Borderline corneal thickness requires especially cautious planning, and in some cases laser eye surgery is modified or avoided to protect corneal strength.
Careful assessment in borderline cases
Detailed scans and ectasia risk models help decide whether the combination of thickness, curvature, and prescription is acceptable.
- Use of tomography to assess anterior and posterior elevation patterns
- Calculation of residual stromal bed and percentage tissue altered
- Comparison with published ectasia risk thresholds
- Review of any asymmetry between eyes or family history of keratoconus
- Potential preference for PRK over LASIK to preserve more tissue
When a different path is safer
If risk remains above acceptable levels, non-thinning options usually become the first recommendation.
- ICLs or lens procedures to correct refractive error internally
- Cross-linking, with or without limited laser, in selected ectasia-prone cases
- Continuing with high-quality spectacles or contact lenses
- Regular monitoring to detect any spontaneous corneal weakening
- Clear explanation so the decision not to operate feels informed, not disappointing
