With a Prescription of -10.5, Am I a Candidate for Lasik?

Question

I keep hearing two different opinions: one that it's OK and people with higher prescriptions had Lasik done and have perfect vision now, and the other that all I could get is reducing my prescription to around -4. My eyes are healthy, only very near-sighted. Can you give me some advice?

Arturo Chayet, MD · Answer

We do LASIK for prescriptions as high as yours only if pupils are small enough and the cornea is thick enough. As a result, most cases like yours are being treated with intraocular lenses.

William Ellis, MD, FACS · Answer

For high myopia it is safer to do PRK procedure, because it requires less tissue from the cornea, because a flap is not being created. The doctor will also determine if the patient requires PRK, based on their corneal thickness and curvature.

Sandy Feldman, MD · Answer

THere are a number of different procedures which are effective in treating individuals with severe myopia. LASIK, photorefractive keratectom, PRK and Implantable collamer lenses [ICL] are all options to reduce one's dependance on glasses or contact lenses. I would recommend that you seek the care of an eye specialist that can advise you on the best option for your eyes. This will depend on the thickness and shape or topography of the cornea as well as your age and activities. You should be educated about the benefits and risks of sugery.

Jon Dishler, MD, FACS · Answer

Nearsightedness or myopia above 7 diopters is considered high myopia and can be treated effectively on several different laser platforms.  Whether you are a candidate for this treatment depends on several factors.  Most important is the thickness of your corneal tissue, since more correction removes more tissue and there has to be enough left for safety.  
The other important factor is the shape of your eye to begin with.  If your eye is in the normal range, then it is more likely that you would be a candidate, and this is measured as k readings values.  Also important is that the shape of your eye is normal and symmetric without signs of preexisting weakness in the structure.  Also a consideration is the size of your pupils, since this plays a role in your outcome.
Another possibility for a laser correction procedure is surface treatment or PRK.  This is less invasive than LASIK so for high corrections we can sometimes perform PRK when there is not enough tissue for LASIK.
As with many of these type of questions, you really need to have an evaluation by an experienced LASIK surgeon who can evaluate and discuss your particular case.  There are other options for high myopia, the most popular one is the ICL which is a lens placed inside the eye to correct the myopia rather than having a LASIK procedure.
We have treated a number of patients with a -10.50 prescription by LASIK with excellent results so I would not be discouraged from investigating this further but be prepared that there is a chance that you would not be an ideal candidate.

Jerreyll Jackson, MD · Answer

Today's laser technology can effectively treat prescriptions as high as -14. However, the physical characteristics of your eyes are what determine if LASIK is safe for you. Let me explain; thin corneas or corneas with an abnormal shape may make LASIK unsafe for someone like yourself. You should get an evaluation by a LASIK surgeon who can take these measurements accurately. Your long term ocular health depends on it.

Anthony J. Kameen, MD (retired) · Answer

The key measurement that will determine which is the best procedure for a high level of nearsightedness is the thickness of the cornea. If LASIK is predetermined to thin your cornea too much, thus increasing chances of postoperative visual fluctuations, halos, etc, then an Intraocular Contact Lens(ICL) would be a better choice. ICL's are collamer devices that are implanted by a surgeon into the front portion of your eye, behind your cornea. The risks of this procedure are slightly higher than LASIK and the cost is, as well. Your best bet is to choose a great surgeon who performs all of these procedures, then heed the advice you are given.

Gary Kawesch, MD (retired) · Answer

You might be a candidate for LASIK, you might not.  It really depends on the characteristics and health of your eyes.  Primarily, your corneal thickness must be sufficient to allow this amount of correction (higher prescription dictate more corneal tissue removal).  The thickness of your cornea can be measured at an exam.  The shape, or topography of your cornea is also important.  If you have an unusually shaped cornea, LASIK may not be a good option.
If this is the case, sometimes PRK (surface ablation) would be an option, and sometimes a lens-based procedure such as an ICL or Refractive Lens Exchange (RLE) would be best.  If your corneas are flat, LASIK would flatten them even more, which could lead to quality-of-vision problems postop.  In this case, a non-corneal procedure such as an ICL or RLE would be preferred.
If you do have LASIK, a wavefront ("custom") treatment would be helpful to reduce your risk of night side effects such as halos and glare.  These side effects are more common in patients who start out with extreme prescriptions, so anything that can be done to mitigate this risk is helpful.
The general health of your eyes is important as well.  If you have cataracts (clouding of the lens inside the eye), usually an RLE procedure is a better option than LASIK.  I don't know how old you are, but cataracts generally develop in your 60s, but in extremely nearsighted patients, they tend to develop about 10 years sooner.
In short, a thorough examination with a refractive surgery specialist (a surgeon who offers ALL types of refractive surgery) would be your best bet to determine which procedure (if any) might be best for you.
Hope this helps.

With a Prescription of -10.5, Am I a Candidate for Lasik?

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