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Admin DXD from Singapore asked a question

What are good LASIK options for very high grade myopia and floaters?

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Dr David Chan
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Since I was a kid (around 4 or 5 years old), I’ve been wearing glasses. I’m now 24 years old and working mostly 12 hrs a day around 4 to 5 days in front of a computer. I’m near-sighted. I have a very high grade in both eyes; one is around 1800 and the other is around 1400. There are also floaters in my eyes that I have for quite a long time already. I want to know if any of these factors will affect my chance of getting Lasik? If so, what could be a possible type of Lasik (and probably the safest one) that you can suggest?

DOCTOR’S ANSWER (2)

Hi Karen,

Eye doctors generally prefer ICL (Implantable Contact Lens) surgery, instead of LASIK for high grade myopia.

As the name suggests, ICL is where a soft contact lens is implanted in front of your eye’s natural lens behind the cornea, via a small cornea incision. Unlike LASIK, it doesn’t require any removal of corneal tissue.

LASIK is typically used to correct myopia of up to -14D (1400 degrees), while ICL can treat much higher degrees of myopia of up to -18D (-1800 degrees).

ICL carries the associated risks of having a foreign body in your eye, such as a slightly increased risk of infection etc. It’s also more expensive than LASIK.

Eye floaters do not affect the outcome of LASIK. However, LASIK is not a treatment for floaters.

Besides the severity of myopia, there are other factors to consider in determining the most appropriate treatment to correct myopia – this requires an eye examination and history.

I’d suggest going for a proper consultation with a LASIK surgeon to evaluate these factors, with the other main considerations being your corneal thickness and shape. He will then be able to advise on the best treatment modality.

You may also want to check out this article Dr Yong Ming wrote on how to prevent myopia from worsening.

Cheers

0 187 views 0 Doctors agree Fri Jan 26 2018 02:07:01 GMT+0000 (UTC)

Hi Karen!

Thanks for reaching out. Your myopia sounds very severe!

It’s important in patients who report severely high degrees of myopia to consider concomitant ocular or systemic disorders including Marfans, Weil-Marchesani, Sticklers / Wagners syndrome etcetera.

Such conditions don’t automatically disqualify you from refractive surgery, however a comprehensive assessment would be required to exclude these conditions.

Even patients with severe myopia alone may have concomitant problems like retinal holes or detachment, early cataracts or retinal pathology.

In general, such high degrees of myopia as you have described are not normally suitable for LASIK nor epiLasik as the cornea is not usually thick enough to allow the safe performance of surgery. In addition, the incidence of complications including glare and haloes normally mean that most patients do not choose this option.

All is not lost though! If your anterior chamber depth is sufficient, the option of an Implantable Collamer Lens within the eye provides excellent vision, with minimal side-effects.

The surgery takes less than 10 minutes per eye, and is fully reversible with a much more acceptable side-effect profile for patients with pre-existing severe myopia. Do consider this option and we would love to see you in clinic for an assessment after which we can consider your options fully!

0 187 views 0 Doctors agree Fri Jan 26 2018 02:08:20 GMT+0000 (UTC)
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