Conventional laser eye surgery is not suitable for people with keratoconus, because it removes tissue from a cornea that is already structurally weak.
Why keratoconus is a contraindication
Keratoconus involves progressive thinning and bulging of the cornea, so further thinning with LASIK or PRK can accelerate ectasia.
- Topography and tomography show cone-shaped protrusion and irregular astigmatism
- Residual stromal thickness is often low even before surgery
- Studies link pre-existing ectatic patterns to post-LASIK ectasia
- Laser ablation would not provide stable or predictable vision
- International guidelines generally list keratoconus as an absolute exclusion
Safer alternatives for keratoconus
Other treatments can stabilise the cornea and improve functional vision without removing more tissue.
- Corneal cross-linking to strengthen and halt progression
- Rigid gas permeable, scleral, or hybrid contact lenses to smooth the optical surface
- Intracorneal ring segments or partial transplants in advanced cases
- ICLs once the cornea is stable and safe for intraocular surgery
- Ongoing monitoring and avoidance of eye rubbing to protect long-term vision
