Laser vision correction reshapes the cornea to improve how light focuses onto the retina. It does not improve retinal function itself.
If the macula, the central retina responsible for fine detail vision, is unstable or diseased, corneal precision cannot compensate for reduced retinal performance.
Guidelines caution against elective refractive surgery in the presence of uncontrolled retinal disease, particularly active diabetic retinopathy or macular oedema. ¹ Clinical reports have also described progression of diabetic retinopathy in some patients following LASIK when systemic control was suboptimal. ²
Red flags include:
- Active diabetic macular oedema
- Recent intravitreal anti-VEGF therapy
- Neovascular age-related macular degeneration
- Myopic choroidal neovascularisation
- Unexplained reduction in best-corrected acuity
Even if surgery itself does not directly worsen retinal disease, elective corneal intervention should not proceed while the macula is unstable.
At Blue Fin Vision®, retinal stability is a prerequisite before refractive surgery is considered. High-resolution OCT imaging forms part of screening when indicated.
Laser surgery is designed to optimise optical quality. It must never distract from prioritising retinal health.
Clarity begins at the macula.
References
- American Academy of Ophthalmology Refractive Surgery PPP Panel. Refractive Surgery Preferred Practice Pattern®. Ophthalmology. 2017;124(1):P1-P104.
- Choi JA, Han K, Kim T. Progression of diabetic retinopathy after LASIK. Retina. 2011;31(3):493-499.
- Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Arch Ophthalmol. 1985;103(12):1796-1806.
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