Can I Have Laser Eye Surgery If I Have Keratoconus?

It’s rare we have to turn people away at London Vision Clinic, but some conditions are simply outside of our control of even the best surgeons and most advanced tech.

One of those conditions is keratoconus, a genetic eye condition in which the normally round dome-shaped window of the eye progressively thins over time and causes poor vision.

Keratoconus is characterised by an inherent weakness within the stromal layer of the cornea. Laser Eye Surgery works by reshaping this part of the cornea, and so by undergoing a treatment such as LASEK or LASIK, it stands to reason that a relatively stable cornea may actually be made more unstable.

If this were to happen, the patient could be back in glasses or perhaps even with a higher prescription within a year. And that is certainly not what you want from Laser Eye Surgery.

However, before you write off Laser Eye Surgery for good, although people with keratoconus are often unsuitable for the treatment as a means of improving refractive errors such as longsightedness or shortsightedness, there may be the possibility of using it to stabilise the condition.

Treating Keratoconus With Laser Eye Surgery

As keratoconus is progressive, different treatments are often offered depending on the severity or stage of the condition.

For instance, in the early stages of keratoconus, glasses or soft contact lenses may be used to improve vision. As the cornea becomes thinner and steeper, these are often insufficient and soft or rigid gas permeable (RGP) contact lenses are required for the same job. If these methods are ineffective or the condition is advanced, a corneal transplant may be recommended.

However, since the introduction of a treatment known as Cross-Linking treatment (CXL), keratoconus getting to the stage in which a corneal transplant is necessary is less and less common. A modern procedure in use since 2016, cross-Linking treatment is suitable for more than 90 percent of patients, and although after it you may need to still wear your glasses or contacts, it can prevent keratoconus from getting worse.

Cross-linking for keratoconus works by combining ultraviolet light used in the laser process with riboflavin (vitamin B2) drops. This process mimics a natural stiffening of the cornea that happens with age, helping to cause fibres in the cornea to “cross-link” and prevent keratoconus from progressing.

Cross-linking is typically only used in cases in which keratoconus is getting worse. As by the mid-30s cross-linking in the eye naturally starts to occur, the condition tends to stop getting worse and therefore older patients do not often require the procedure.

Despite not expecting it to get rid of your longsightedness, shortsightedness, or astigmatism, many patients do experience an improvement in their vision after cross-linking. How much of an improvement you can achieve depends on several factors including your prescription and the severity of the condition.

If you’d like to find out if you’re suitable for cross-linking treatment for keratoconus, leave a comment below or get in touch with our friendly team of eye experts.