With procedures that create a permanent flap in the cornea (such as LASIK), there is also the possibility of accidental traumatic flap displacement years after the surgery, with potentially disastrous results if not given prompt medical attention.For patients with strabismus, risks of complications such as diplopia and/or increased strabismus angle need to be evaluated carefully. In case both refractive surgery and strabismus surgery are to be performed, it is recommended that the refractive surgery be done first. Children
Pediatric refractive surgery involves other risks than refractive surgery on adults, yet it may be indicated especially for children whose cognitive or visual development is failing due to refractive error, in particular in cases of bilateral high refractive error, anisometropia, anisometric amblyopia or accommodative esotropia.Interventions on young children may require general anaesthesia in order to avoid risks due to involuntary movement, and children have a higher risk of rubbing or manipulating their eyes post-surgically. Changes to refractive error occurring during normal age development need to be accounted for, and children have a higher risk of developing postoperative corneal haze. This risk is particularly relevant with relation to myopic children.One study evaluated the outcome of LASEK interventions on 53 children aged 10 months to 16 years who had anisometropic amblyopia. The choice of LASEK was made as it was felt it would give fewer complications than LASIK and less post-operative pain than PRK. In the intervention, which was performed under general anaesthesia, the refractive error in the weaker eye was corrected to balance the refractive error of the other eye.
Bacterial colonization: Poor oral hygiene can result in colonization of the mouth with excessive amounts of bacteria, which is linked to increased incidence of aspiration pneumonia. Ethnicity: Asians diagnosed with aspiration pneumonia have a lower risk of death compared to other ethnic groups while African Americans and whites share a relatively similar risk of death. Hispanics have a lower risk of death than non-Hispanics. Others: Age, male gender, diabetes mellitus, malnutrition, use of antipsychotic drugs, proton pump inhibitors, and angiotensin-converting enzyme inhibitors. Residence in an institutional setting, prolonged hospitalization or surgical procedures, gastric tube feeding, mechanical airway interventions, immunocompromised, history of smoking, antibiotic therapy, advanced age, reduced pulmonary clearance, diminished cough reflex, disrupted normal mucosal barrier, impaired mucociliary clearance, alter cellular and humoral immunity, obstruction of the airways, and damaged lung tissue. Bacteria
Bacteria involved in aspiration pneumonia may be either aerobic or anaerobic. Common aerobic bacteria involved include:

Streptococcus pneumoniae
Staphylococcus aureus
Haemophilus influenzae
Pseudomonas aeruginosa
Klebsiella: often seen in aspiration lobar pneumonia in alcoholicsAnaerobic bacteria also play a key role in the pathogenesis of aspiration pneumonia. They make up the majority of normal oral flora and the presence of putrid fluid in the lungs is highly suggestive of aspiration pneumonia secondary to an anaerobic organism. While it is difficult to confirm the presence of anaerobes through cultures, the treatment of aspiration pneumonia typically includes anaerobic coverage regardless. Potential anaerobic bacteria are as follows:

Bacteroides
Prevotella
Fusobacterium
Peptostreptococcus

Pathophysiology
Aspiration is defined as inhalation of oropharyngeal or gastric contents into the pulmonary tree.