Considering Lasik, Already got my consultation

[jcarrey4]

Ok all, I just want the community's opinion on my situation, and assessment on the future of the business.

I went in for my free consultation at [national chain] laser eye center in Westchester, IL this week, just to see if I qualified, and here's what I got:

Prescription is around -3 D in both eyes and less than 1 astigmatism. I don't have the exact measurements, since they don't give that out, for fear that I'll take my prescription elsewhere, I'm sure. My current glasses are around there, so, I'm assuming it hasn't changed, since it hadn't changed in the last 4 years or whatever. I'm 28, by the way.

My corneal thickness is 622-625 micron...which was funny to hear, since they were like "well the range is 480-600, and the computer's just getting your number now, it's...623 and 625 in each eye!" So, thickness is not a problem, especially with my low prescription. My dilated pupil is 5.5mm.

The doctor is Dr. [LP], the Machine is the VISX Star s4 IR, and it's all-laser LASIK. So, as far as i know, the doctor is top-50 in the world, and the machine is #1. However, in the FDA report, it mentions something about minimum age of 40? any thoughts?

So: as far as the actual process goes, I'm pretty confident in at least getting 20/20, and there's always the chance for better. I understand the risks, but everything I;'ve read about all the risks, 99% of the problems can be resolved or resolve on their own. Also, since I expected to need reading glasses either way after about 40 years old, I'm not worried about that. I just want to get these guys that I were all-day everyday off my nose.

The issue I'm worried about mostly is the longevity of [national chain], since their parent company is under Bankruptcy protection. So, since I'm 28, a lifetime commitment sounds perfect...unless the company's gone! Also, what about post-operative visits and those pesky complications? Anyone have any ideas on what will happen to all of us?

FYI, I'm going with [national chain]due to the discount through BC/BS of IL, and I'll eventually start up my FSA to get the surgery ASAP.

Anyone have any opinions on anything I;ve said?

Note: Names of doctor and clinic redacted.

[PRKorIntacs]

As a guy your age looking at getting PRK, let me offer some advice.

1. With your fairly low prescription, PRK would be an option and it has less risks than lasik. I am getting PRK myself to reduce my -5.5 to -1.5
2. My choice of laser is the Allegretto, from what I read, it's the best in America and the only laser to give a prolate profile.
3. Try measuring your pupils yourself with a ruler in front of a mirror in dim light. Your pupils are unusually small, id reconfirm this.
4. Have realistic expectations. You are seeking out 20/20 or better vision which I read isn't realistic. I don't get 20/20 even with glasses.
5. Do you see clearer up close without glasses? Do you remove your glasses for any circumstances? I do and is why I am aiming for -1.5
6. How long have you researched lasik/prk? I researched this for several years and have realistic expectations of a reduced glasses dependancy.

[ronsivillo]

pesky complications(??) -- you want to know what is pesky for me?

debilitating dryness
photophobia (extreme sensitivity to light)
inability to see clearly


I could go on and on --- and this is from Lasik in Dec 2007 -- want my advice - do not risk the most important sense - it is CRAZY STUPID - DO NOT DO IT!!!!!!!!!!!!!!!!!!! Again, DO NOT DO IT!!!!!!!!!!!!!!!!!!!

[jcarrey4]

pesky complications(??) -- you want to know what is pesky for me?

debilitating dryness
photophobia (extreme sensitivity to light)
inability to see clearly


I could go on and on --- and this is from Lasik in Dec 2007 -- want my advice - do not risk the most important sense - it is CRAZY STUPID - DO NOT DO IT!!!!!!!!!!!!!!!!!!! Again, DO NOT DO IT!!!!!!!!!!!!!!!!!!!

Ronsivillo-

What type of surgery did you have? LASIK, LASEK, etc? what technology? all-laser, wavefront custom, etc? What was your dilated pupil size and your prescription and your corneal thickness? Did you have higher-order aberrations? How many surgeries had your doctor done, and with what machine?

I want to find out if we are looking at similar things. If mine is a more 'routine' surgery, yes, there is still a chance of issues, but i'm just trying to find out your situation.

[davidmartinomalley]

You're right to do your due diligence. You are right to say that 99% of all procedures are "successful", but the 1% are no "pesky annoyances".

