Can I Have LASIK If I Have Keratoconus?

LASIK has a good track record treating common visual deficits.  But is it a viable option for patients with keratoconus?

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Most people who are diagnosed with keratoconus are primarily concerned with two things:

  1. Preventing further vision loss
  2. Exploring options to improve vision
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What is LASIK Surgery?

LASIK is a popular surgical procedure where the cornea is reshaped, leading to dramatic improvements in eyesight. Many people with previously impaired visual deficits now see perfectly thanks to LASIK. 

LASIK Is Unsuitable For Keratoconus

Despite the efficacy of laser treatments for improving general visual acuity, they are not viable options for treating keratoconus. Understanding why this is so requires a look at the cause of visual impairment in this ocular disorder.

Anatomy of a Cornea: Why LASIK is Not an Option

Anatomy of a Cornea: Why LASIK is Not an Option

The cornea is the clear outer layer of the eye responsible for focusing light rays on the retina.  Normal shaped eyes are spherical which enables the corneas to properly direct light on the retina. In many common visual deficits, curvatures in the eye misdirect these light rays.

With keratoconus, corneal alteration is more severe than the mere curvature found in most vision conditions. In this complication, the corneas gradually bulge outward into a conical shape, distorting light rays and causing vision impairment. With LASIK and similar interventions, the procedure would likely do more harm, by weakening an already damaged cornea.

What Options Are Available For Keratoconus?

What Options Are Available For Keratoconus?

Surgical interventions vary depending on the severity. Typically, early-onset complications can be treated with standard contact lenses and glasses. As the condition worsens, more advanced interventions may be considered. 

Often the types of contact lenses that will be suitable changes as the condition advances. While soft-lenses may be suitable initially, as the cornea degenerates, gas permeable types and scleral lenses may become necessary. 

Scleral contact lenses are considered the best gas permeable options today for keratoconus patients. For most patients they offer superior comfort and effectiveness. They are uniquely designed to rest on the sclera of the eye rather than the cornea.

In instances where the disorder has advanced, certain procedures may no longer be viable options. One example of this is collagen cross-linking, a surgical procedure which prevents the cornea from changing shape. However, if the corneal alteration has advanced to a certain point, the procedure may no longer be effective. This is why it is critical to schedule routine ocular exams.  An optometrist can detect the early onset of ocular disorders and initiate treatment. Common interventions include:

  • Cross-linking procedure:  A surgical procedure where the eye is treated with riboflavin drops and ultraviolet light, in order to strengthen the eye’s collagen fibers.
  • Corneal transplant: In this surgery, diseased corneal tissue is replaced with a donor’s healthy tissue. Sometimes the scarring following surgery necessitates the use of scleral contact lenses.
  • INTACS: In this procedure, inserts are placed in the eye to flatten the cornea.  Often contact lenses are still required post surgery to correct vision.
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Common Questions

LASIK is generally not recommended for individuals with keratoconus, as it can exacerbate the thinning of the cornea that is characteristic of the condition. An eye doctor or keratoconus specialist would typically advise against LASIK for those with this disorder, as it may lead to further complications and progressive deterioration of vision. Alternative treatments or corrective lenses would likely be explored during a contact lens exam or consultation.
While LASIK itself is not suitable for keratoconus, other laser surgery options may be utilized. Phototherapeutic keratectomy (PTK) and conductive keratoplasty (CK) are examples of laser treatments that an optometrist or keratoconus specialist might consider. These procedures may help reshape the cornea and improve vision, but the suitability depends on individual circumstances and the progression of the condition.
Crosslinking is a procedure commonly used to stabilize the cornea in individuals with keratoconus. LASIK after crosslinking is generally not advised, as the underlying keratoconus condition may still present risks associated with LASIK. Consultation with a keratoconus specialist or eye doctor, including a thorough eye and contact lens exam, would be necessary to evaluate the best course of action for vision correction, taking into account the specific needs and history of the patient.
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Lasik Is Not Suitable For Keratoconus

While laser treatments successfully correct many visual deficits, they aren't suitable for keratoconus which involves weakened corneas. In such instances, the procedure will do more damage.

Although there is no cure for keratoconus, there are many excellent medical interventions to retain and improve vision. Speak with your optometrist to find out what medical options are available. 

If you have not had a comprehensive eye exam, consider scheduling one. You can reach out to your nearest Amplify EyeCare practice either via a call or in-person visit to schedule an eye exam. They are essential for monitoring ocular health and detecting ocular disorders.

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