One of my recent patients with retinal detachment (aka “RD”) had LASIK for myopia 5 years previously. He wondered whether his LASIK surgery had caused his problem. I reassured him that this was likely related to his pre-existing myopia (near sightedness). People who are myopic are 4 times more likely to develop a detachment than people who do not need to wear glasses or contact lenses.
Why Nearsightedness (Myopia) is a Risk for Retinal Detachment
The myopic eyeball is longer than normal and this causes stretching of the retina layer inside the eye which can lead to holes in the retina. The vitreous jelly in the eye also detaches from the retina in myopic people at a much earlier age (a process called posterior vitreous detachment, PVD). PVD can also cause holes in the retina which can lead to retinal detachment.
LASIK Does NOT Change Risk
Some people believe that after they have had LASIK surgery, their myopia is ‘cured’ and they are no longer at risk of retinal detachment. This is not true as LASIK only treats the front of the eye, the cornea. It reshapes the cornea to focus the light rays directly onto the retina so that you do not need to wear glasses again. However, the eyeball size remains longer than normal and the retina is still at risk of future “RD.”
All LASIK surgeons thoroughly check the retina of their patients before surgery to ensure that there are no holes or other signs of retinal disease present. If there are suspicious areas in the retina, these patients are normally referred to a retinal specialist for their opinion. Laser treatment can be done to retinal holes to prevent retinal detachment.
LASIK Probably NOT a Risk for Retinal Detachment
As LASIK surgery is now so commonly done for young myopic people, it is not surprising that some of these people develop retinal detachment years later. It is tempting to link LASIK and a detachment together but most studies have not shown an association. These people would have got a retinal detachment anyway, whether or not they had LASIK surgery in the past. This is due to their eye which has always been myopic.
For more information about myopia, please check out this article I wrote recently in my medical column in the Star newspaper.