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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have Rx around -5 and corneal thickness around 550. My corneas

Resolved Question:

I have Rx around -5 and corneal thickness around 550. My corneas are flat (K around 42). I have moderate Dry ey and am 41 years old. I tried Ortho K and it caused bad halos and night vision.

Am I a candidate for any of the new advanced lasik procedures? I have healthy eyes otherwise. I was wondering if SBK or thin flap lasik or PRK would be better options for me. I am worried about an IOL or RLE causing retinal detachment and is that a valid concern?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.
Hi. I'm online and happy to answer your question today.

How long has it been since you underwent the ortho K "therapy"?

Customer: replied 1 year ago.
2months ago but my corneal measurements were before that. The ortho k gave me bad halos and night vision so I am worried LASIK would do the same.
Expert:  Dr. Rick replied 1 year ago.
Mary,

Yes. I can imagine that the Ortho K would do that....

In any event, with 5D of myopia and a corneal thickness of 550 High normal) you should be fine with normal lasik.

For each diopter of myopia about 12 to 15 microns of tissue has to be removed. After lasik the minimum amount of untouched cornea should be 250 microns. The flap is usually about 160 microns.

So in your case, 550 microns - 160 - (5x15=75) leaves 315 microns of untouched cornea.

That is plenty :)

And, I agree, the risks of a phakic IOL or clear lens extraction is much greater then LASIK, PRK LASEK etc. And, although retina detachment is not that common after RLE or phakic IOL, it can happen.

So. What is the take home message? From what you have posted, I think LASIK is your best refractive surgery option. Given the calculations above, you should do very well.

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS


Customer: replied 1 year ago.
I just have a couple more questions. Would you suggest SBK or the thin flap LASIK in my case due to my dry eyes and my flat Corneas or doesn't that matter. Have you ever heard of relex smile? Would that be worth waiting for? Thanks!
Expert:  Dr. Rick replied 1 year ago.
Mary,

That is an excellent question and it is obvious that you have done your homework :)

After refractive surgery dry eyes are a problem for almost everyone and those with pre existing dry eyes the problem is even worse.

That being said, I do not think that the incidence or severity of dry eyes is significantly different between SBK, Thin flap LASIK, LASEK or regular LASIK.

Yes. The ReLEx Smile LASIK was a big item at last years AAO meeting in Chicago. While it may have its advantages, I'd not put off using a tried and true therapy such as LASIK etc. New doesn't always mean better.....

I think you should just have the type of surgery that your eye doctor feels offers you the best possible outcome.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
Mary,

Oops. I forgot to add this to my closing above ;)

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

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