Am I a Candidate for Refractive Surgery? Part 1 of 2

Sub Title

man and doctor in eye doctors office looking at lab results
by Dougherty Laser Vision

A common question patients ask themselves often is “am I a candidate for refractive surgery?”

If you wear (or need to wear) glasses and/or contacts to see well and don’t like wearing them, you are likely a good candidate for refractive surgery. You should be well informed and willing to take the small risk that is implicit in every surgery. Typically, I operate on people over seventeen or eighteen years of age whose prescription is relatively stable because vision continues to change throughout childhood.

Dougherty Laser Vision always strives to help you in any way possible!

However, we will occasionally perform vision correction surgery on children in unique circumstances. Case in point, I recently had a seven-year-old patient who had high nearsightedness in one eye and was intolerant of contact lenses. Glasses were not an option because of the disparity in power and the resultant magnification difference between the two eyes. She had developed “lazy eye” (an eye that looks normal but cannot see 20/20, even with glasses), with poor vision in this eye due to non-use from the nearsightedness (anisometropic amblyopia). I performed the Vista Vision ICL procedure and astigmatism surgery on this patient in the summer of 2008. Had surgery not been performed, she would have remained blind in this eye for the rest of her life. (For more information on this surgery, see the Associated Press news story and the segment from CBS TV’s The Early Show, available on my website and YouTube channel, respectively.)

There are a few ophthalmic and medical conditions that can be relative contraindications for refractive surgery. The most common eye condition that precludes laser vision surgery is keratoconus, a disease that involves a progressive steepening and thinning of the cornea, which occurs in approximately one in 2,000 people. There is some genetic predisposition to this disease, so we are always more careful in patients who have a family history of keratoconus or corneal transplantation.

Progressive steepening and thinning of the corneaKeratoconus typically have nearsightedness with astigmatism. Early in the disease, they can correct their vision with glasses or soft contacts. As the disease progresses (usually in one’s teenage years or twenties), rigid gas permeable lenses or a corneal transplant may be required to see well. Not every patient with keratoconus will eventually require transplantation, however. LASIK surgery makes keratoconus progress; therefore patients with keratoconus should absolutely not have this procedure. PRK may be considered in early cases since many surgeons believe that removing a little surface corneal tissue does not cause destabilization of the cornea. PRK, however, will not treat any irregularity of the cornea that may be caused by keratoconus. There are many patients that have corneal topography maps that are slightly suspicious for keratoconus (forme-fruste keratoconus) but have no other signs of the disease. These patients (particularly those over age thirty who have shown no progression of the disease) are safe to have PRK with good outcome.

Look for part 2 of this article soon.

If you have additional questions or would like to schedule a free consultation, contact us or call at 866-987-2020.