Question: Is LASIK contraindicated for moderate-to-severely myopic individuals with lattice degeneration? If not, are there any special procedures, precautions or considerations that the surgeon and patient should observe in these cases to prevent complications?
Answer: Lattice Degeneration is not an absolute contraindication for LASIK Surgery in moderate-to-severely myopic individuals. However, moderate-to-severely myopic individuals by the nature of the anatomy of their eyes are more prone to peripheral retinal degeneration such as Lattice Degeneration and thus may be at greater risk for Retinal Detachment, with or without having a LASIK procedure.The presence of uncomplicated Lattice Degeneration does not interfere with visual function and does not constitute a high risk for future development of Retinal Detachment. Lattice Degeneration complicated by tractional tears as the result of an acute, symptomatic posterior vitreous detachment represents a high-risk situation for future Retinal Detachment and is an indication for a Laser Retinopexy with or without the consideration of a LASIK procedure. Lattice Degeneration and atrophic retinal holes complicated by progressively increasing subretinal fluid represents an additional indication for surgical intervention. Thus as you can see, "Lattice is not Lattice"-it can vary in it's risk profile. That said, the conservative approach would be for the LASIK Surgeon to have the patient seen by a Retinal Specialist for a thorough peripheral retinal exam whereby the Lattice Degeneration could be determined to be "complicated" or "uncomplicated" and a decision to treat the area(s) prophylactically, or not, could be made. Once the Retinal Specialist has given a clearance for LASIK Surgery, then the LASIK Surgeon should be able to proceed.
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