can eye lazik be done with high myopia

[Ayshbubbles]

I have a very bad eyesight.  my prescription is - 12.25 in right and - 10.00 in left.  can lasik be done?  

[nevergiveup90]

Hi, I am also suffering from myopia. I heard that the latest advancements in refractive surgery uses a technology called ReLEx SMILE (http://www.zeiss.com/meditec/en_de/products---solutions/ophthalmology-optometry/cornea-refractive/laser-treatment/femtosecond-laser-solutions/relex.html) developed by Zeiss. The surgical intervention is flapless and consists in removing a lenticular portion inside the cornea (in contrast to femto lasik and lasik that cut a flap and use the Excimer laser afterwards). The surgery can remove at most 10 spherical D and 5 cylindrical D of myopia, if the cornea permits. It also works for hyperopia.

[JohnHaganMD]

This is a post from my colleague John F. Doane, MD an internationally known cornea/refractive surgeon and a US investigator for the ReL Ex SMILE procedure:

Yes, ReLEx smile is a developing procedure in ophthalmology – refractive surgery.  It has been under development by Carl Zeiss Meditec of Germany since 2008.  Conceptually we are using thoughts that date back to 1960.  Like, Lasik, with advances in laser technology we can add immensely accurate laser to procedural concepts that the surgeons of the 1960’s would be mesmerized with.  That being said, there have been 450,000 ReLEx SMILE procedures performed world-wide to date for nearsightedness ( myopia ) with and without astigmatism.  At present there are about  1,000 procedures being performed per day as of June 2016 and this is only increasing with time.  In the US we are completing FDA trials for spherical myopia ( completed 2014 with follow-up at one year end of 2015 ) and myopic astigmatism – last eyes to be treated June 2016.  FDA approval possibly in early 2017 for spherical myopia.  Hyperopia is under optimization now outside the US.  I would expect hyperopia to only improve.  Maybe ready for commercial usage 2017 outside the US.   Inside the US quite a ways off at best.   Postulated advantages of SMILE are greater biomechanical strength since no flap and less dry eye since less corneal sensory nerve interruption.  JFD   MD

[JohnHaganMD]

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[SoftwareDeveloper]

This review suggests a phakic IOL may be the better choice:

http://www.cochrane.org/CD007679/EYES_excimer-laser-versus-phakic-intraocular-lenses-for-the-correction-of-moderate-to-high-short-sightedness
"The results of this review suggest that, at one year post surgery, phakic IOLs are safer than excimer laser surgical correction for moderate to high myopia in the range of -6.0 to -20.0 D and phakic IOLs are preferred by patients"

This next article was updated this month and shows lasers approved by the FDA for up to -14D of myopia.

http://emedicine.medscape.com/article/1221604-overview#a8

However how much can be corrected partly depends on details about your particular eyes, not everyone is a candidate.  That said, that particular article doesn't say anything about the risks and outcomes. Again, often implantable lenses are recommended for high myopes, though there are risks (but then there are risks with wearing regular contact lenses for decades).

[SoftwareDeveloper]

I don't know if the information below from some doctors on the topic is the most current, but it appears surgeons vary in how much they treat. I suspect it depends partly on whether they have the latest equipment and use the latest techniques, and partly on how much risk they and the patient are comfortable with. As mentioned another option is to implant a lens, called a phakic IOL (IntraOcular Lens) or   ICL (either standing for Implantable Contact Lens or Implantable Collamer Lens), and again surgeons will differ in their experience with them and their perception of the risks, some surgeons are inherently conservative, which merely means patients should educate themselves to decide whether to risk using a less conservative surgeon and getting a procedure done anyway since it is their risk to take  if they are truly informed enough to decide to take it:

http://www.ophthalmologymanagement.com/articleviewer.aspx?articleID=109384
"Corneal excimer laser surgery — LASIK and advanced surface ablation techniques including PRK, LASEK and Epi-LASIK — is undoubtedly the most popular refractive surgical procedure performed in the pre-cataract population. It can accurately treat myopic refractive errors up to 12.00 D.

However, potential problems can crop up.   ...

Phakic IOLs are a great option for myopes between -5.00 D to -20.00 D younger than age 40 years without cataract but with mild-to-moderate astigmatism. Additionally, PIOLs give us something for patients for whom LASIK and PRK are not appropriate. ...

Potential drawbacks of PIOLS ..."
http://www.allaboutvision.com/askdoc/lasik.htm

"Some doctors consider -8 D to be the maximum, but in the United States the FDA has approved LASIK to treat up to -12 D....

Some patients with myopia of -10.5 D may choose to have an implantable lens (known as a phakic IOL) placed inside their eye as an alternative to LASIK.

The same complications are possible for a -10.5 D myope as for any other patient undergoing LASIK surgery. However, there will be a higher chance of needing a LASIK enhancement — a second, fine-tuning procedure — to obtain the best possible vision. — Dr. Caster...

A: The maximum treatment varies, based on several important factors, most prominently the thickness of the cornea. Different doctors have different criteria that they use when determining maximum treatment. For some doctors, 8 diopters of nearsightedness is the maximum, while others feel comfortable treating up to 12 or 14 diopters. — Dr. Caster"

[JohnHaganMD]

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[JohnHaganMD]

Yes but it will not correct all of your myopia. Depending on your corneal thickness and the surgeons skill and experience and the instrumentation used about 6-8 diopters might be corrected. That however would make a huge difference in your vision without glasses and make your glasses much thinner.