Why does surgeon say: don't need wavefront guided ablation?

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Why does surgeon say: don't need wavefront guided ablation?

Postby kschueleraugsburg » Sun Jun 17, 2007 3:22 am

Hello USAEyes:

I've been reading messages on the board for quite some time already, and I've done a lot of research regarding laser vision correction. I am very close to making a decision towards A) having Lasik done, and B) what surgeon to pick.

There is one question that puzzles me, and maybe someone on the board can shed some light on this.
My prescription is:
Right: -2.75, astigmatism -1.75 (7 deg)
Left: -1.75, astigmatism -2 (165 deg)
Cornea thickness 568 and 553
pupil size 6mm and 5mm (dark, no drops)
tear production normal
per 2 doctors so far "nothing special or concerning"

The first doctor was at one of the larger chains, they said I was good candidate, reccomended Visix S4, non-wavefront guided, mechanical keratome for flap.

The second doctor was a local practice in Chicagoland area, recommended Intralase for flap, and Bausch&Lomb Technilas non-wavefront guided.

Both doctors told me: wavefront guided not necessary, could do but really not necessary.

At first doctor, wavefront would have been higher price.
At second doctor, wavefront would have been same price.

I'm somewhat confused: Why do they advise against wavefront, or more accurately: say wavefront no necessary in my case?
I was under the impression, that All Laser Lasik with wavefront guided ablation was the technologically advanced method, and should be preferred? Someone on the board said something like: "If you don't want to go through PRK, then Intralase plus wavefront guided flying spot ablation would be the way to go".

Can someone help me understand this? Should I try to go for the wavefront guided? Or should I not worry about, is there maybe even an advantage not doing the wavefront (for example less tissue removed)?

Thanks for your help!!!
Best regards,
Chicagoan
kschueleraugsburg
 
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Postby JPD » Sun Jun 17, 2007 3:44 am

Wavefront guided ablations help reduce certain irregularities in your cornea(if you have them), so if you don't have any of these irregularities, which it sounds like you don't, then wavefront won't help any. It can still be done, but won't help to improve anything.

Wavefront IS the latest and greatest technology, because it now corrects these irregularities for those who have them, that would in the past not have been corrected with a standard ablation, and probably had a less then satisfactory outcome.

It really isn't necessary for everyone, it just helps broaden the scope of people who can have a successful refractive surgery.
JPD
 
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Location: Southern California

Postby LasikExpert » Sun Jun 17, 2007 7:40 am

Wavefront Custom Lasik is not for everyone and will not provide superior results (compared to conventional) in all cases.

Your prescription shows you have low myopia (nearsighted, shortsighted) vision and moderate astigmatism, but astigmatism that is high relative to your low myopia. Astigmatsim is when the cornea is not spherical like the top of a ball, but is elliptical like the back of a spoon. In other words, a big part of your vision problem is topography. A conventional ablation is more "topography driven".

It may be that in the professional experience of your doctors a person with your type of refractive error has not shown benefit from custom wavefront-guided Lasik. Your doctors may have both found that a situation like yours indicates that conventional may be as good as wavefront-guided...or even better.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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Postby kschueleraugsburg » Sun Jun 17, 2007 7:16 pm

Hi Glenn:

Maybe I'm making this more complicated than required.

Is it reasonably correct to say to myself:
** surface of cornea is reasonably simple in shape (I've seen the wavefront analysis, relatively regular football shape)
**With a non-custom flying spot correction, shape can be corrected well and it will (might) remove less tissue compared to a custom-correction.
**All things considered: my prescription is relatively simple, regular non-custom ablation can correct it well enough, therefore don't waste precious cornea tissue by going with custom-wavefront-guided.

That sound o.k.?

Glenn, thanks for all the effort you put into this website, you can't even imagine how valuable this website is to all of us out here.

Best regards,
Chicagoan
kschueleraugsburg
 
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Joined: Tue Jun 12, 2007 7:16 pm

Postby LasikExpert » Sun Jun 17, 2007 7:39 pm

kschueleraugsburg wrote:** surface of cornea is reasonably simple in shape (I've seen the wavefront analysis, relatively regular football shape)


The optics and surface are actually rather complicated, but it is simplicity of shape that the cornea strives for and is what generally proivides the best vision quality.

kschueleraugsburg wrote:**With a non-custom flying spot correction, shape can be corrected well and it will (might) remove less tissue compared to a custom-correction.


Absolutely.

kschueleraugsburg wrote:**All things considered: my prescription is relatively simple, regular non-custom ablation can correct it well enough, therefore don't waste precious cornea tissue by going with custom-wavefront-guided.


Based upon what two different doctors have told you, this does seem to be reasonably accurate.

kschueleraugsburg wrote:Glenn, thanks for all the effort you put into this website, you can't even imagine how valuable this website is to all of us out here.


Thank you for your kind words, and you are probably correct that I have no real idea of the effect we have. Truthfully, I can take little credit for whatever positive effect the information we provide may have. It is all the work of others, I just compile it and try to put it into words that anyone can understand.
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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