Can Corneal Scarring Impact LASIK Surgery Outcomes?

In this comprehensive guide, we’ll explore the relationship between corneal scarring and LASIK surgery outcomes. It is often a result of injury or disease and can affect vision correction procedures, such as LASIK. Understanding the causes, effects, and treatment options is essential for patients considering LASIK and experiencing corneal scarring.

What Is Corneal Scarring?

Corneal scarring or eye scarring refers to damage to the cornea – the transparent, dome-shaped surface of the eye. This can result from injuries, infections, or underlying conditions. The scarred tissue disrupts the smooth structure of the cornea, causing blurred or distorted vision. Severe scarring can compromise the success of LASIK surgery by interfering with the procedure’s precision and outcomes. Let’s take a look at the causes of corneal scarring.

Also Read: Corneal Thickness & LASIK

Causes of Corneal Scarring

Injuries

• Physical trauma to the eye can lead to scarring:
• Penetrating Injuries: Cuts or punctures from sharp objects like glass or metal can leave permanent scars.
• Chemical Burns: Exposure to acids or alkalis can damage the corneal tissue, with alkalis being particularly severe.

Infections

Certain eye infections can result in scarring if untreated or severe:

• Keratitis: Inflammation caused by bacteria, fungi, or viruses that can erode the cornea.
• Herpes Simplex Virus: Viral infections can cause recurrent corneal ulcers, leading to scarring.
• Contact Lens Infections: Improper care of lenses can result in bacterial or fungal infections, which may scar the cornea.

Underlying Diseases

Eye conditions can predispose individuals to scarring:

• Keratoconus: A thinning and bulging cornea can lead to structural irregularities and scarring.
• Corneal Dystrophies: Genetic disorders that cause abnormal deposits in the cornea, resulting in clouding and scar formation.

Post-Surgical Complications

Corneal surgeries, while often successful, can sometimes cause scarring:

• Corneal Transplants: Healing issues or rejection of the graft can result in scars.
• Refractive Surgeries (e.g., LASIK): Rarely, improper healing or infection can cause scarring.

Foreign Bodies

Objects like sand, glass, or metal fragments can scratch or embed in the cornea:

• Superficial Scratches: Minor abrasions may heal quickly, but deeper scratches can leave scars.
• Debris Left Untreated: Persistent irritation or infection from foreign bodies can worsen the damage.

Severe Dry Eye

Dry eye conditions can lead to chronic irritation of the cornea:

• Inflammation and Damage: Prolonged dryness can create micro-tears, leading to scarring.
• Exposure Keratopathy: Lack of tear protection in severe cases can damage the corneal surface

How Does Corneal Scarring Affect LASIK Surgery?

Corneal or eye scarring can influence the suitability and outcomes of LASIK surgery, but it depends on the type of scar and its location. While a faint scar may be alright, thick and deep scars can be a problem for flap development. Similarly, if it’s a central scar, LASIK is not recommended. Other factors here are:

Irregular Corneal Surface

A smooth corneal surface is essential for LASIK. Scarring disrupts this smoothness, making it difficult for the laser to target the cornea evenly. This can result in incomplete or uneven vision correction, potentially leading to issues like glare or halos after surgery.

Reduced Corneal Thickness

LASIK involves reshaping the cornea by removing small amounts of tissue. Scar tissue can thin the cornea, reducing the amount of tissue available for reshaping. If the cornea is too thin, the structural integrity may be compromised, and LASIK may not be a safe option.

Increased Risks

Patients with corneal scarring face higher risks during and after LASIK, including:

• Complications in Laser Application: Irregular or scarred areas may not respond predictably.
• Slower Healing: Scars can complicate recovery and lead to prolonged discomfort.
• Higher Infection Risk: Scarred areas are more prone to irritation and inflammation.

For patients with significant scarring, alternatives like PRK or implantable contact lenses (ICL) may be recommended.

Treatment for Scarred Cornea

Corneal scar repair can happen in multiple ways.

Medications

• Antibiotics: To treat underlying infections and prevent further damage.
• Anti-inflammatory Drops: To reduce swelling and irritation.
• Lubricating Drops: To relieve symptoms caused by dryness.

Non-Surgical Interventions

• Contact Lenses: Scleral lenses can provide smoother vision surfaces.
• Eye Patching: For minor abrasions or early scarring.

Surgical Interventions

• Corneal Transplant: Replaces damaged corneal tissue with healthy donor tissue.
• Phototherapeutic Keratectomy (PTK): Removes superficial scarring and irregularities using a laser.
• Amniotic Membrane Transplant: Repairs corneal scars and promotes regeneration.
• Artificial Corneal Implants (Keratoprosthesis): For advanced damage when other treatments fail.

Advanced Laser Techniques

• Topography-Guided LASIK: Customized to individual corneal irregularities.
• Wavefront-Guided LASIK: Targets specific aberrations caused by scarring.

Also Read: Corneal Topography

Lifestyle Tips to Maintain Corneal Health

• Protect Your Eyes: Wear protective eyewear during activities prone to injury or exposure to chemicals.
• Maintain Eye Hygiene: Wash hands regularly to prevent infections.
• Use Artificial Tears: To combat dryness and irritation.
• Balanced Diet: Include foods rich in vitamins A and E for eye health.
• Regular Check-Ups: Monitor your eye health, especially if you’ve had injuries or surgeries in the past.
• Avoid Rubbing Eyes: This can exacerbate scarring or irritation.

Take the first step towards a life without glasses or contact lenses. Schedule an appointment at Planet Lasik

Frequently Asked Questions