With 450um of Thickness, -2,-2,18: -1.75,-1.5,175 of Prescription, Am I a Lasik Candidate?

I can see why you are confused. The thickness of the cornea is one of the most important criteria in determining which procedure is best, and, in some cases, whether a procedure can be performed at all. Saying that, if your corneal thickness is 450 microns, I believe it is safer and better to do PRK, even though the recovery is somewhat slower. The long term results of both PRK and Lasik, over a 20 year time span, have proven to be equal with the prescription you describe. Since this is the case, we know you will get a great result with either PRK or Lasik, however, I am concerned that Lasik might thin your cornea too much. I would perform PRK on you and I believe you will love the results!

The question of how thick a cornea needs to be is one that is debated among LASIK surgeons.  We all agree that it is important to leave enough cornea untouched.  That number is generally at least 250 microns and most of us like to leave 300 microns.  Much research has shown that those with thinner corneas do just as well as those with thicker corneas as long as enough cornea is left.  Some surgeons never perform LASIK on those with who start with a cornea of less than 500 microns.  I along with many of my colleagues have performed many LASIK procedures on those with corneas less than 500 microns.  WIth a femtolaser, it is easy to get a consistent thickness flap of about 100 microns.  On a 450 microns that would leave at least 50 microns to correct the nearsightedness.  With your correction this should be possible and I would not worry as long as your surgeon can tell you ahead of time that you will still have at least 300 microns of untouched cornea when finished.  PRK is also a good option, and there is nothing wrong with a surgeon being conservative.  Personally, as long as the curvature of my cornea was normal, I would prefer LASIK.  Good luck.

You're not a candidate for LASIK IntraLase PRK or Lasek. The first two will cut your corneal nerves and make your dry eyes worse plus waste tissue w the flap that you can't spare. The last two will leave you with well over 350 microns. However recent research has shown people with under 475 to start may get ectasia after even if left w over 350. Safest option is ICL 

emil Chynn md FACS MBA