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Your question:

Dear Dr. Gatinel,
Because of the finesse of my cornea, I thought that a LASIK operation was not possible (myopia of-5.50 and cornea of 453). One of your colleagues told me about the possibility of doing this with the LASIK Xtra technique. What do you think of this technique? And what would be the most appropriate solution for you?
Thank you

Our answer:

The LASIK Xtra is a controversial technique, which involves conducting a crosslinking in conjunction with LASIK. If you read the sacred pages to the technique of crosslinking on this site, you will understand in more detail why I would not recommend to realize this association in your situation. Crosslinking (CXL) is designed to harden the cornea, but no clinical studies are able to demonstrate any tangible hardening of the corneal dome after CXL, and the measured changes are in the healing of the corneal epithelium and the consequences of Inflammation caused by this technique within the tissue of the cornea. In addition, the combination of a flap cut, an excimer laser photoablation, followed by exposure to ultraviolet light (required in crosslinking case) exposes certain complications (marked inflammation and Interface).

The PKR (surface laser), without associated cross linking, is a certainly safer technique in your case, if the myopia is stable, the normal cornea for each eye (apart from the finesse). Prior to the introduction of CXL, many studies have shown that PKR can be effective and safe in the medium term on fine corneas and even horns with keratoconus. The "Success" (in number of procedures performed) of the CXL is explained by the patient's demand for more "safety" (illusory benefit in my opinion with regard to the CXL), and the financial advantages that this technique provides (increase in the price of the procedure of refractive surgery coupled with CXL...).

Of course, you should absolutely avoid rubbing your eyes vigorously and repeatedly, with fine corneas being more easily prone to deforming in case of repeated mechanical stress.

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