Yes, you can get LASIK if you have a scleral buckle, but it depends on the health of your eyes, the integrity of the scleral buckle, and the condition of your retina.
A detailed evaluation by an experienced ophthalmologist is crucial to determine whether LASIK is safe and suitable in your specific case.
To help you better understand, this blog explores the relationship between LASIK and scleral buckles, explaining the key considerations, potential challenges, and factors influencing candidacy.
What Is a Scleral Buckle?
Before discussing LASIK candidacy, it’s essential to understand what a scleral buckle is.
A scleral buckle is a flexible band surgically placed around the eye to treat a retinal detachment, a condition where the retina separates from the back wall of the eye. The buckle applies pressure, reattaching the retina to the supportive tissue and preventing further detachment. It can remain in the eye permanently unless complications arise.
Patients with scleral buckles may have undergone this procedure years ago or more recently. The buckle itself does not directly interfere with vision. Instead, any visual issues are often a result of retinal damage. Many people with scleral buckles wonder if they can benefit from LASIK to correct refractive errors like nearsightedness, farsightedness, or astigmatism.
What Is LASIK, and How Does It Work?
LASIK (Laser-Assisted in Situ Keratomileusis) is a popular refractive surgery that reshapes the cornea using a specialised laser. Its goal is to reduce dependency on glasses or contact lenses.
The procedure involves:
- Creating a thin corneal flap.
- Reshaping the underlying cornea to correct its refractive errors.
- Repositioning the corneal flap to heal naturally without the need for stitches.
While LASIK has a high success rate, the decision to proceed with LASIK depends on many factors, particularly in patients with pre-existing eye conditions like those with a scleral buckle.
Factors to Consider Before LASIK With a Scleral Buckle
Whether LASIK is an option for you depends on the following critical factors:
1. Eye Health and Retinal Stability
The primary consideration for patients with a scleral buckle is the health and stability of the retina. Since the scleral buckle is placed to treat significant retinal issues (such as detachment), it is crucial that the retina is fully healed and stable. Performing LASIK on an unstable retina could increase the risk of complications.
Your ophthalmologist will assess your retinal health through detailed retinal imaging and testing before recommending LASIK. If your retina remains fragile or prone to further issues, LASIK might not be suitable.
2. Corneal Thickness
LASIK reshapes the cornea, and patients must have sufficient corneal thickness to support the procedure. Individuals with a scleral buckle can undergo tests like a corneal topography scan to verify that their corneal tissue is thick enough for LASIK. If your cornea is too thin, alternative vision correction surgeries like PRK (Photorefractive Keratectomy) or implantable contact lenses (ICLs) may be more appropriate.
3. Impact of the Scleral Buckle on the Eye’s Structure
Although a scleral buckle typically does not interfere with the cornea where LASIK is performed, it may slightly alter the eye’s overall shape or biomechanics. This could make specialised LASIK technologies, like wavefront-guided LASIK, necessary to achieve accurate results.
Additionally, your doctor will consider how the scleral buckle affects eye pressure and fluid dynamics when evaluating LASIK candidacy.
4. Previous Vision Preservation After Retinal Detachment
The extent of any functional vision loss resulting from your retinal detachment is another significant factor. LASIK corrects refractive errors like myopia or astigmatism, but it does not restore vision impaired by retinal damage. If your visual issues are mainly due to prior retinal trauma, LASIK may not provide the full improvement you hope for.
Important: LASIK enhances the clarity of refracted light onto the retina, but it cannot correct loss from previous retinal injuries.
5. Potential for Eye Discomfort or Dryness
Scleral buckles can sometimes cause a degree of surface discomfort or dryness for patients already managing post-detachment symptoms. Since dry eye is a common side effect after LASIK, combining these factors might exacerbate discomfort. Doctors will assess your tear production and overall ocular surface condition before deciding on LASIK.
6. General Suitability for LASIK
Apart from your scleral buckle, you must meet other standard LASIK criteria:
- Being at least 18 years old.
- Having a stable glasses/contact lens prescription for at least 1 year.
- No active eye infections or severe dry eye syndrome.
- Not pregnant or nursing, as hormonal changes can impact eye stability.
Challenges and Risks of LASIK in Patients With a Scleral Buckle
While LASIK is generally safe, patients with scleral buckles may face additional challenges and risks, including:
- Compromised Retinal Support: Even minor changes in intraocular pressure during LASIK could potentially pose risks for eyes with a history of detachment. Surgeons must take precautions.
- Limited Vision Improvement: If pre-existing retinal damage obscures visual clarity, LASIK won’t address this underlying issue. Patients need realistic expectations.
- Surgical Complexity: Having a scleral buckle might require more intensive preoperative planning to tailor LASIK for your unique anatomy.
It’s vital to choose an experienced LASIK surgeon who is familiar with treating individuals with previous retinal detachments.
Alternatives to LASIK for Vision Correction
If LASIK is deemed unsuitable due to your scleral buckle or other factors, alternative vision correction options include:
1. PRK (Photorefractive Keratectomy)
PRK is often recommended for patients with thin corneas or unique eye conditions. Unlike LASIK, PRK reshapes the cornea without creating a flap, which reduces the risk for individuals with structural eye concerns. However, recovery time is longer than that of LASIK.
2. Implantable Contact Lenses (ICLs)
ICLs are surgically placed inside the eye to correct refractive errors. They are a good alternative for patients who cannot undergo corneal-based procedures like LASIK or PRK.
3. Continued Use of Glasses or Contacts
If surgery is not a viable option, custom prescription glasses or contact lenses can still provide effective vision correction.
Frequently Asked Questions
Can having a scleral buckle affect LASIK results?
The scleral buckle itself usually does not interfere with the mechanism of LASIK because LASIK focuses on reshaping the cornea. However, precautions are required to ensure the retinal repair remains unaffected.
How long after retinal detachment surgery can I consider LASIK?
Doctors typically require a healing and stabilisation period of at least 6–12 months after a retinal detachment repair before evaluating LASIK candidacy. This ensures that the retina is stable and ready to support postoperative healing.
Will LASIK reverse vision changes caused by retinal damage?
No, LASIK only corrects refractive errors like myopia or astigmatism. Vision loss caused by retinal damage will not improve with LASIK.
Making the Decision
If you have a scleral buckle and are considering LASIK, the next step is to book an evaluation with a qualified LASIK surgeon and ophthalmologist. During the consultation, they will assess your eye health and retina, ensuring it’s safe to proceed.
To maximise safety and a favourable outcome, it’s crucial to follow your doctor’s advice. By undergoing personalised testing and understanding your options, you can make an informed decision tailored to your eye’s unique needs.
Final Thoughts
LASIK is possible for scleral buckle patients, but only if the eyes meet the required health conditions. With the right surgeon, thorough testing, and consideration of alternatives, achieving improved vision is within reach.
If LASIK isn’t suitable, explore alternatives like PRK or ICLs for effective vision correction tailored to your requirements.
Don’t hesitate to consult your ophthalmologist today to discuss your path to better vision!
