Here is a recent question I was asked on whether LASIK is suitable for thin corneas:
“Dear David, I wrote a while ago to ask whether Z Lasik gave greater scope to those of us with thin corneas for having Lasik as opposed to Lasek or PRK. At the time, I didn’t know what my actual measurement was – I have since had my notes from my previous check and they read L 465, R 473. However, reading recent posts on your blog I see that you do not recommend any ‘flap cutting’ to anyone with a corneal thickness measurement of under 500. I suppose what I’m asking, is if that is completely set in stone? Does Z Lasik not allow you to consider previously borderline cases?“,
And another question on the same topic:
I have myopia of -6.5 and -2 for astigma. I have a corneal thickness of 490 micron. I went for 2 different consultations. One surgeon recommend that i should do PRK because he said that it is safer than iLasik (intralase) due to zero flap create. The other doctor recommended me to go with Intralase because he said that it is possible. I know that both procedures are safe. But i am just a bit concern in the long term. Also, what is the down side of having intralase over PRK or the other way around?
Average central corneal thickness is 530-540 microns. Many surgeons, myself included, don’t cut LASIK flaps in corneas less than 500 microns, although there are surgeons who will. In the first question, this person had very thin corneas (465 and 473 microns) and in my opinion should NOT have LASIK. In the second, the corneas are thin at 490 microns, but not excessively so.
It is true that being able to create very accurate LASIK flaps with the new femtosecond lasers (e.g. Ziemer, Intralase, Zeiss) leaves more tissue behind and so allowing larger treatments. More on this topic in my next post.
About the Author: Mr. Dave Allamby FRCS FRCOphth is a leading London-based laser eye surgeon. You may have seen him on the This Morning TV show with Phillip Schofield and Fern Britton or read one of several articles in the national press, recently for treating Denise Van Outen, rock giant Rick Wakeman and broadcaster Paul Ross. David is Medical Director at Focus Laser Vision, known as a world-leading clinic in the treatment of presbyopia, or age related loss of close vision. Focus Laser Vision is also London's only clinic to offer next-generation Z-LASIK laser eye treatment for short sight, long sight or astigmatism.