PRK, Lasik advice needed

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

PRK, Lasik advice needed

Postby Borderline » Thu Jul 05, 2007 11:01 pm

So, I have been to two Lasik doctors and had consultations. I have been researching PRK and Lasik, and I am in need of another opinion.

I do not have my exact numbers, but I do have approximates. My cornea is around 571 microns. Both corneas were around that same number.

My latest contact perscription(1 year ago w/ my vision remaining stable) was:

Right eye Left eye
-5 .75 -5.00
- 2.75 -1.50
.005 1.80

My eyeglass perscription was slightly different. With there testing methods, my persription was between -6 and -6.5.

The first lasik center I went to was a significant chain location. They wanted to do PRK with the Alcon LADARVision laser.

The second place I went to was local and the surgeon was a cornea specialist. My opthamologist works with him (and other doctors) and said that is who she would trust. Since then,she has done Lasik with this doctor. The technician seems to think I am a canidate for Lasik. She wants to talk to the surgeon because of the high percentage of cornea the surgery will require to see how he feels about it. After the surgery with CustomCornea Wavefront, my cornea will be 287 microns thick. This is over the 250 micron limit. the technician said that this will still allow for an enhancement if my perscription was off up to 2 diopters. Does this information seem correct? PRK is also an option, but due to my higher level perscription there is a chance of haze. Do you have any insights on this particular situation? I am not the type of person that has to have this surgery. I only want to do something if I am a good canidate. With all of this being said, I do trust the surgeons opinion. It will be a week before I can hear his thoughts on my specific situation. I am interested in hearing anyones opinion about my options.
Borderline
 
Posts: 20
Joined: Thu Jul 05, 2007 9:22 pm
Location: Missouri

Re: PRK, Lasik advice needed

Postby LasikExpert » Sat Jul 14, 2007 9:16 pm

Borderline wrote:Right eye Left eye
-5 .75 -5.00
- 2.75 -1.50


You have significant astigmatism in your right eye that is going to be much more of a challenge to correct.

Borderline wrote:My eyeglass perscription was slightly different. With there testing methods, my persription was between -6 and -6.5.


It is common for contact lens prescriptions to be slightly lower than eyeglass prescriptions.

Borderline wrote:After the surgery with CustomCornea Wavefront, my cornea will be 287 microns thick.


That may be above the 250 micron limit, but this would be disrupting about half the entire thickness of the cornea. A surface ablation like PRK, or its cousins LASEK and Epi-Lasik should be investigated.

Borderline wrote:PRK is also an option, but due to my higher level perscription there is a chance of haze.


The use of Mitomycin C during surgery to change the wound response has all but eliminated PRK haze. Mitomycin C is strong medicine that is probably best avoided if possible, but is appropriate when required.

Borderline wrote:I am not the type of person that has to have this surgery.


This is elective surgery and any surgery is a balance between potential gain v. potential risk. Only you can decide the relative value of the reduced need for corrective lenses. Your surgeon can best advise regarding potential and elevated risk.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Location: California

Surgery booked, but questions still...

Postby Borderline » Sat Jul 14, 2007 10:22 pm

Thank you so much for your response! I have been studying all of the posts on this website, trying to become completely informed.

I have surgery scheduled for July 19th. The surgeon/ Cornea specialist reccomended that I do Lasik. He does not use intralase, but the flap he will make with the mikrokeratome will be 120 microns thick. I expressed to him that I am ok with doing a survice abbalation like PRK. In his office they call it ASA. He still feels that LASIK is a good option for me doing a 120 flap with cutsom wavefront. He mentioned putting a contact bandage over the flap for a few days for extra stability. I have not found any information on this being done.

If I remember my numbers correctly, the technician said I would have 287 microns of untouched cornea with a 160 flap. Now that the surgeon is doing a 120 flap. I am assuming that this will leave 327 microns of untouched cornea. Is it common to have a high percentage of cornea tissue removed? With the amount of cornea tissue being removed, do I have a higher percentage of chance of ecstasia(or any other serious issues)? You mentioned my astigmatisim being more of a challenge to treat, what can I expect from that? Does this mean that the chance of having great vision is decreseard. During the preop, my eye doctor said that I should expect my right eye to be at best 20/30 and my left eye to be significantly better. Also, I am curious if my age factors into the equation to do the surgery? I am relatively young, 25.

I should mention a little about this surgeon, he is highly regarded and he is also a member of the teaching faculty at a University near by. My opthamoligist(of 10 years) said that he tends to be more conservative when deciding who can have the procedure. With this being said, although I have a lot of trust in his opinion to do LASIK, I am concerned about the procedure. I know that being informed about the risks makes the decision to actually do the surgery that much more difficult. The technician told me I was her most informed patient. I can't imagine people not researching this before they do it!

Thank you so much for your advice and postings. This website has been an excellent tool for a very difficult decision!
Borderline
 
Posts: 20
Joined: Thu Jul 05, 2007 9:22 pm
Location: Missouri

Re: Surgery booked, but questions still...

Postby LasikExpert » Sat Jul 14, 2007 11:14 pm

Borderline wrote:In his office they call it ASA.

Advanced Surface Ablation (ASA) is PRK, LASEK, or Epi-Lasik with a wavefront-guided or wavefront-optimized laser. You may want to read about Wavefront Custom Lasik.

Borderline wrote:He still feels that LASIK is a good option for me...

You will make the final decision, but that decision should be based upon the advice of a competent surgeon.

Borderline wrote:Is it common to have a high percentage of cornea tissue removed?

The amount of tissue removed is based upon the amount of correction required. You may want to look at Lasik calculations.

Borderline wrote:With the amount of cornea tissue being removed, do I have a higher percentage of chance of ecstasia(or any other serious issues)?

Of course, however about five decades of practical experience has determined that 250 microns of untouched tissue in a healthy cornea will maintain stability - more is always better.

Borderline wrote:You mentioned my astigmatisim being more of a challenge to treat, what can I expect from that?

Expect that for you Lasik will be a journey, not an event. You will be more likely to have vision fluctuation and need Lasik enhancement surgery. You may get the 20-Minute Miracle, but expect a six month process. Talk to your doctor about these issues.

Borderline wrote:I am relatively young, 25.

Your relative youth provides the advantages of accommodation and a cornea that is probably in better shape than someone older.

Borderline wrote:I should mention a little about this surgeon...

Everything you state sounds good. Feel free to use our 50 Tough Questions For Your Lasik Doctor too.

Borderline wrote:I can't imagine people not researching this before they do it!

Me too, but that is why we are here.

Borderline wrote:Thank you so much for your advice and postings. This website has been an excellent tool for a very difficult decision!

I'm glad that we have been helpful. Be sure to tell all your friends and include a link to us in your personal website, blog, or in other forums.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California


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