Keratoconus is generally considered to be a contraindication for conventional or custom wavefront Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, or any other refractive surgery technique that removes tissue. There is a possibility that these procedures could further weaken a cornea that is affected by keratoconus resulting in a further unstable cornea.
Keratoconus can be diagnosed with corneal thickness measurements, slit lamp microscopy, as well as topography and orbscan measurements. Should keratoconus be discovered, it would be recommended that LASIK or other similar laser vision correction not be attempted.
As keratoconus is a progressive eye disease, LASIK and similar laser vision correction could increase the rate of the disease and ultimately require a corneal transplant or other more invasive surgery. Keratoconus causes a thinning of the cornea, the clear front surface of the eye. As LASIK, PRK, and other laser vision corrective surgeries also thin the cornea, the combination of both keratoconus and LASIK would often be a poor choice.
As keratoconus progresses, the quality of vision deteriorates. Often people with keratoconus seek out laser vision correction at this point, including LASIK and PRK, in hopes that their vision can be improved. Unfortunately, LASIK, PRK and other laser vision correction is the exact opposite treatment that is required to help keratoconus. Since performing LASIK further thins the cornea, the vision would become even worse and could result in ectasia, a bulging of the cornea outward.
It has been suggested that since keratoconus does not tend to progress as much after age 40, that perhaps surface laser vision treatment, such as PRK but not LASIK, might be allowed in cases of early keratoconus where there is no sign of progression. Studies in Europe are testing this theory. A conservative surgeon would not perform LASIK or other laser vision correction in fear of activating a non-progressive state of the disease.
Keratoconus requires a diagnosis from a professional eye doctor, preferably a corneal specialist. After a complete eye examination this eye doctor can determine if LASIK would be contraindicated. In each case, the specialist can then recommend the best course of treatment to provide the healthiest eye and the best possible vision.