Figure 6-17 Blood in the LASIK interface. (Courtesy of Jayne S. Weiss, MD.)

Visual Disturbances Related to Femtosecond Laser LASIK Flaps

Transient light sensitivity

Several weeks to months after LASIK with femtosecond laser flaps, some patients experience acute onset of pain, photophobia, and light sensitivity in an otherwise white and quiet eye with excellent uncorrected distance visual acuity (UDVA; also called uncorrected visual acuity, UCVA). The cornea and flap interface appear normal. It has been speculated that an acute onset of ocular inflammation or dry eyes is somehow related to use of the femtosecond laser. Treatment consists of frequent administration of topical corticosteroids (eg, prednisolone acetate, 1%, every 2 hours) and topical cyclosporine A, titrated to the clinical condition. Almost all cases respond to treatment and resolve in weeks to months.

Rainbow glare

Rainbow glare, a new optical adverse effect of treatment with the femtosecond laser, is described as bands of color around white lights at night. This complication seems to be related to higher raster energy levels and increased length of time between service calls for the laser.

Farjo AA, Sugar A, Schallhorn SC, et al. Femtosecond lasers for LASIK flap creation: a report by the American Academy of Ophthalmology. Ophthalmology. 2013;120(3):e5–e20. Epub 2012 Nov 20.