REFRACTIVE EWAP MARCH 2022 33 Contact information Clinch: Thomas.Clinch@edow.com Faktorovich: ellaJpacificvision.org Nikpoor: drnedaJalohalaser.com A patient unhappy after LASIKp thankfully, as Neda Nikpoor, MD, put it, there are not many. LASIK was established by the P,"WL studies1 as safe and effective with a high level of satisfaction, but there are patients who are unhappy with their outcomes, though rarely. Why this happens and how to best manage these patients is what Dr. Nikpoor, Ella aktorovich, MD, and Thomas Clinch, MD, shared with EyeWorld. More than 9x% of participants in the P,"WL study were satisfied with their vision after LASIK. According to analysis by the DA, some patients developed problems after the procedure, including visual disturbances such as starbursts, glare, halos, or severe dry eye. The unhappy LASIK patient by Liz Hillman Editorial Co-Director The studies found that less than 1% of patients had difficulty performing their usual activities due to any symptoms that developed postop. Reasons for unhappy patients Dr. Nikpoor said she could think of less than a handful of patients who were unhappy after LASIK. "ne was a man in his early 40s who was beginning to experience the symptoms of early presbyopia. She had offered to leave him a little myopic in his non-dominant eye, but he chose to see perfectly at distance in both eyes. His distance vision postop was good, and he could still read 1-plus uncorrected, but he said it felt more difficult to see near. “9ou could tell that he was struggling to deal with the fact that he was 40 now, and this was unmasking that,” she said. Dr. Nikpoor said she has had a couple of patients experience “rainbow glare.” Evidence suggests that the majority of these cases diminish with neuroadaptation over time, and Dr. Nikpoor and her partner Alan aulkner, MD, have found that to be true in their experience. Dr. Clinch said he has had this experience, too, and time resolves most cases of rainbow glare. He also said pulsed doses of topical steroids can be effective. Another side effect that could result in an unhappy patient is dryness. Dr. Clinch said patients with dryness preoperatively should be treated and counseled that it could get worse during the postop period, as should patients who spend a significant This article originally appeared in the December 2021 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. Dr. Nikpoor performs a LASIK procedure. Source\ Neda Nikpoor, MD
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