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What is my doctor looking for during my evaluation?
Your eye doctor should look for risk factors prior to surgery that may make you a less than ideal candidate for surgery and discuss any abnormal findings with you at length. The following are considered to be risk factors for refractive surgery.
High prescriptions: Patients with extreme eyeglass prescriptions (high myopia or high hyperopia) may not be good candidates for LASIK because too much corneal tissue would need to be removed to safely perform the procedure.
Thin corneas: Because all excimer laser surgery (LASIK and surface ablation) requires the removal of small amounts of corneal tissue to correct your refractive error, the thickness of your corneas must be measured before surgery. Patients who have very thin corneas are at risk for excessive corneal weakening after surgery and may not be good candidates for LASIK. In these cases, surface ablation or other procedures may be more appropriate.
Abnormal corneal curvature: There are many devices used today to measure the overall shape and curvature of your cornea. These devices are called topographers and are an essential part of your initial evaluation. Abnormalities in the shape and curvature of your cornea may indicate that your cornea is weaker than that of the average person, and this will exclude you from having LASIK safely.
Dry eyes: Patients with dry eye symptoms, such as burning, redness, and tearing may have worse symptoms after LASIK surgery. This occurs because corneal nerves are cut during this procedure, and these nerves are partly responsible for stimulating tear secretion. Most patients have a full return back to their baseline state after surgery; however, patients with significant dry eye before surgery may not be appropriate surgical candidates
Large pupils: Although less common today, some patients still notice glare, halos, or other night vision issues after LASIK. Patients with larger pupils may be more prone to noticing these things, so your screening evaluation should include measurement of your pupil size in a dark room.
Previous refractive surgery: Prior corneal surgery or other types of refractive surgery, especially radial keratotomy (RK), may complicate additional procedures. You should talk to your eye doctor about this situation in order to make the best decision possible about your ability to be corrected with further surgery.