Absolute ophthalmic contraindications to laser vision correction
To undergo laser vision correction, the patient must meet a number of conditions. The type of vision defect, the anatomical condition of the eyes, age and any eye diseases, as well as general health, determine whether our eyes can undergo laser surgery. Absolute and relative contraindications to the procedure also count.
In the following article, we will focus exclusively on the absolute ophthalmic contraindications to laser vision correction surgery.
- Too high a visual defect (nearsightedness of more than -10 diopters and farsightedness of more than +5 diopters) and difficult-to-treat irregular astigmatism, especially co-occurring with another visual defect, are contraindications for laser correction performed by LASIK. Patients who do not qualify for this method may benefit from surface methods with complete removal of the corneal epithelium (PRK, LASEK). Thin corneas can also be laser-operated with any of the newer methods, including EPI-LASIK or EBK. Patients with severe farsightedness, astigmatism and, in some cases, myopia may also be recommended RLE (refractive lens exchange) or CLE (clear lens extraction), or refractive lens exchange, which involves removing the patient’s own lens and replacing it with a technologically advanced artificial lens to correct the visual impairment, or implanting a phakic lens.
- The thickness of the cornea (as well as its elasticity and hydration status). The ratio of corrected diopters to corneal thickness determines whether correction is possible. A cornea that is too thin can be the result of high myopia, corneal diseases (corneal cone, congenital corneal pathologies, dystrophic diseases, corneal scarring) or simply an individual feature of a healthy eye. In methods in which the surgeon uses the cornea to create a so-called corneal flap (flap), such as LASIK, he or she is not able to develop the so-called architecture of the procedure, i.e. plan the operation in such a way as to achieve the optimal result for the patient. But modern refractive surgery is not only LASIK. Patients who do not qualify for this method can benefit from surface methods with complete removal of the corneal epithelium (PRK, LASEK). Thin corneas can also be laser-operated with any of the newer methods, including EPI-LASIK or EBK.
Read more about superficial and deep laser vision correction methods here: https://swisslaser.pl/blog/powierzchniowe-i-glebokie-metody-laserowej-korekcji-wad-wzroku/
- Acute Dry Eye Syndrome (ARS) ( Dry Eye Disease, DED). Abnormal composition or too rapid evaporation of tear fluid leads to excessive drying of the cornea and conjunctiva. Patients often show pinpoint epithelial defects in the lower part of the cornea or within the eyelid stroma. The lesions occur bilaterally and are very chronic. There is no complete cure for dry eye syndrome. The symptoms of the disease usually persist throughout life. The exception is the so-called secondary dry eye syndrome, associated with the use of medications, the symptoms of which may regress or diminish after their withdrawal. Everything you want to know about it can be found here: https://swisslaser.pl/blog/zespol-suchego-oka-przyczyny-objawy-diagnostyka-i-leczenie/
- Age-related macular degeneration (AMD) and other degenerative diseases of the retina. Everything you want to know about the course of the disease can be found here: https://swisslaser.pl/blog/zwyrodnienie-plamki-zoltej-amd/
- Glaucoma. High intraocular pressure in glaucoma patients can falsify measurements taken during qualification. If lesions have appeared in the affected person’s optic nerve, they will cause impaired vision regardless of the visual defect, and performing laser treatment will not yield satisfactory results. For more information and glaucoma, click here: https://swisslaser.pl/blog/jaskra-przyczyny-objawy-rokowania/
- Monocularity. When a patient can only see with one eye, or uses only one eye, or has one eye, no surgical risk is taken on the healthy eye.
- The tendency to form scarring, or thickened skin, which forms at the site of a former injury or other break in tissue continuity, such as a surgical cut, and grows in size beyond the limits of the original injury, plus hurts, itches, impedes movement and causes significant discomfort.
