Custom LASIK Candidates

Custom LASIK has been shown to produce impressive changes in the quality of patients’ vision, and has few restrictions in its ability to treat a variety of visual challenges. However, it is not right for everyone. A range of factors can affect whether a person is a suitable candidate for custom LASIK, or whether he or she may be better served by another refractive procedure.

General Custom LASIK Requirements

Overall, if you are a healthy person with a stable refractive error and have vision affected by myopia, hyperopia, and/or astigmatism as well as higher-order aberrations (visual irregularities that affect your quality of vision), you are an excellent candidate for custom LASIK.

To undergo custom LASIK, you must have a refractive error (eyeglasses or contact prescription) that has stayed the same for at least twelve months. Generally, those under 18 are disqualified from undergoing custom LASIK for this reason, as refractive error rarely stabilizes until adulthood.

In addition, women who are pregnant, nursing, or may become pregnant in the near future should wait to undergo custom LASIK, as the hormonal changes associated with pregnancy, childbirth, and nursing affect visual acuity.

Corneal Thickness

In the process of correcting your eyes’ higher-order aberrations, custom LASIK removes slightly more corneal stroma than traditional LASIK. For this reason, it is imperative that those undergoing custom LASIK have sufficient corneal thickness. Your LASIK doctor can easily measure your corneal thickness and tell you whether it is sufficient for custom LASIK, or if you may be better-suited for another procedure such as PRK, LASEK, or Epi-LASIK, which have different guidelines for sufficient corneal thickness.

Pupil Size

In addition, having large pupils can affect the results of your custom LASIK procedure. Like corneal thickness, your pupil size is easily measured at your LASIK doctor’s office. Large pupils may require your LASIK surgeon to make adjustments, but will not usually preclude you from successfully undergoing custom LASIK.

Corneal Scarring

Lastly, corneal scarring from an injury or past eye surgery can disqualify you from undergoing custom LASIK. As with corneal thickness and pupil size, this condition will be detected during an eye exam at your LASIK surgeon’s office. In many cases, however, patients who have undergone past eye surgery undergo custom LASIK with excellent results — in fact, custom LASIK is a popular way to address vision regression that can occur after less sophisticated refractive surgery procedures.

Eye Conditions and Custom LASIK Candidacy

Eye conditions such as cataracts, glaucoma, retinal detachment, dry eyes, keratoconus, ocular herpes, and diabetic retinopathy can affect whether you are a candidate for custom LASIK.

Some conditions, like cataracts and keratoconus, are barriers to a successful custom LASIK procedure; however, cataracts can be successfully managed with multifocal intraocular lenses such as ReSTOR®. In other cases, custom LASIK surgery can proceed once the eye condition is controlled. Dry eyes, for example, can be controlled with artificial tears, punctal plugs, prescription eye drops, and other methods, and with dry eye symptoms addressed, custom LASIK surgery can be successfully performed.

Other eye conditions — such as amblyopia (lazy eye) and previous eye surgery or injury — should be brought up to your doctor during your pre-surgery consultation and exam.

General Medical Conditions – Informing Your Surgeon

Medical conditions that affect healing, such as diabetes, as well as collagen vascular disease and conditions associated with a compromised autoimmune system (rheumatoid arthritis, lupus, fibromyalgia, etc.) can disqualify a patient from successfully undergoing custom LASIK.

In addition, a history of keloid scarring, back problems, and other medical conditions may affect whether custom LASIK is a good choice for you. Discussing your medical history with your surgeon is the best way to avoid complications. Though few conditions automatically disqualify a patient from undergoing custom LASIK vision correction, many require adjustment on the part of your LASIK surgeon and should be brought to his or her attention.

Medications and Custom LASIK

Certain medications such as Accutane® or Cordarone® can affect your custom LASIK candidacy. Medications that suppress the immune system can make custom LASIK extremely risky. In addition, some medications can cause dry eye syndrome, and dry eye symptoms must be controlled before custom LASIK is performed. To avoid any medication-related complications, tell your LASIK surgeon about all medications you are taking.

Patients with Higher-Order Visual Aberrations

In addition to nearsightedness, farsightedness, and astigmatism — so-called lower-order aberrations that affect how far you can see — your quality of vision is affected by another class of imperfections, called higher-order aberrations. Many patterns of higher-order aberrations exist, and they don’t always negatively impact a person’s vision. However, when they do affect vision, they can cause double vision, blurriness, ghosts, halos, starbursts, poor contrast sensitivity, and other quality-of-vision issues that often become most apparent in low light conditions.

Glasses, contacts, and traditional LASIK can successfully address farsightedness, nearsightedness, astigmatism, or a combination, but cannot address these higher-order aberrations. However, custom LASIK can.

Custom LASIK is guided by a Wavefront™ map — a three-dimensional model of the eye’s unique pattern of lower- and higher-order aberrations — that is translated to a treatment guide for the laser that reshapes your cornea. Custom LASIK represents a breakthrough because it can successfully treat these imperfections and vastly improve a person’s quality of vision beyond the abilities of glasses, contacts, and traditional LASIK. Therefore, those with vision noticeably affected by higher-order aberrations are perfect candidates for custom LASIK.

Find a LASIK Eye Doctor in Your Area

While this page is a good introduction to custom LASIK candidacy, it takes an eye exam and a discussion with a custom LASIK surgeon to determine whether the procedure is right for you. For further information about custom LASIK surgery and whether you are a candidate, find a custom LASIK doctor in your area through DocShop today.