I have recently had another consultation with an actual Surgeon who says I am suitable for lasik but I may only be able to get down to -1. At present I am -10 and my cornea thickness is 535. My Lasik operation is booked for 26th Jan

do not do LASIK if you have borderline corneal thickness. If your surgeon can only bring you down to -1.00 initially, then you obviously do not have enough corneal thickness to consider surgery.
As you may know - patients with higher degrees of myopia are at much higher risk of regression. So if you have surgery, you may end up regressing back to -2.00 or even worse. And then you would not have any more room for further surgery.
As well - the microkeratome can occasionally cut deeper then expected. There is no way to know before surgery how deep your flap will be. Plenty of studies have shown that there is a large range in flap thickness. So if you end up with a thick flap - then you can only have a smaller treatment (a goal of -2.00 or -3.00). If your surgeon does not measure the flap thickness, then you might accidently get a deep flap and then have too much treatment - putting you at risk for ectasia (which is where the cornea becomes week).
Instead - you have 2 options

1. Surface ablation (PRK/LASEK): This surgery has been around for 10 years, and uses the same laser as LASIK - but no flap is cut. So by being superficial - you can have a full treatment and you can also have an enhancement if necessary.
The downside of PRK/LASEK is that there is a risk of haze, and the risk is higher with higher levels of myopia. In my practice, I advise my PRK patients who are -10.00 to avoid UV light exposure and to take Vitamin C orally for 1-2 months after surgery. As well, your surgeon can opt to use an anti-haze medication called mitomycin C at the time of surgery. The mitomycin C is very effective, but the long term risks are not clear. Finally, if your doctor uses mitomycin C, he/she must reduce the amount of treatment in the cornea by 10%.
Option 2: Phakic Intraocular lens. This technology is available in many countries throughout the world, but is still investigational in the US. I am a clinical investigator for one company, and the results have been very good. However, the FDA wants to see 3 year followup on all patients before giving approval.
I hope this helps

Bill Trattler,MD
Miami,FL

>do not do LASIK if you have
>borderline corneal thickness. If your surgeon
>can only bring you down to
>-1.00 initially, then you obviously do
>not have enough corneal thickness to
>consider surgery. As
>you may know - patients with
>higher degrees of myopia are at
>much higher risk of regression. So
>if you have surgery, you may
>end up regressing back to -2.00
>or even worse. And then
>you would not have any more
>room for further surgery.
>As well - the microkeratome can
>occasionally cut deeper then expected.
>There is no way to know
>before surgery how deep your flap
>will be. Plenty of studies have
>shown that there is a large
>range in flap thickness. So
>if you end up with a
>thick flap - then you
>can only have a smaller treatment
>(a goal of -2.00 or -3.00).
>If your surgeon does not
>measure the flap thickness, then you
>might accidently get a deep flap
>and then have too much treatment
>- putting you at risk for
>ectasia (which is where the cornea
>becomes week). Instead -
>you have 2 options

>1. Surface ablation (PRK/LASEK): This
>surgery has been around for 10
>years, and uses the same laser
>as LASIK - but no flap
>is cut. So by being
>superficial - you can have a
>full treatment and you can also
>have an enhancement if necessary.
> The downside of
>PRK/LASEK is that there is a
>risk of haze, and the risk
>is higher with higher levels of
>myopia. In my practice, I
>advise my PRK patients who are
>-10.00 to avoid UV light exposure
>and to take Vitamin C
>orally for 1-2 months after surgery.
> As well, your surgeon can
>opt to use an anti-haze medication
>called mitomycin C at the time
>of surgery. The mitomycin C
>is very effective, but the long
>term risks are not clear.
>Finally, if your doctor uses mitomycin
>C, he/she must reduce the amount
>of treatment in the cornea by
>10%. Option 2: Phakic Intraocular lens.
>This technology is available in many
>countries throughout the world, but is
>still investigational in the US.
> I am a clinical investigator
>for one company, and the results
>have been very good. However,
>the FDA wants to see 3
>year followup on all patients before
>giving approval. I hope
>this helps

>Bill Trattler,MDMiami,FL

Hi, thanks for your reply which was very helpful and I am considering cancelling my surgery. My surgeon is able to do lasek but has not offered this to me? also as he works in various hospitals he has mentioned that he uses a different machines . Does the type of machine make any difference?