Two opinions: one say PRK, one says Lasik ?? Really confuse

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.

Two opinions: one say PRK, one says Lasik ?? Really confuse

Postby ksoldan » Tue Apr 10, 2007 1:44 am

After wearing soft contacts for probably 15-20 years successfully, I became intolerant last July. It was very disturbing to me and I underwent general medical exam, blood work from my general doctor and repeated visits with my opthamologist. Everyting came back normal. I was evaluated by him for Lasik in November and he said that given my corneal thickness and high prescription, I'd be a better candidate for PRK. He actually taked about the possible need for a cornea transplant if healing didn't go well. In discussion about PRK, he mentioned micro c? to reduce hazing but stated the long term effects are not known. After that visit I had pretty much given up on any corrective surgery. But as time went on the glasses really both and hinder my daily life. I went to another dr. in an effort to find out more about PRK and hear his opinoin. He stated that I would be a decent candidate for Lasik. ??? There are no problems with my pupils, my right is is a -7.25 corneal thickness of 543. Left eye is a -6.75 with corneal thickness of 553. Does Lasik sound possible with these numbers?? I do not know of any other factors which would prevent the Lasik. Also, does the use of intralase reduce teh amount of microns removed from the cornea? Is it a better route when high prescriptions and simi-thin corneas? any hlep would be greatly appreciated!
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Re: Two opinions: one say PRK, one says Lasik ?? Really conf

Postby lkestler » Tue Apr 10, 2007 5:26 am

My cornea thickness is 550 and my prescription was -8 in my right eye and -7 in my left eye. I had Lasik March 29th and had 20/20 vision by that evening and have not had one side effect. I am so thrilled with the results. The procedure itself was very easy. I would have this done again in a heartbeat.
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Postby ksoldan » Tue Apr 10, 2007 8:50 pm

Thanks for the reply. It's always encouraging to hear from others. I am getting another opinoin on Thursday. Did you have intralase?
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Postby ZinMe » Tue Apr 10, 2007 9:15 pm

I just logged onto this forum for the first time because I have the exact same question. Freeky.

Two doctors gave me different recommendations-- one recommended PRK and the other recommended Lasik. I didn't get my corneal thickness reading, but the doctor who recommended PRK said the lack of thickness, my high perscription (-7.5/-8.0) and my large pupils he didn't want to take the chance with Lasik. The PRK procedure actually sounds more conservative in that it requires less removal of lens tissue and there are fewer issues with flap-healing, however, the recovery time is a big issue for me due to a very busy schedule (I travel for business frequently and have three young kids...)

I'm wondering what questions I should be asking each doctor to determine the right course of action. I'm also wondering where I can go to get recommendations on each doctor.
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Re: Two opinions: one say PRK, one says Lasik ?? Really conf

Postby lkestler » Wed Apr 11, 2007 6:51 am

The laser they used on me was the Alcon LADARVision Flying spot laser. I am not sure what intralase is. I only got one opinion and only saw one doctor but I felt so comfortable with him and I asked the 50 toughest questions list that they have on this board and he answered all of them so I felt pretty sure I was going with a good doctor and as it turned out I was right.
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My stats

Postby ZinMe » Wed Apr 11, 2007 4:08 pm

Pupil: 7.0 / 6.7
Thickness: 490 / 498
Perscription: -9.0 / -8.75
I don't have any astigmatism figures, but the Drs. have commented that I have very little.

Am I a good candidate for Lasik or better off with PRK?
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Postby lvziggy » Wed Apr 11, 2007 4:44 pm

Hi. I had PRK after listening to the very thorough explanation from my surgeon. He said that, given my fairly thin corneas (512 and 514) and my high prescription (6.75 and 7.25) and large pupils (7) he thought I would have better results with PRK and more chances for problems with Lasik. I had gone to another dr. at an assembly-line kind of place and they said I would be fine with Lasik. I'm very leary of those kinds of places, they just want to get you in the door and get your money. The surgeon I went to was only concerned with good results and happy patients. So I would question the dr. very carefully about each procedure and the pros and cons of the equipment and how it relates to your particular eyes.

PRK definitely is a more involved process, I had one eye done at a time, 2 weeks apart. 1st eye was done on 3/15 and second eye was done on 3/29. 1st eye now is 20/30 and 2nd eye is 20/40, but they are still healing and each day I think I see just a little bit better. Also, from reading some others accounts of their experiences on this forum, I think I had a pretty easy time of the whole process. Overall I'm very happy that I had the surgery done, and that I went with the PRK rather than the Lasik.

~Alison
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Postby ZinMe » Wed Apr 11, 2007 5:11 pm

lvziggy wrote:Hi. I had PRK after listening to the very thorough explanation from my surgeon. He said that, given my fairly thin corneas (512 and 514) and my high prescription (6.75 and 7.25) and large pupils (7) he thought I would have better results with PRK and more chances for problems with Lasik.

