Should I get Lasik? (consultation results included)

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.

Should I get Lasik? (consultation results included)

Postby brianmc » Wed Jul 18, 2007 10:42 pm

My options are between intralase with Allegretto vs. intralase with Visx.
Allegretto is wavefront-optimized, meaning they give the same wavefront treatment to everyone. Visx is wavefront-customized for my specific eyes.

Based on the below information, is there anything that should jump out at me regarding one treatment over the other based on my eyes, or are there any glaring contraindications to lasik all-together?

Both centers have told me that I'm a great candidate, but they also obviously have a conflict of interest. I'm hoping someone here can give me a more objective opinion.

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Postby JPD » Thu Jul 19, 2007 5:05 am

I'll admit most of that info means nothing to me, but one observation that did catch my eye was based on the size of your dialated pupils, I think the Allegretto might be a better option. The wavefront optimized Allegretto ablation zone is about 7.5mm, where as the Visx when using the wavefront is 6mm. Your sheet listed your pupils as 6.5mm and 7mm. This isn't huge, and still within the ablation zone, but they are bigger then the fully corrected 6mm and will enter into the "transition zone". You should question the doctor who uses the Visx about this, and see what their opinion is. In fact you should ask both doctors about this. Does each center only use one laser exclusively? Because if they use multiple lasers, it would be good to know why each place recommend what they did. Why didn't they both recommend the Visx, or both recommend the Allegretto. Do you follow my train of thought?

In terms of Laser technology, both the Visx and Allegretto are top of the line equipment.
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Postby brianmc » Thu Jul 19, 2007 10:33 am

I'm concerned about two things.
1. My pupils have been measured with a pupillometer as 7.5/7.0, 8/7, 7/6.5 mm, and the customvue data shows 9/8.8mm. I've heard that both treatments have an optical zone of 6.5mm, and the Allegretto has an ablative zone to 9mm, whereas the Visx has a blend zone to 8mm. When my pupils dilate past the optical zone (at night), I have a higher chance of seeing glare, halos, etc (or so the story goes). I'm not sure which of the two treatments is better for large pupils, or if I simply shouldn't get lasik because of them.

Also, my cusotmvue chart shows that my spherical aberration is slightly negative in my right eye (OD), and I'm concerned that Allegretto's one size fits all wavefront data will account for this incorrectly.

Anyone have insight regarding these two issues?
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Allegreto Wavefromt

Postby Mr.UnPerfect » Thu Jul 19, 2007 11:38 am

I thought the FDA now approved the Allegretto to now do Wavefront (not optimized) treatment. That would solve the issue. the best of both worlds. Allegretto + Wavefront. Yes? No? Maybe?

WaveLight Receives Wavefront-Guided Approval for the ALLEGRETTO WAVE® Excimer Laser System; Wavefront-Guided and Wavefront Optimized™ Treatments Demonstrate Equivalence in Clinical Trials; Procedure Pricing to Remain Same for Both Treatments

"Another one bites the dust"
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Part2 Allegretto vs Visx

Postby Mr.UnPerfect » Thu Jul 19, 2007 11:48 am

I had my eyes checked with a doctor who had both the Allegreto Eye-Q and the Visx custom he said I woud do better with the Allegreto.

The second Doctor I saw had the Visx custom and he threw it out for the Allegretto Wavelight Eye-Q. He is the one who did my procedure.
Doctor does majority of patients with Optimized unless wavefront needed.
Bottom line is it depends on the prescription.

Some people need a Corvette and some people are happy with a Kia.
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Re: Allegreto Wavefromt

Postby JPD » Thu Jul 19, 2007 3:01 pm

Mr.UnPerfect wrote:I thought the FDA now approved the Allegretto to now do Wavefront (not optimized) treatment. That would solve the issue. the best of both worlds. Allegretto + Wavefront. Yes? No? Maybe?


The 400hz Allegretto Eye Q does wavefront guided and optimized, but the regular 200hz Allegretto is wavefront optimized only. So if this is the laser his doctor has, then problem not solved.

I also don't know exactly what you mean by best of both worlds, Allegretto + Wavefront? Wavefront is good yes, but are you implying the Allegretto is a lot better then the Visx? For one thing, FDA studies have shown the Visx and Allegretto to be very comperable, and additionally a study done by Opthomologists in the U.S. Navy have show the Visx to be superior to the Allegretto. The Margin of superiority is small of course, and I believe it was comparing the wavefront optimized Allegretto. So it's possible the Eye Q is slightly better then the Visx. But the reality is both machines are top of the line, and when the procedure is performed by a good doctor there is virtually no difference between the two machines.
Last edited by JPD on Thu Jul 19, 2007 3:21 pm, edited 1 time in total.
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Postby JPD » Thu Jul 19, 2007 3:09 pm

brianmc wrote:1. My pupils have been measured with a pupillometer as 7.5/7.0, 8/7, 7/6.5 mm, and the customvue data shows 9/8.8mm


I noticed that too, and that should be an area of concern. I don't know the reason for the disparity, but the pupilometer should be the most accurate method. Ask both your doctors about this, and maybe get a third opinion.

brianmc wrote:'m not sure which of the two treatments is better for large pupils, or if I simply shouldn't get lasik because of them.


I was told by a corneal specialist that the Allegretto is better for larger pupils.
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