Keratoconus (a serious disease) is caused by thinning of the central cornea. Lasik (refractive surgery) thins the central part of the cornea. Don't you think every lasik patient will suffer from keratoconus / ectasia after lasik at some point of time in his/her life because of central corneal thinning ?
Corneal Thinning and Lasik?
Doctor Answers (3)
Keratoconus After LASIK
Only about 1 patient in 2000 develops keratoconus after LASIK. This is actually quite close to the frequency of keratoconus in people who have not had LASIK. People who have early undiagnosed keratoconus often seek out LASIK because they do not see well with their glasses. Surgeons need to be very,very careful not to perform LASIK on this group no matter how motivated they are. Most surgeons (including myself) now believe that patients who develop keratoconus after LASIK always had keratoconus, but it was unfortunately not diagnosed prior to the laser surgery.
KC after LASIK vs LASEK
if you're worried about increasing your risk of KC, you really must get LASEK instead of LASIK
when i was doing LASIK, i was cutting a flap about 100 microns, and using a limit of 250 microns as the minimum safe residual corneal thickness to reduce the chance of getting KC. this is what all LASIK surgeons do. after 5,000 cases, i caused 2 KC cases--EVEN THOUGH I STAYED ABOVE THE 250 LIMIT
i switched to LASEK in 2007, even though i had LASIK myself in 1999 (i was the 1st LASIK surgeon in NYC to get it himself), because i was unhappy with even a 2 in 5000 risk, and wanted a safer procedure
since i switched, i now use a 350 micron limit, which is much thicker, stronger, and safer than the LASIK limit of 250. i can do this bc LASEK is flapless, so i'm saving 100 microns of tissue by not cutting a flap. simply put, it's a safer procedure when it comes to preventing KC--THIS IS A FACT AND NOT A MATTER OF DEBATE
you can ask any LASIK surgeon who isn't 100% dishonest the following question:
for any patient, with any prescription, for any starting corneal thickness, is it true that LASEK will leave him with significantly more untouched residual corneal tissue thickness, thereby decreasing the risk of KC, at least theoretically, over having performed a LASIK in the same patient?
that surgeon will have to answer: YES
Emil W Chynn, MD, MBA
Park Avenue LASEK
only 100% LASEK Center in the US performing over 1,000 LASEK cases per year
There are criteria for who can have LASIK based on their prescription, corneal thickness and corneal shape. When these criteria are followed, the risk of corneal ectasia after LASIK is extremely low.
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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