1. Custom wavefront lasik takes off about 15 microns/diopter so at -8, you lose 120 microns. At 498 cornea its too thin for any lasik. 498- 120- thin flap is 90-100 microns. This leaves you with under 300 microns. That is too thin. A. Because it weakens the structure of your eye, and b. because at a high prescription you might not get to plano on the first try and might want to opt for a second surgery, there would be no way to do that. Hence PRK or IOL are your only options.
2. I know nothing about IOL.
3. If you have great vision with contacts or glasses then dont do the surgery. I personally wish I had never done it, and cant believe that so many people are glad they did it. I had thin flap lasik all laser with custom wavefront. The regrets are as follows: 1. There is a permanent flap in your eye. Docs never tell you that, you find that out AFTER through sites like these. Some argue that thin lasik is similar to prk and that these thin flaps do heal all the way back to the original but i have seen 0 studies to support or contradict that - to me it is a theory; 2. There is no gaurantee that you wont get any of the bad results - i think with prk you are faced with haze, lack of crispness in your vision, dry eye, starbursts. If you dont have any of that now, why would you trade down? I thought that with lasik I was trading up based on all of the accolades that my friends gave it. I now see it as a big risky trade down. My vision overall was way better with contacts and my eye health was certainly better. Should have waited until i was 80, got some cataracts, and then got the IOL.