Question: About 4 years ago I was told by a very reputable LASIK doctor that that I was not a good candidate for LASIK. I had RK in around 1992 and have had my astigmatism come back, rather severely, in both eyes over the past 5 years. I now wear RGP contacts which can only correct my vision to 20/60 at best. Is there a chance that some of the latest advances in LASIK technology can help improve my vision? Does having the corneal scars of RK make LASIK not an option? I really would love to see better and get out of contacts once again.
Answer: LASIK after previous RK can be performed in many, but not all, instances. RK can structurally weaken the Cornea and often lead to progressive changes in vision. RK can sometimes result in both regular and irregular astigmatism. The fact that you wear RGP lenses and can only be corrected to 20/60 vision is not a favorable prognostic factor and suggests that the overall integrity of your Cornea may not be the best.
Whether or not you are a LASIK candidate-or a candidate for ANY type of Laser Eye Surgery for vision correction-is going to depend first and foremost on the health and integrity of your Cornea. The newer techniques used for advanced surface ablation and even LASIK can often be appropriate for the post RK patient, but only with good corneal integrity. The use of Custom Wavefront Guided or Wavefront Optimized LASIK can often be helpful in reducing the aberrations that can be caused by RK, but again only where the Corneal is structurally sound. Your best next step is to find a top LASIK Surgeon who is a full scope Refractive Surgeon and consults on both routine and complex cases, and perhaps is even a corneal specialist, and schedule an examination and consultation. You need to understand why your vision is only correctable to 20/60 with RGPs and whether your Cornea is structurally intact before considering any type of additional surgery.
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