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Ophthalmology & Optometry/Severe myopia and laser eye surgery


QUESTION: Dear Dr Berger,

Is it possible to have myopia so severe that you'd be ineligible for laser eye surgery, and if so, is your vision at that degree still able to be completely corrected by glasses or contact lenses?

Also, at the degree that you'd be ineligible for laser eye surgery, what would your prescription likely be? Would it be, like, -15, -16, etc.?

Thank you very much.

ANSWER: Yes there is a dioptric limit to refractive surgery., e.g. LASIK    It is primarily contingent upon the corneal thickness. If the cornea us too thin , there won't be enough tissue to remove to equal the amount of severe myopia, hence the procedure is not recommended . However. If say a prescription for example is -14.00 and Lasik can bring the prescription to -5.00 then although the dependency on glasses still remains,  the lens thickness and frame choices are much more cosmetically appealing and contact lens were may be much more tolerable and acceptable giving better vision .

---------- FOLLOW-UP ----------

QUESTION: Thank you very much, Dr Berger.

Is the corneal thickness dependent on the severity of the prescription (that is, would you have a cornea too thin only if you had a very strong prescription, such as -16.00 or above), or could your cornea be too thin even if your prescription was only about -8.00?

A -16.00 diopter myope can have a thin or thick cornea.  The same with a nearsighted correction of -1.00.  The general rule of thumb is that 15.5 microns of tissue had to be ablated (removed) for every diopter of power. e.g. A -10.00 would require 155 (10x15.5) microns of tissue ablation.  The average cornal thickness is approximately 550 microns.  So if a cornea is only 475 microns thick , that patient is not a good candidate for refractive surgery Hope this helps.   DrKen  

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Any and all questions with regard to ocular ailments, eye diseases as cataracts, glaucoma, macular degeneration, diabetic retinopathy, etc , eye and visual sympomatology, eyeglasses, contact lenses, low or subnormal vision, pediatric vision conditions,and special and unique ailments will be discussed.


36 years of clinical experience in opticianry and therapeutic optometry. Still in private practice with special interests in vision conditions, diagnosing and treating ocular ailments, prescibing treatment plans which include medicine, eyeglasses, and contact lenses primarily. Although surgery is not within the realm of my area of expertise, I co-manage many pre and post -op surgical cases which include Lasik and PRK procedures.

New Jersey Society of Optometric Physicians American Optometric Association

B.A.,1968, Hunter College of the City University of New York B.S.,1970, Pennsylvania College of Optometry O.D.,1973, Pennsylvania College of Optometry Therapeutic Pharmaceutical Administration Certification, New Jersey 1992

Awards and Honors
Clinical Efficiency Award, 1973, Pennsylvaania College of Optometry

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