The Power of my Glasses is -11. Can Lasik Surgery Help Me to Remove Glasses? Or is There Any Other Way my Eyeside Becomes 20/20?

Question

Jay Bansal, MD · Answer

There are a number of factors that need to be considered for your highly near-sighted prescription. 

	1. Corneal thickness - laser vision corrections on the cornea reduce the thickness of the cornea in order to flatten it.  If your prescription is too high or the cornea is too thin, it is not safe to perform a laser vision correction.

	2. Initial corneal curvature - Since the cornea is being flattened, if your cornea starts off relatively flat and must be flattened further, the result could cause problems with aberrations or dryness.

	3. Pupil size - A larger than normal pupil size would exacerbate vision problems as it could require a larger optical zone for treatment.

	4. Prescription history - If your prescription has been increasing steadily over time than laser vision correction might be unsatisfactory as the prescription could continue to change.

	5. Eye health - The eye must certainly be checked for other possible problems prior to surgery such as keratoconus or retinal tears or detachments.

	 

	Often a surgeon will recommend a phakic intraocular lens for this high prescription but there are certainly many people who have had laser vision correction with a -11 Rx and are very happy.  You just need to realize the risks and find a surgeon that you feel confident could perform the correct procedure (or no procedure if it turns out you are not a good candidate).

Emil William Chynn, MD, FACS, MBA · Answer

there is no way you can get LASIK for that high an Rx, you would run out of tissue and it wouldn't be safe

	i agree w dr kameen that most surgeons would recommend an ICL for Rxs higher than -10

	i am presenting the largest case series in the US of extreme prescriptions like yours next week at the largest meeting of refractive surgeons in europe, ESCRS, over 200 eyes

	i have actually made every single eye worse than -10 see BETTER than they did in contacts or glasses after their LASEK without any correction. the main reason is probably because by putting the Rx directly on the cornea, we eliminate the minification of image size that you get with high - Rxs, which is kind of the same as magnifying your world!:)

	in my hands, since all i do is LASEK and am doing about 1,000 procedures a year, with oral steroids and MMC, i get no scarring, and can safely and effectively treat -10, and have actually treated the highest Rx in US history w the laser in 2010: -22! with no scarring and a final vision of 20/25 uncorrected (she flew in from China and only had 20/50 vision in glasses or contacts)

	anyway, at least in my hands, i think that a LASEK is safer than ICL, as it's not an intraocular procedure. i would still recommend ICLs for patients who cannot get their entire Rx fixed w LASEK (like if their cornea is too thin to laser off the entire rx)

	Emil Chynn, MD, FACS, MBA

Anthony J. Kameen, MD (retired) · Answer

It is likely that your visual outcome will be better if you have what is called an ICL procedure(Intraocular Contact Lens). This procedure is a little more invasive than LASIK, since an artificial lens is surgically placed inside of the eye, but, because of this, we can choose almost any power lens that is available and reverse nearsightedness even twice as severe as yours! The only way that LASIK would give you a great result would be if your corneal thickness was so abundant, that the surgeon would be able to correct of your nearsightness without thinning your cornea too much.  Please be encouraged, though, that one of the two procedures should make you extremely happy with your vision without glasses!

The Power of my Glasses is -11. Can Lasik Surgery Help Me to Remove Glasses? Or is There Any Other Way my Eyeside Becomes 20/20?

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The Power of my Glasses is -11. Can Lasik Surgery Help Me to Remove Glasses? Or is There Any Other Way my Eyeside Becomes 20/20?

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