I am considering Lasik. I have 498 and 506 micron corneas are they thick enough?

Question

I am almost 40 yrs and have -2.0 in both eyes. They have been stable at -2.0 for 3 years. Had initial evaluation and told my corneas are borderline. Should I still consider LASIK bladeless or not? Thanks.

Michael K. Tracy, MD · Answer

I never like to do borderline cases when there is a safer alternative. You would probably be an excellent candidate for PRK which is much safer in your case.

Arthur Benjamin, MD · Answer

For years many vision correction surgeons, myself included, had this psychological threshold of 500 microns for performing LASIK.  501 or more LASIK is ok, 499  or less consider PRK.  A recent study of 50,000 LASIK patients has revealed this 500 micron threshold to be completely arbitrary and irrelevant.  What is more important to consider than the thicknes is the shape of the cornea, especially the shape of the back or inside surface of the cornea.  Such evaluation  cannot be performed by a typical corneal topographer capable of imaging and analyzing the front surface only.  Specialized equipment such as Oculus Pentacam, Zeimer Gallilei, or Bausch and Lomb Orbscan  are preferred.  These can image and analyze both the front and the back surfaces of the cornea.  If the shape and architecture of the cornea is shown to be normal and healthy as imaged  with these devices, it would be safe to proceed with lasik.  Good luck with your pocedure!

Brian Davis, MD · Answer

I assume you have normally shaped corneas (there are some corneal anomalies associated with thinness and irregular shape that would not make you a good candidate for surgery). If your corneas are normally shaped then you could have either blade-free Lasik using a femtosecond laser or you could have Photorefractive Keratectomy (PRK). During Lasik, a flap is created from the front of the cornea which is then lifted and your prescription is treated. During PRK, no flap is created and your prescription is treated near the surface of the cornea. Since with PRK no flap is created, your cornea is effectively thinned less than with Lasik. Just a side note-some Lasik facilities refer to PRK as bladeless Lasik. This is misleading because PRK is not lasik. Bladeless Lasik is where the flap is created using a laser instead of a blade.In comparison to PRK, Lasik is less painful, has a quicker vision recovery, and less risk of corneal haze. PRK would leave more corneal tissue in the rare instance that you need a second surgery or enhancement.If I were in your shoes and had normally shaped corneas I would have bladeless Lasik.I hope this helps. Best of luck with your surgery.

I am considering Lasik. I have 498 and 506 micron corneas are they thick enough?

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