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?

Can I Have LASIK If I Have Keratoconus? in Manhattan

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

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.

Anatomy of a Cornea: Why LASIK is Not an Option
Anatomy of a Cornea: Why LASIK is Not an Option

Anatomy of a Cornea: Why LASIK is Not an Option

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.
Dr. Wernick cartoon

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. They are essential for monitoring ocular health and detecting ocular disorders.  Contact our office to find out more.

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