Is LASIK and squint surgery recommended for exotropia?

Question

Hello doctor,

I have had an exotropia squint in my right eye for the last 10 to 12 years. Presently I have very low vision in that eye, and near and far vision is blurry. I consulted an ophthalmologist, and he recommended a LASIK surgery and, after that, a squint correction surgery a month later. Should I go for that? I am attaching my prescription for your reference.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your images (attachment removed to protect patient identity). You can proceed with the LASIK surgery and the squint correction as advised.:Your right eye is amblyopic (lazy eye). So, the vision, even after a LASIK, will be 6/18 p and not 6/6. As your eye power is very high, you will have some residual power even after the LASIK. Moreover, your squint is also very large. So, you may need to get both eyes operated on for the squint correction. Even after this surgery, there will be a residual deviation. Do discuss with your doctor regarding these points.

Answer 2

Hello,

Welcome back to icliniq.com.

Sorry, I did not mean that. I am just asking you to keep your expectations a little low.

Regarding squint, you may need to get both eyes operated on for this large angle of exotropia. Surgery gives a favorable outcome in 90 % of the patients, but a little under or overcorrection is possible. Regarding LASIK, there are two aspects to understand:

As your right eye seems amblyopic, the vision in the right eye will be 6/18, even after the LASIK. That is, it will be less than your left eye.
You have very high myopia in the right eye. So, there may be some residual refractive error even after LASIK.

I am not discouraging you, and I would recommend these surgeries to you. But, sometimes, patients have huge expectations from surgery. I am just requesting you to understand the fact and outcome of the surgery. The difference in corneal thickness of the two eyes is around 40 microns. For such a huge difference, I usually repeat pachymetry.

I hope this helps.

Regards.