I had an issue, recently, and I can tell you, even with all the reassurances of doctors, family and friends, living a problem is a nightmare. Nightmare.

Both the surgeon and the technology matter, immensely. What you need to find out is what defines "success" - for many that's 20/40 or better. I'm 20/25 in one eye (20/15 in the other) and I can tell you that if I was 20/25 in both, I'd still need glasses. That's NOT the expectation you want.

The surgeon, if he's using the latest technology, should be able to tell you your "Best corrected vision attainable" - for me that was 20/15, so with my left eye, I can opt for a touch up, but only after 6 months.

The questions you should be asking are along these lines:
- Define "success"
- What is your success rate (as defined by the above question), as a percentage of patients
- What %age achieve 20/20 or better the first time (should be in the mid-high 90's)
- What complications have you experienced
- How did you handle those complications
- Who treated the complications? (the surgeon or referred to a specialist)
- What other surgeries does the doctor perform?
- Who pays for treating complications (VERY important!)
- This is [national chain], who is the responsible party? Is it the company, or the doctor? What is the professional relationship between [national chain] and the doctor? Who's patient are you? This is important as it pertains to the legal term "abandonment". Once a doctor initiates treatment, they have to follow through with treatment or get you a suitable medical replacement. If [national chain] goes belly up the day after your surgery, what happens to you? Never mind years down the road!

Use my experience as a case study, if you like:
viewtopic.php?f=2&t=2333

I'm of the opinion that you should use someone who's name hangs over the door of the business, who has a vested interest in maintaining their name in the community, and truly fears your trashing that name. I feel that if I was going to a [national chain] or similar, I would have been kicked to the curb, and my problem would have been explained away as a "risk of the procedure". I am 100% confident in that statement, by the way. Time does not heal, intervention heals.

That being said, I will say, my problems were, literally, one in 1000, and the benefits of not having glasses are great. The problem is that when things go wrong, even a little, its disastrous. You cannot be prepared for that, no matter what anyone says. What you can do is answer these questions ahead of time and hope you don't need them. Your doctors willingness to answer these questions, openly, and spend time with you, will give you an idea of their attitude towards patients with complications.

Best of luck, let me know if I can help more, and let us know how it works out.

Cheers.

Note: Name of clinic redacted.

[jcarrey4]

You're right to do your due diligence. You are right to say that 99% of all procedures are "successful", but the 1% are no "pesky annoyances".

I had an issue, recently, and I can tell you, even with all the reassurances of doctors, family and friends, living a problem is a nightmare. Nightmare.

Both the surgeon and the technology matter, immensely. What you need to find out is what defines "success" - for many that's 20/40 or better. I'm 20/25 in one eye (20/15 in the other) and I can tell you that if I was 20/25 in both, I'd still need glasses. That's NOT the expectation you want.

The surgeon, if he's using the latest technology, should be able to tell you your "Best corrected vision attainable" - for me that was 20/15, so with my left eye, I can opt for a touch up, but only after 6 months.

The questions you should be asking are along these lines:
- Define "success"
- What is your success rate (as defined by the above question), as a percentage of patients
- What %age achieve 20/20 or better the first time (should be in the mid-high 90's)
- What complications have you experienced
- How did you handle those complications
- Who treated the complications? (the surgeon or referred to a specialist)
- What other surgeries does the doctor perform?
- Who pays for treating complications (VERY important!)
- This is [national chain], who is the responsible party? Is it the company, or the doctor? What is the professional relationship between [national chain] and the doctor? Who's patient are you? This is important as it pertains to the legal term "abandonment". Once a doctor initiates treatment, they have to follow through with treatment or get you a suitable medical replacement. If [national chain] goes belly up the day after your surgery, what happens to you? Never mind years down the road!

Use my experience as a case study, if you like:
viewtopic.php?f=2&t=2333

I'm of the opinion that you should use someone who's name hangs over the door of the business, who has a vested interest in maintaining their name in the community, and truly fears your trashing that name. I feel that if I was going to a [national chain] or similar, I would have been kicked to the curb, and my problem would have been explained away as a "risk of the procedure". I am 100% confident in that statement, by the way. Time does not heal, intervention heals.

