According to this study: (ScienceDirect - Journal of Cataract & Refractive Surgery : Simultaneous laser in situ keratomileusis on the stromal bed and undersurface of the flap in eyes with high myopia and thin corneas) if the cornea is too thin to perform LASIK on highly myopic eyes, the underside of the flap can be lasered as well as a portion of the stromal bed. I wonder if a center mark is placed on the cornea before the flap is made so the surgeon can make sure the laser is centered properly. This would be interesting to watch. About 80% of patients obtained 20/30 or better post-operatively. The conclusion of the study was
"Simultaneous LASIK appears to be a useful surgical aid in LASIK treatment in eyes with high myopia with or without astigmatism when an adequate residual stromal bed does not exist."
Our LASIK surgeon e-mailed me the following after reviewing this article: "Yeah, that is interesting, but with our laser we can't do that because the
ReplyDeletelaser tracks the eye on the pupil so it won't track on the underside of
the flap. What I have done is just do the enhancement with PRK- just
treat the flap directly from the surface. It works well and our laser CAN
to that. It hurts less than regular PRK because the lasik flap has cut
most of the nerves."