Would LASEK with This Presc Cause Keratoconus on my Eyes?

Dear Doc. My power is: Right:sph -6.50, cyl 1.00, axis :180, vision 6/6 corneal thickness 474 ( thinnest 462 ) pupil diameter 2.7mm Left:sph -5.50 , cyl 1.00, axis:180 visin 6/6. thickness 490(thinnest 478)pupil diam of 2.9 OS mild but dry eyes consulted two docs.One doc suggested PRK/LASEK . Another doc says no way laser can be used on my eyes so ICL is the way out. Im in a dilemma now.Kindly suggest which of LASEK/ICL would be a safe bet for me.

Doctor Answers 1

LASEK vs ICL for high Rx and thin corneas

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

i'm using the VISX laser, which is the #1 laser in the US, and tissue-sparing


the laser needs to take off about 8 microns per diopter for low-def, and 12 for hi-def


for your Rx, assuming you want hi-def, it would have to take off about 100 microns


the thinnest flap you can cut in LASIK or in IntraLase is 100 microns


so starting with 450 microns (there is variability in measurement, so we round down), you cut a flap of 100, and are left with 350, then you laser off 100, and are left with 250


that's the absolute thinnest left or you might get keratoconus and need a corneal transplant, so this is why you should NOT get LASIK


in LASEK there is no flap, so the math looks like this:


450 - 0 (no flap) - 100 (ablation) = 350 which is way more than 250 so totally safe


i would NOT recommend ICL for anyone less than -10, and personally don't recommend it for anyone less than -15, because that's intraocular surgery, so much more risky than a surface ablation, so not worth the risk/benefit ratio at your level of Rx

New York Ophthalmologist

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.