Thanks for your response Alison. It is very helpful to hear from people who are going through the same thing-- I don't personally know enough people who have had the same eye characteristics. The doctor who is recommending PRK appears to be more experienced and everyone I've talked to has great things to say about him. He also is a director at a highly regarding teaching hospital. But both Doctors have been willing to talk about the procedures, it is just a matter of risk tolerance-- i have barely enough cornea for lasik but I don't want to take the risk that if i needed an enhancement down the road, I don't think i would have much cornea left to work with if I chose lasik. I'm 90% sure I will go PRK, but just want to make sure I understand if Lasik is OK because the recovery is much easier.
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Postby lvziggy » Wed Apr 11, 2007 7:05 pm

It took me awhile to get comfortable with the thought that the whole process for PRK was going to be more involved. But once I was finally able to focus on the end result - far less chance for ongoing problems (such as dry eye and night vision problems) - and not focus so much on the initial procedure and recovery, I was ready to have it done as soon as I could. For me the initial procedure and recovery for both eyes took about a month. But I'm confident that from here on I will just be happy that I can see without glasses and not have the ongoing problems others here have had. So far I don't have any dry-eye problems and my night vision is very good as well, no halos or glare. I think that had I let the assembly-line place talk me into having Lasik, I'd be right here with all the same complaints everyone else is having.

I think what it really came down to as far as deciding between Lasik and PRK is that, with such a possibility of continuing problems if I had Lasik, I decided Lasik just wasn't an option for me. Then it really became a matter of do I want to go with PRK and deal with the initial recovery issues and then not have to wear glasses, or just continue to wear glasses. That made my choice easy.

~Alison
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Postby ZinMe » Wed Apr 11, 2007 7:46 pm

lvziggy wrote:I think what it really came down to as far as deciding between Lasik and PRK is that, with such a possibility of continuing problems if I had Lasik, I decided Lasik just wasn't an option for me.

Alison,

Thanks again- its great to exchange informaiton with an experienced patient! I just got off the phone with the doctor recommending the Lasik. He says he uses a Xioptic device for Lasik that cuts a smaller flap-- about 80-90 microns vs. 120-130 microns. He said based on my parameters, he would use about 180 microns total of cornea so that I would be at 300 microns thickness post surgery with enough room for an enhancement if needed afterwards. So, the math seems OK, but the points you make about follow-up issues with night vision and dry eye are certainly considerations as well. I'm still 90% sure I'll go PRK.

BTW, did you do monovision?

Thx!! Dave
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Postby ksoldan » Wed Apr 11, 2007 9:11 pm

My question is in regard to corneal hazing. Did your DR. discuss this with you? Mine scared me in regard to this. I've read that the higher the prescription, the higher the chance of this occuring. Seems logical since they'd be removing more cells. That is one side effect I couldn't handle.
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Postby lvziggy » Wed Apr 11, 2007 10:06 pm

Dave, no I did not have monovision and I'm glad I didn't. I didn't like the whole idea of my brain having to adjust to the difference between my eyes. I'm a dizzy blond as it is! :D I don't mind having to use reading glasses, I just wanted to be able to see distance without glasses. As it turned out, I can read just fine without reading glasses (for now anyways). A friend of mine was talked into the monovision and she hates it. She's getting it changed as soon as her eye has healed enough.

Also, my surgeon explained about how he could do a certain type of lasik correction (not sure what he called it, custom lasik?) that would create a thinner flap, but that it would, I don't remember exactly how he described it, but he basically said it would make a larger diameter flap, and that could cause problems due to my large pupils. Everything he told me just pointed to PRK as the better option, so that's what I went with.

Ksoldan, my surgeon told me the same thing I've read here about the haze problem with PRK. Take 1000 mg vitamin C everyday for a couple of weeks prior to the surgery and for 6 months after. He also used the mitomycin (sp?). I know Glenn has expressed some concern on this board about that (although not just what his concer is), but I figure if I'm going to have this done I want the best chance of a good outcome.

It's nice to be able to offer advice to others since I've gotten so much useful advice here myself!

~Alison
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Postby ZinMe » Wed Apr 11, 2007 10:59 pm

Hi Alison,

I'm 41 and in just the last 3-4 months, my presbyopia has gotten signficantly worse. I'm testing contacts now with -1 in my non-dominant eye, and it helps a lot. It is slightly awkward but actually very manageable, and it is better than not being able to read my blackberry and newspapers.

Thx,
Dave
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Postby lvziggy » Wed Apr 11, 2007 11:11 pm

Dave, obviously you need to do what's right for you. People have posted on here that seem to be fine with monovision. I'm 46 so I'm definitely at that age! I just prefer to be able to see distance clearly. I'm not that into tech stuff so I don't have a blackberry to worry about being able to read. Just the stoopid computer I'm always tied down to! I do have 1.25 reading glasses for the computer, but I rarely use them.

~Alison
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Postby Betty39 » Thu Apr 12, 2007 4:30 am

Ksoldan: The fact that you are now intolerant to contacts is a BIG concern. If it is due to dry eyes then I would NOT have lasik if I were you. Just my opinion. Lasik will most likely make the dry eyes much worse. I had no dry eye issues that I knew of pre-lasik. I wore contacts successfully for 21 years. Now I am told by the doctor that did my surgery that perhaps I was "boarderline" pre-surgery. I wish he had told me that before! Since my lasik 6 months ago my eyes have been very dry and uncomfortable. If you are going to get lasik at least insist that tear testing be done on you so you can know for sure if you have dry eyes.
Good luck in your decision!
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