Today I met a patient in the LASIK Center with two scars in the right cornea from ulcers due to contact lens wear. She was asking if the scars would remain following LASIK surgery.

Ulcers and trauma to the cornea can sometimes form scars if they penetrate beyond the layers of the epithelium. These scars will most likely be permanent since the inner layers of the cornea do not recycle like the outer epithelial layer. These superficial scars are generally not a problem for LASIK unless they are very thick and very deep, in which case they could affect the creation of the flap.

Since PRK treats the underlying Bowman’s layers as well as the outer layers of the stroma, PRK can remove these scars but has a longer healing time than LASIK. If the scars do not affect vision, most surgeons will not change treatments in order to be rid of a scar that has no effect on visual performance.

When I see patients with multiple corneal scars, I do tend to think that LASIK is a much safer and healthier alternative to contact lens wear for these patients. This patient will probably be safer with a one-time surgical procedure than in continued contact lens wear for the next 20 years.