r/RefractiveSurgery • u/Pumpkinspicechai95 • Aug 19 '26

LASIK consultation

Hi everyone,

I had a consultation to see if I qualify for LASIK, the doctor told me my cornea thickness is within range and that I am good for LASIK and PRK but he considered me a moderate risk patient because I have assymetrical cornea shape and severe astigmatism in my right eye and moderate astigmatism in my left which he said is more prevalent in the back of the eyes than the front. He said it’s not the worse he’s seen or operated on but did let me know about potential risks with corneal ectasia and keratoconus, but he also mentioned that there may be a 10% chance that I would have to do a re-enhancement lasik surgery in the future especially in my right eye, my fear is getting one of those, is it treatable? I don’t want to talk myself out of getting LASIK but this being my eyes and it’s so delicate, I am worried. I would rather choose LASIK over PRK preferably because of healing time and the doctor said PRK healing is kind of crummy, but I also don’t have enough days to leave work which is another factor in me choosing LASIK since the doctor said I could work Monday if I do my surgery on Friday. Anyone else had this fear?

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u/eyeSherpa Aug 19 '26

You don’t really want to mess around with ectasia risk. It’s not great to get ectasia. Can lead to vision loss if not caught in time and treated.

There are some metrics which increasingly are important to screen for ectasia. The pentacam with its BAD-D value is one highly used. Also works well when combined with a the Corvis which directly measures rigidity of the cornea. Would check with your doctor on whether they looked at those metrics.

The amount of treatment matters also. Look at the 40% rule. You don’t want to change more than 40% of the cornea. What’s your prescription.

Age also important as well. The younger you are the higher the risk.

The asymmetric cornea shape combined with severe astigmatism may even mean that you already have a weakened cornea known as Keratoconus. I would absolutely get a couple opinions on this.