and improvements in post-operative care.
Causes of Keratitis After LASIK
Keratitis following LASIK generally arises from either infections or non-infectious irritants. Below are some possible triggers:
1. Bacterial or Fungal Contamination
During LASIK, a corneal flap is created, temporarily compromising the eye’s natural protective barrier. If bacteria or fungi enter this space, it can lead to infectious keratitis. Contaminated surgical instruments, improper cleaning of the eye, or exposure to unclean environments can all contribute.
2. Dry Eye Syndrome
Many LASIK patients experience dry eyes as a temporary side effect of the procedure. If untreated, this can contribute to corneal irritation or inflammation, raising the risk of keratitis. Patients with pre-existing dry eyes are more vulnerable to this complication.
3. Microbial Keratitis
If hygiene protocols are not rigorously followed, harmful microorganisms can enter the eye during or after the surgery. Improper handling of medications, dirty hands touching the eye, or exposure to unsanitary conditions can all increase this risk.
4. Poor Healing Response
Everyone heals differently. If the corneal flap takes longer than average to heal, it leaves the eye exposed to potential irritations or infections for a prolonged period, making keratitis more likely.
5. Excessive Eye Rubbing
Patients often feel dryness and irritation post-surgery, leading to a natural instinct to rub the eyes. Doing so can disturb the newly formed corneal flap or introduce bacteria, both of which increase keratitis risk.
Symptoms of Post-LASIK Keratitis
Recognising the symptoms of keratitis early is crucial for addressing it effectively. Common signs include:
- Persistent eye redness or irritation.
- Pain or discomfort in the operated eye.
- Light sensitivity (photophobia).
- Blurred or hazy vision.
- Excessive tearing or discharge from the eye.
- A sensation of something being stuck in the eye (foreign body sensation).
These symptoms should not be ignored, as untreated keratitis can lead to more severe complications, including corneal scarring or long-term vision damage.
Can Keratitis After LASIK Be Prevented?
The good news is that the risk of developing keratitis post-LASIK can be minimised with proper precautions. Here are some preventative measures:
1. Choose a Qualified Surgeon
The first step in avoiding complications is to select an experienced and reputable LASIK surgeon. A professional who follows stringent hygiene standards significantly reduces the risk of post-operative infections.
2. Adhere to Post-Surgery Care Protocols
After surgery, maintaining good hygiene is critical. This includes:
- Using prescribed antibiotic eye drops as directed.
- Avoiding touching or rubbing the eyes.
- Keeping the eye area clean and free from contaminants.
- Using artificial tears to combat dryness.
3. Avoid High-Risk Environments
Stay away from dust, smoke, pools, hot tubs, or other environments with a high level of contaminants during the healing process. Wear protective glasses to shield the eyes when necessary.
4. Report Symptoms Immediately
If you notice any abnormal symptoms, such as redness, pain, or discharge, consult your surgeon or ophthalmologist without delay. Early intervention is often the key to preventing complications from worsening.
5. Monitor Dry Eyes
Stay vigilant about managing dry eye symptoms. If necessary, continue using lubricating eye drops or follow the guidelines recommended by your ophthalmologist. Dry eyes can impair healing and increase inflammation risk.
How is Keratitis Treated?
If keratitis does occur after LASIK, it’s important to seek treatment promptly to avoid complications. The treatment approach depends on whether the keratitis is infectious or non-infectious:
1. Antibiotics or Antifungals
For cases involving an infection, medications such as antibiotic or antifungal eye drops are typically prescribed. More severe infections may require oral medications or injections.
2. Lubricating Eye Drops
When keratitis stems from dry eyes or irritation, artificial tears can help soothe the cornea and form part of the treatment plan.
3. Steroid Eye Drops
If inflammation is non-infectious but significant, mild steroid drops may be used to reduce swelling and improve comfort. These should always be used under professional supervision.
4. Corneal Surgery (Rare Cases)
In rare and extreme cases, such as when keratitis causes corneal scarring, corrective surgery may be required to restore vision and repair the corneal damage.
Most cases of keratitis, however, resolve with timely and appropriate treatment without causing long-term issues.
Final Thoughts on LASIK and Keratitis
LASIK is a highly advanced solution for vision correction, offering proven benefits for millions of patients worldwide. However, like any surgical procedure, it carries a minimal risk of complications, including keratitis. The key to avoiding such issues lies in thorough pre-operative evaluation, an experienced surgeon, strict adherence to aftercare protocols, and early reporting of any post-surgery symptoms.
If you’ve undergone LASIK or are considering it, stay informed and proactive about your eye health. Prevention and early intervention are critical to ensuring a safe and successful recovery.
For personalised advice or more information about LASIK risks and benefits, consult with your ophthalmologist or an experienced LASIK surgeon.