That being said, I will say, my problems were, literally, one in 1000, and the benefits of not having glasses are great. The problem is that when things go wrong, even a little, its disastrous. You cannot be prepared for that, no matter what anyone says. What you can do is answer these questions ahead of time and hope you don't need them. Your doctors willingness to answer these questions, openly, and spend time with you, will give you an idea of their attitude towards patients with complications.

Best of luck, let me know if I can help more, and let us know how it works out.

Cheers.

Note: Name of clinic redacted.

Those are definitely some good questions I have to ask. Thank you for your response, I appreciate it! I am definitely concerned with the national chain vs doctor issue...I'll find out and re-post when I do!

[PRKorIntacs]

You're right to do your due diligence. You are right to say that 99% of all procedures are "successful", but the 1% are no "pesky annoyances".

That depends on your expectations and what you consider a "success" in my case, reducing my dependancy on glasses is a "success" for others, they insist on perfect vision both near and far.

Both the surgeon and the technology matter, immensely. What you need to find out is what defines "success" - for many that's 20/40 or better. I'm 20/25 in one eye (20/15 in the other) and I can tell you that if I was 20/25 in both, I'd still need glasses. That's NOT the expectation you want.

One person can end up 20/40 but have excellent quality vision both day and night and not need glasses. Another person can be 20/20 but have terrible vision with ghosting, glare, starbursts and loss of contrast. Glasses would not correct this aberrations, only the residual refractive errors. My expectation is not so much what I see on the eyechart, but being 20/happy with decent quality vision and maintaining my BCVA with glasses.

The surgeon, if he's using the latest technology, should be able to tell you your "Best corrected vision attainable" - for me that was 20/15, so with my left eye, I can opt for a touch up, but only after 6 months.

I don't correct to 20/20 with glasses and do not expect to see 20/20 with glasses after PRK. I do expect to attain my BCVA with thinner glasses after PRK. A loss of BCVA is indeed considered a complication. My goal is to improve my UCVA(what I see without glasses) while maintaining my BCVA(what I see with thin glasses)

- What %age achieve 20/20 or better the first time (should be in the mid-high 90's)

I don't consider the 97% 20/20 quote to be realistic at all. Besides, 20/20 does not guarantee youll see "perfect" in all situations, especially at night. Also 20/20 distance vision for presbyopes only means needing reading glasses several hours a day, sometimes all day. I am not even aiming for 20/20 distance, but am aiming for a -1.5 in both eyes(monovision isn't for me) so I see better and reduce my dependancy on glasses without trading for readers.

That being said, I will say, my problems were, literally, one in 1000, and the benefits of not having glasses are great. The problem is that when things go wrong, even a little, its disastrous. You cannot be prepared for that, no matter what anyone says.

If I do get PRK, I hope my surgeon can address any problems I have. I also understand some problems can not be fixed with "enhancements" or glasses and ill have to live with them and wait for better technology to address those.

[jcarrey4]

You're right to do your due diligence. You are right to say that 99% of all procedures are "successful", but the 1% are no "pesky annoyances".

That depends on your expectations and what you consider a "su...

...its of not having glasses are great. The problem is that when things go wrong, even a little, its disastrous. You cannot be prepared for that, no matter what anyone says.

If I do get PRK, I hope my surgeon can address any problems I have. I also understand some problems can not be fixed with "enhancements" or glasses and ill have to live with them and wait for better technology to address those.[/quote]

rant/

Oh my god PRK you're so annoying. Seriously, this want's even a thread about you or your concerns, it was about me and mine. You Bogey'd my thread to randomly talk about your concerns and issues that apply to you and your surgery. Go stay in your own thread unless you are going to comment on my personal situation. I couldn't care less abut your opinion on 20/happy which is a meaningless phrase anyway. GO GET YOUR DAMNED PRK! For me, my eyes are different, and my situation is not the same as yours. I'd be OK not hearing your opinion again, since you seem to do this in every thread. I get that you're concerned, and you're scared about some of the things with LASIK, but I'm not. I understand statistics, I get the risks, deal with the fact that some people assess those risks differently than you do.

/end rant

[jcarrey4]

Oh, and by the way, I have an appointment with Dr. [LP] himself in 2 weeks to discuss the issues above directly with him, not some random [national chain] person, so I should be able to update everyone when the time comes.