Thin Cornea Treatment Options

The cornea is an amazing piece of tissue. Located at the very front surface of the eye. The clear dome over the coloured iris, the cornea comprises of five layers of tissue. The layer of the cornea is designed to be optically transparent. The average cornea is approximately 550 microns thick. Light must be able to pass through this structure unhindered. As well as other structures, such as the crystalline lens. To reach the sensory retina at the back of the eye to provide vision. The cornea also provides a surface for the tear film. The layer of moisture with many functions, to adhere. The cornea and the tear film provide the majority of the refractive power of the eye. Meaning that light bends to the greatest degree when passing through these structures. To come to a clear and focused point on the retina. The crystalline lens accounts for the remaining third of refractive power.

Refractive Error

Refractive error arises when the power of these anatomical components, the cornea and the crystalline lens, are not well coordinated with the physical length of the eyeball. In long-sightedness (hyperopia) the eyeball is too short for its refractive power. In short-sightedness (myopia) it is too long. LASIK and PRK are traditional refractive surgery techniques. They have sought to address this mismatch of refractive power to eyeball length. By reshaping the cornea and changing its refraction. However, difficulties arise with a thin cornea. Since treatment options become limited when there is less corneal tissue to work with.

Thin Cornea Treatment

Some refractive procedures are better suited than others for addressing thin corneas. Treatment suitability is also subject to other eligibility criteria. Such as pre-existing corneal disease and even lifestyle factors. Choosing the appropriate candidates for each type of procedure is important for success. The least corneal thickness required for refractive surgery is dependent on the degree of refractive error for correction. The higher the prescription, the more corneal tissue that needs removing. If too little residual corneal tissue is left after surgery, there is the risk of a condition known as keratectasia. This refers to warping and distortion of a structurally weakened cornea.

LASIK

The LASIK procedure involves the creation of a flap of corneal tissue. This already reduces the amount of tissue available for reshaping.

PRK

PRK surgery circumvents this problem by removing the very top layer. Known as the epithelium. Leaving the rest of the corneal tissues available for sculpting by excimer laser. For some, corneal thickness and prescriptions exclude them even from PRK surgery. But there are still other treatment options available. Such as, refractive surgery techniques that do not involve the typical laser reshaping of the cornea.

ICL

Intraocular contact lenses, or implantable contact lenses (ICL), involve an artificial lens made of biosynthetic materials inserted between the iris and the crystalline lens. The only disruption to the cornea is a small incision to position the intraocular contact lens inside the eye. No corneal tissue is removed during this procedure. So there is no minimum corneal thickness requirement. Intraocular contact lenses are able to correct very high degrees of myopia, hyperopia, and astigmatism. This would be unachievable with corneal refractive techniques such as LASIK or PRK.

Refractive lens exchange

Refractive lens exchange (RLE) is a procedure akin to cataract surgery. But performed in the absence of a cataract (that is, while the crystalline lens is still clear). It involves removal of the eye’s natural crystalline lens and replacing it with an artificial lens implant. Known as an intraocular lens, which is calculated to account for the refractive error of the eye. Like the intraocular contact lens technique, refractive lens exchange does not need any removal of corneal tissue. Involving minimal disruption to this structure. Patients with thin corneas and who have passed the age of presbyopia (the natural age-related decline of near vision) are best suited to this procedure. Several eligibility criteria apply to ensure that any refractive surgery technique is safe and effective for you. There are options in the form of both traditional and newer surgical procedures. Allowing patients with thin corneas the freedom from glasses and contact lenses. To discuss which treatments are best for you, contact Eye Laser Specialists now to organise your initial consultation. Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from a qualified health practitioner.

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About the expert

Dr Anton van Heerden, MBCHB; FRANZCO
Ophthalmologist & Laser Eye Surgeon

Based in Melbourne, but with a reputation that transcends borders, Dr Van Heerden sets the highest bar for laser vision correction surgery in Australia. While his skills and experience are second to none, it is his fun, caring and down to earth nature that truly set’s him apart from the rest. You can sit back and enjoy the journey knowing every detail has been carefully considered.

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