3 weeks out from enhancement

[Mikewas+4]

Pre enhancement I was around +1.25 in both eye's with an astigmatism around 90 degrees to the other side of the eye/s then that of the original astigmatism.

Post enhancement I'm now -.25 in the right eye and +.25 in the left. I forgot to ask about the astigmatism. That was not what he was trying for but thats what I ended up with.
My near vision is great and my distant vision was dissapointiong at first but starting to come around.

As I stated in my last post, the mapping with the wavefront scanner did not look as good as what the doctor could get with manually dialing in the refractor. With that we discussed and agreed on going with a traditional lasik enhancement.

I have to admit that I like my vision even though I did not want monovision especially if my distance vision keeps improving.

2 questions.
1. Does anyone know what the ideal monovision is? + and - ?
2. Is it common for the laser to miss plano by this much even with two tries?
Thanks for any replies.
Mike

[Mack]

1. Does anyone know what the ideal monovision is? + and - ?

The monovision + offset varies with age and gets higher as we get older. Monovision correction is really only intended for presbyopes. +1.5 offest for the non-dominant eye is common for ages 40 to 50. +2 for 50 to 60, and higher for true seniors.
I had "defacto monovison" during the healing process coming from +5.25 in one eye and +3.75 in the other. But that dissipates when both get near plano.
2. Is it common for the laser to miss plano by this much even with two tries?
Not for us higher hyperopes Mike. Determining the exact amount of expected regression is a calculated guess, based on nomograms that show averages for the population of those who have already been corrected. It depends on age, sex, race, heredity and other factors. Almost all high hyperopes need enhancements to end up at or near plano.

[croanster]

Mike – How’s your distance vision going now? Any more improvements?

Mack (and anyone else...) I’m curious to know your take on enhancement for me. I’ve been consistently refracted at around -0.25 -0.5 030. Doesn’t sound like much of an error but gives me no end of trouble at night with blur and a bit of double vision. I’m puzzled by the fact that a dilated refraction gets me somewhere out to +0.75 -0.75 020 but I think my pupil probably dilates outside the treatment zone and mucks up the results. Glasses with the -0.25 / -0.5 030 correction give me sharp vision at all distances. My doc is not keen to do an enhancement. Hasn't really said why although I think he thinks its good enough which it almost is in bright light. Dim light and night I don't really feel that safe driving etc without the specs on.

Thanks for your thoughts.

[Mack]

Croan.....you are spot on about why your vision degrades in low light. I still have the same problem after 9 years. Your ablation zone was not quite large enough to cover adequate correction completely for your larger pupils in lower light. For us hyperopes, thats difficult to fix with enhancement, but in the hands of a skilled doc, it may help. Since your effective refractive error is now mixed astig myopic in good light, but fully hyperopic astig in low light, that makes it even tougher. You may drift towards a bit more regression until about the one year mark, so its best to wait and see what happens then. Until and unless you get about one full diopter of effective refractive error, it will be hard for any doc to recommend an enhancemnt of any kind in good conscience. You are below that right now. It's good you can get your BCVA to a sharp 20/20 with correction. Many higher h-lasik survivors have not been that lucky. I lost one line with my lasik ordeal.