High myopia (-6.50) with borderline corneal thickness + blepharitis — LASIK vs SMILE vs TransPRK vs ICL?
Hey all, I'm 25 and trying to get a read on which direction to push toward before my consultation. Current prescription is -6.50/-0.75 OD and -6.50/-0.75 OS (my left eye actually crept up from -6.00/-0.50 to -6.50/-0.75 over the last ~21 months; right eye's been rock stable).
Central corneal thickness came in at 535 microns on a screening, which is just under the population average, so nowhere near "thin cornea" territory but also not giving me a ton of buffer. I also got diagnosed with blepharitis recently and I'm doing the whole warm compress / lid wipe routine twice a day to get my ocular surface calmed down before anyone will even consider operating.
Given the corneal thickness and the blepharitis, I'm leaning toward ICL or TransPRK since they're the least dependent on my cornea being pristine, but I know TransPRK's recovery week is supposed to be rough (blurry vision, real discomfort for several days vs 1-2 days for SMILE/ICL) and ICL is a lot more expensive and comes with lifelong endothelial cell count monitoring since it's intraocular.
LASIK's obviously appealing for the fast recovery but I keep reading that it's the least tissue-conserving option and carries the highest dry-eye risk of the bunch, which worries me given I already have blepharitis. SMILE seems like a reasonable middle ground but I don't have much info on it.
Has anyone here been in a similar boat (moderate-high myopia, average-ish corneal thickness, and needing to deal with blepharitis first) and can share how their surgeon actually ranked these options once they had the real tomography/topography numbers in hand? Also curious about real-world experiences with TransPRK's recovery week specifically, and whether anyone regretted going ICL vs. laser given the extra cost and monitoring requirement. I'm in the Toronto area if pricing comparisons are useful.
Appreciate any input!