When LASIK complications occur, they may be associated with the creation of a hinged flap in the clear front covering of the eye (cornea), which is lifted for laser re-shaping of the eye. The flap then is replaced to form a type of natural bandage.

If the LASIK flap is not made correctly, it may fail to adhere correctly to the eye's surface. The flap also might be cut too thinly or thickly. After the flap is placed back on the eye's surface, it might begin to wrinkle.

These types of flap complications can lead to an irregularly shaped eye surface. But problems also often are resolved through re-treatment or enhancements of the eye.

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Studies indicate that flap complications occur in from .3 percent to 5.7 percent of LASIK procedures, according to the April 2006 issue of American Journal of Ophthalmology. But inexperienced surgeons definitely contribute to the higher rates of flap complications. Again, remember that you can improve your odds of avoiding LASIK risks by selecting a reputable, experienced eye surgeon.

Some problems associated with LASIK flap complications include:

Irregular astigmatism can result from a less than smooth corneal surface. Irregular astigmatism also can occur from laser correction that is not centered properly on the eye. Resulting symptoms may include double vision (diplopia) or "ghost images." In these cases, the eye may need re-treatment or an enhancement.

Diffuse Lamellar Keratitis (DLK), also nicknamed "Sands of the Sahara," can occur with the appearance of cellular debris that can create inflammation underneath the LASIK flap. In the first week, the cornea then reacts to the presence of foreign matter, causing inflammation that in rare cases leads to scarring. Potentially permanent vision loss can occur without prompt treatment with therapies such as antibiotics and topical steroids. The flap also might need to be lifted and rinsed for removal of inflammatory cells and to prevent tissue damage.

Keratectasia or keratoconus is bulging of the eye's surface that can result from a flap that is cut too deeply, when too much tissue is removed from the cornea during LASIK, or when the cornea was initially weakened as evidenced from cornea topography mapping prior to LASIK. Resulting distorted vision likely cannot be corrected with laser enhancement, and rigid contact lenses or implants (Intacs) may be prescribed to hold the cornea in place. [Read more about keratoconus and Intacs]

Other, more commonly reported complications that can result from LASIK eye surgery include:

• Dry Eye After LASIK: Almost half of all patients report problems with dry eye in the first six months following LASIK, according to the April 2006 issue of American Journal of Ophthalmology. These complaints appear related to reduced sensitivity of the eye's surface immediately following the procedure. If you have this problem, temporary remedies such as artificial tears or prescription dry eye medication may be needed along with oral flaxseed oil capsules.
   
  After about six months to a year, however, most of these types of complaints disappear when healing of the eye is complete. People who already have severe dry eye usually are eliminated as LASIK candidates. [Read more about dry eyes and flaxseed oil for dry eye]
   
• Significant Undercorrection, Overcorrection, or Regression: Significant overcorrection or undercorrection of vision errors means that your outcome is less than optimal and makes it difficult to function in certain conditions. This type of result may be attributed to different reasons such as an inaccurate diagnosis or incorrect settings programmed into software guiding the laser during eye surgery.
   
  Regression from "over-healing" occurs when your eyesight is optimal at first, but then begins to deteriorate for different reasons that can include unexpected changes in your eye. Enhancements from additional laser vision correction or other refractive surgery methods such as conductive keratoplasty might be used to sharpen vision.
   
• Eye Infection or Irritation: In some rare cases, you may develop an eye infection, inflammation or irritation requiring treatment with eye drops containing antibiotics or anti-inflammatory medication such as steroids.
   
  When infection does occur following LASIK, it appears to be related increasingly to outbreaks of an antibiotic-resistant form caused by Staphylococcus aureus. Survey results indicating a growing problem with this type of infection were reported at the 2008 annual meeting of the American Society of Cataract and Refractive Surgery (ASCRS).
   
  LASIK surgeons also reported that the infection occurred more frequently with surface ablations such as PRK and when bladed instruments known as microkeratomes were used to create the flap. ASCRS reports indicate that flaps that are lifted and replaced on the eye during LASIK, serving as a type of "natural" bandage, and laser-created flaps appear to create a more sterile surgical environment.

If you are younger when you undergo LASIK, remember that your reading vision naturally will change when you are 40 or older. These changes in the flexibility of your eye's natural lens from presbyopia will cause you to slowly lose the ability to focus at closer distances. (If you are nearsighted and have presbyopia, you lose your near vision when you wear your regular lenses for distance correction.) This vision problem is not from LASIK, but represents a natural change in how you see in the near vision range.

You also might develop cataracts, which are unrelated to LASIK, that cause the eye's lens to become cloudy. These changes in an aging eye have nothing to do with your LASIK procedure, and will require additional correction through eye surgery or artificial lenses when you are older.

[See also: Eye Surgery for Presbyopia.]