Is it advisable to do LASIK if family member has RP?

Doctor's Answers 2

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Dr E-Shawn Goh

Ophthalmologist

This question is tricky. Retinitis Pigmentosa (RP) has many variants, severity types and inheritance patterns. So just because your family member has RP, does not necessarily mean that you will develop RP, may develop RP, or even be symptomatic for RP.

First of all – I would suggest that you consult your eye-care provider for a comprehensive evaluation of your eye.

If you clearly do not have RP, then you can discuss with your eye-care provider which option of PiXL, LASIK / Cornea-refractive surgery, Implantable Contact lens is best for you.

If after your consultation with your eye-care provider, it is apparent that you manifest early signs of RP, or heaven-forbid that you may manifest severe findings of RP then I would suggest that any form of refractive surgery would not be suitable for you. I don’t mean to be a wet-blanket on your hopes, however patients with RP experience variable degrees of peripheral and central vision impairment, and are prone to developing cataracts and glaucoma at an early age. Cornea refractive surgery increases the degree of higher-order aberrations in the cornea, resulting in loss of contrast sensitivity and ultimately would set you on the path to poorer vision than if you had the RP alone.

The most difficult decision you might be faced with is if your eye examination was completely normal, and yet you had a strong family history of RP / suspected / or even just that you are worried that you might develop RP in future.

Further investigations including an Electro-Retino-Gram (ERG) may be able to detect sub-clinical forms of RP.

If you absolutely could not tolerate using spectacles or contact lenses and wanted to consider a surgical procedure for your myopia / astigmatism but had the concerns above, then why not consider alternatives to LASIK?

We have 2 viable options you may consider. The first is photorefractive Intrastromal Cross-Linking (PiXL), and the second is an Implantable Collamer Contact Lens (ICL). The ICL is completely reversible and does not suffer the same complications of dry eyes, loss of contrast sensitivity, glares and haloes. Did I forget to mention that it is completely reversible?

Oh yeah… if you’re not suitable for it we can take it out!

In general while having Retinis Pigmentosa is not a contraindication for having LASIK – most doctors wouldn’t perform it as Retinitis Pigmentosa typically causes a narrowed field of vision (tunnel vision), and some associated side effects of LASIK like glare/haloes can exacerbate the problem.

You didn’t specify if you suffer from RP yourself, or it’s only your mum – This makes it rather difficult to position my answer.

I’d strongly suggest that you discuss this situation (positive family history with your mom having RP) with a LASIK surgeon, and see what he advises based on the pros vs cons.

Many doctors in Singapore tend to provide a waivered LASIK consult.

Cheers

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