Post-op Complications Following Refractive Surgery Vary by Procedure, Time Interval

Incidence of ocular pain following refractive surgery was lower after LASIK vs. PRK but dry eye was equally likely from either procedure in the immediate postoperative period and then rates climbed for the PRK patients thereafter. Photo: Martin L. Fox, MD. Click image to enlarge. Despite extensive literature on refractive surgery outcomes with LASIK and PRK, the timing of associated complications in routine clinical practice remains poorly characterized—particularly how complication risk evolves over time. In a recent study, researchers used the IRIS Registry to conduct a retrospective analysis of 48,892 eyes to compare the incidence and timing of dry eye disease (DED), visual disturbances and ocular pain following LASIK and PRK. They found that PRK was associated with a higher risk of visual disturbances in the early postoperative period and a higher incidence of DED during the one to three months interval compared with LASIK. The findings were reported in American Journal of Ophthalmology.Incidence was evaluated across three postoperative intervals (one day to one month, one to three months and three to 12 months). Interval-specific incidence rates and incidence rate ratios (IRRs) comparing LASIK and PRK were estimated.Dry eye was the most frequently documented postoperative complication, occurring in 16.1% of LASIK eyes and 15.6% of PRK eyes over the follow-up period. While incidence was generally comparable, LASIK was associated with a lower incidence of DED compared to PRK during the one to three months postoperative interval (IRR: 0.8).PRK was associated with a higher frequency of visual disturbances in the first month post-op compared to LASIK (IRR: 0.3), but differences between the two procedures were not significant at later intervals.Ocular pain was rare overall for both surgeries. During the three-to-12-month interval, the incidence was lower after LASIK compared to PRK (IRR; 0.5). More recent surgery was associated with a reduced risk of complications (IRR: 0.9), likely reflecting technological and management advances.The study suggests that postoperative complication profiles vary by both procedure and time interval. These findings can help guide patient counseling and inform optimized follow-up strategies, the researchers noted in their paper on the work. Regarding targeted care, early ocular surface optimization is recommended following PRK to mitigate the peak in symptoms during the first three months. For LASIK, sustained DED surveillance is warranted beyond the early post-op period.The authors noted that because the analysis relied on electronic health record documentation, it may be subject to variation in coding practices and under-capture of milder, subjective symptoms compared to studies using patient-reported outcome measures.Click here for the journal source. Kang S, Persad LS, Woreta FA, Yoo SH. Temporal incidence of dry eye disease, visual disturbances and ocular pain after LASIK vs PRK. Amer J Ophthalmol. April 17, 2026. [Epub ahead of print.]  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.