Lasik with Corneal Scar?

Question

I have a corneal scar on my right eye due to a pseudomonas ulcer I had a month ago. I've told it is deep but is not close to the center of cornea and so it did not affect my vision. I've been not examined by lasik surgeons yet but the other doctors said lasik in the future will be too risky and no one will like to touch my eye because the scar will be always deep. Dose my deep scar ( even if it is not close to the centre) disqualify me from the operation? ...Thanks so much

Jon Dishler, MD, FACS · Answer

LASIK requires making a corneal flap and although it can be performed in small superficial scars, and long standing scars, the type you describe may make it a better option to consider PRK or surface treatment even if the scar is not directly over your pupil. Of course, this depends on the size, depth, healing, and other factors that can only be made by your LASIK surgeon. Pseudomonas is a very virulent infections and can create significant damage, which is why I am leaning in this direction. You may also get some extra reactivation and need to have longer steroids post operatively.

Mark Golden, MD · Answer

LASIK can be performed in those with corneal scars secondary to bacterial infections. I would urge anyone with a recent corneal infection to have treatment for 4-6 weeks at least if there is any sign of the previous infection at all. We generally suggest that anyone with an infection wait 3 months before surgery. Once fully treated and the cornea stabilizes, the question is LASIK or PRK. If there is a visually significant scar the PRK may reduce the scar. If not LASIK should be fine.

Christopher Coad, MD · Answer

I cannot answer without examining the eye and test results, but a corneal scar does not necessarily disqualify one for laser vision correction.  Visian ICL may be another option too.

Sandy Feldman, MD · Answer

LASIK or PRK, photorefractive keratectomy can be performed in eyes with corneal scars. Sometimes, PRK might be preferred if the scar is central, dense. Your LASIK doctor should discuss this with you during your consultation.

Anthony J. Kameen, MD (retired) · Answer

It is a good thing, on many levels, that your corneal scar is not in the center of the cornea(your visual axis). Obviously, a central scar from a contact lens infection can cause tremendous visual distortion. A peripheral scar will not do this, but it might make our approach to laser vision correction change. It is impossible to say, without seeing you, if you are not a candidate because of the corneal scar. However, assuming that it is peripheral and relatively deep, I would likely perform the procedure known as PRK(photorefractive keratectomy) rather than LASIK. The PRK procedure is more of a surface treatment(rather than under a flap) so the laser will, essentially, ignore your scar and not stir it up. It is sometimes difficult to make a LASIK flap through a corneal scar, so, without physically seeing your eye, I would defer to PRK.

Lasik with Corneal Scar?

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