Opinion appreciated

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.

Opinion appreciated

Postby mbr » Mon Sep 15, 2008 6:41 am

Hi there! Thanks creating this great forum which is filled with a wealth of information for those contemplating eye surgery.

I am a 41 year old woman and have been short sighted since 12. I stopped wearing contact lenses about 5 years ago and have have been on glasses since.

My current prescription:

Right: -5.25 -3.25 x 180
Left: -5.25 -3.25 x 4

No presbyopia at the moment.

I have contemplated going for Lasik for the last few years but have put it off due to my age and high degree of astigmatism. I have yet to attend any pre-Lasik evaluation. May I know what is your opinion? Would I be a suitable candidate for Lasik or other type of refractive eye surgery?

Lasik aside, should my high astigmatism be a cause for concern and warrant further investigation? Should I be concerned about keratoconus?

Your expert opinion would be greatly appreciated. Thank you & have a great day!
mbr
 
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Re: Opinion appreciated

Postby LasikExpert » Mon Sep 15, 2008 5:59 pm

mbr wrote:No presbyopia at the moment.


This is probably not accurate. It's just that the presbyopia has not yet become bad enough that it affects your near vision and the fact that you are nearsighted using glasses provides a small advantage over presbyopia. Lasik may change this. Read Sudden Presbyopia after Lasik.

mbr wrote:Would I be a suitable candidate for Lasik or other type of refractive eye surgery?


Your refractive error is within the treatable range for Lasik for most lasers. Suitability is another issue. Your astigmatism is high and it is more than half of your myopia (nearsighted, shortsighted) vision. High astigmatism is more challenging to correct and astigmatism greater than half myopia is additionally challenging to correct. Read about Lasik Astigmatism Correction.

It can (and has) been done, however it would be reasonable to expect that you would need more than one surgery per eye to "fine tune" the correction.

An important issue will be your pupil size. The size of the fully corrected treatment zone is reduce to an ellipse to correct astigmatism. The narrow width of astigmatic treatment zone may be smaller than you pupil size. This can lead to poor night vision. Read about Lasik Night Vision Problems.

mbr wrote:Lasik aside, should my high astigmatism be a cause for concern and warrant further investigation? Should I be concerned about keratoconus?


Keratoconus normally presents before the fourth decade of life. A common symptom is progressive astigmatism, but you do not report any major prescription changes. Scans can be performed to determine if your astigmatism is caused by a weakening/thinning of the cornea.
Glenn Hagele
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Postby mbr » Wed Sep 17, 2008 4:53 am

Hi Glenn

Many thanks for your reply.

Yes, I do experience poor night vision now even with glasses. And I noticed that my near vision in low light is not as good as before. Sign of age, huh?!

For monovision Lasik, how much myopic degree is normally left in the non-dominant eye?

I read somewhere that people who had done Lasik would have a higher risk of developing retinal detachment several years down the road. What is your view on this?

Cheers!
mbr
 
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Postby LasikExpert » Wed Sep 17, 2008 5:48 pm

mbr wrote:Yes, I do experience poor night vision now even with glasses. And I noticed that my near vision in low light is not as good as before. Sign of age, huh?!


Actually, yes. The ability to focus on close objects diminishes for most people after about the age of 40. This is why Sudden Presbyopia may be a concern for you.

mbr wrote:For monovision Lasik, how much myopic degree is normally left in the non-dominant eye?


This varies greatly depending upon the individual's preferences. This is another advantage of a contact lens trial. You can try different powers of monovision to find what suits you best. Normally, not more than 2.00 diopters of difference is tolerable.

mbr wrote:I read somewhere that people who had done Lasik would have a higher risk of developing retinal detachment several years down the road. What is your view on this?


Let me give you a statistic: 98% of all pedestrian vrs. auto accidents occur while the pedestrian is within a marked crosswalk. The analysis: A crosswalk is the most dangerous place for a person to cross the street.

The statement that people who have had Lasik have a higher risk of retinal detachment is like the comically incorrect analysis of crosswalks. People who have Lasik have a higher risk of retinal detachment because the vast majority are myopic (nearsighted, shortsighted) and myopia is the most prevalent cause of stress on the retina.

Most myopia is caused by the eye being elongated. Unfortunately, the thin membrane attached to the back of the eye called the retina is not equally elongated. The normal sized retina and the elongated eye put stress on the retina to detach from the back of the eye. The greater the myopia, the greater the stress.

Lasik does increase the intraocular pressure (IOP) in the eye for a short time and this can be problematic for a stressed retina, but the effects would likely be almost immediate, not years later.

As a general rule, anyone with myopia over about 8.00 diopters should see a retina specialist before having any elective eye surgery.

The US National Library of Medicine has about 50 peer-reviewed articles about Lasik and retinal detachment with virtually all showing that Lasik does not increase the incidence of retinal detachment.

BTW: Cataract surgery and its counterpart Refractive Lens Exchangeare the most traumatic on a stressed retina.
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
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Postby mbr » Fri Sep 19, 2008 2:41 pm

Glenn, thanks for the clarification. You've been most helpful!
mbr
 
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