Who is not suitable for laser eye surgery?
The dream of getting rid of glasses and contact lenses… How beautiful, isn’t it? Waking up in the morning and being able to see the ceiling, the clock, and the light coming through the window clearly without needing any help. As Kudret Göz İstanbul, we work with the most advanced technologies every day to make this dream come true. Laser eye surgery is truly a life-changing miracle for the right candidates. However, our greatest responsibility to every patient who enters our clinic is to ask the most critical question before promising this miracle: Who is not suitable for laser eye surgery? Perhaps this is the most important feature that distinguishes a good clinic, a great doctor from the rest; not only knowing when to say “yes” but also when to say “no”. This “no” is not the end, on the contrary, it is the clearest proof that we prioritize your eye health above all else. Let’s talk honestly and in full detail about who is not a candidate for laser surgery.
The Limits the Eye Sets: Cornea and High Numbers
Let’s think about it this way: laser surgery is actually the art of delicately reshaping the transparent and domed layer at the very front of our eye, which we call the cornea, like a sculptor. The laser corrects the refractive error by vaporizing micron-thin tissue from this layer. Naturally, the material to be worked on, namely the cornea, must be suitable for this procedure. Our most basic rule is this: The cornea thickness must be sufficient. If your cornea is naturally thinner than it should be, this is our red line. Because removing too much tissue from a thin cornea, especially to correct a high number, endangers the structural integrity of the cornea. This can lead to irreversible problems such as “keratectasia”, where the cornea weakens and bulges forward, seriously impairing vision. That’s why, in our detailed examinations, determining your corneal thickness and map is the most important step that determines the “go/no” decision for the operation.
Another issue is your eye numbers themselves. Laser technology has come a long way, but it still has a limit. Very high myopia, hyperopia, or astigmatism values can unfortunately remain outside the laser’s effective area. Why? Because the higher the number, the more tissue needs to be removed from the cornea for correction. This brings us back to the same risky area, namely the danger of excessive thinning of the cornea. Our goal is not just to save you from glasses, but to provide you with quality and healthy vision that you can carry for a lifetime. That’s why, instead of laser, we recommend different and safer technologies such as phakic IOL (intraocular lens) that are placed inside the eye and correct the number for our patients with very high numbers. Not to offer the same treatment to everyone, but to offer everyone the most suitable treatment for themselves… That’s the whole point.
General Condition of the Body: Age, Diseases and Other Obstacles
Our eyes are not independent organs from the rest of our body. If things are not going well in the body, the eyes will also suffer sooner or later. That’s why we evaluate you as a whole, not just your eyes, before laser surgery. Some systemic diseases or conditions can prevent laser surgery because they directly affect the body’s healing capacity. This is a precaution we take to prevent problems during the recovery period, even if the surgery itself goes smoothly. So what are these situations?
There are some “red flags” that we especially focus on in our interviews with our patients. Knowing these clearly is very important in order to manage expectations correctly. Here are some of the conditions that definitely or probably prevent laser surgery:
- Uncontrolled Diabetes: Constant fluctuations in blood sugar both temporarily change the eye number and seriously impair wound healing.
- Autoimmune Diseases: Active and uncontrolled diseases, such as Lupus and Rheumatoid Arthritis, where the body attacks its own tissues, can make the corneal healing process unpredictable.
- Unstable Eye Number: This is especially true for our young patients. If your eye number has been changing for the last 1-2 years, rushing to have surgery means going back to the beginning after a few years. It is essential to wait for the number to “settle”.
- Pregnancy and Breastfeeding: Hormones! The hormonal storm in the body causes temporary fluctuations in eye numbers. Measurements taken during these periods are not reliable. It is best to wait for this special process of nature to be completed.
- Certain Eye Diseases: Active eye diseases such as advanced glaucoma (eye tension), history of keratitis, uveitis, or untreated severe dry eye syndrome are also obstacles to laser.
To be clear, this list is not to scare patients, but to protect them. A 19-year-old university student came to us recently. He was very eager to get rid of his glasses as soon as possible. However, we saw in his measurements that his number had still changed in the last year. When we explained the situation to him, his face fell, but when he understood why we had to wait and that it was for his own good, he agreed with us. Being patient for a year or two is much better than regretting a lifetime, right?
