Laser eye surgery is usually not suitable for significantly irregular corneas, because irregularity often signals underlying weakness or disease.
Why irregularity is a concern
Irregular corneal shape can reflect ectasia, scarring, or previous infection, all of which can behave unpredictably after ablation.
- Topography/tomography showing asymmetric or distorted curvature patterns
- Irregular astigmatism that glasses cannot fully correct
- Associated thinning or posterior bulging on scans
- History of trauma, ulcers, or surgery that weakened structure
- Higher risk that laser could worsen irregularity and reduce vision quality
Alternative ways to improve vision
Other treatments can often provide clearer, safer vision than corneal laser in these situations.
- Specialist contact lenses such as RGP or scleral designs to mask irregularity
- Cross-linking for progressive ectasias like keratoconus
- Topography-guided surface treatments combined with cross-linking in select cases
- Partial or full-thickness corneal transplantation when scarring is advanced
- ICLs or lens surgery once the corneal issue is stabilised
