Is enhancement technically possible in my case?

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Is enhancement technically possible in my case?

Postby skenehouse » Mon Apr 12, 2010 2:20 pm

I had intralase lasik (all blade procedure) about a year ago and my current prescription is:-
R plano, -0.75 cyl approx 20/20 to 20/15
L plano, -1.0 cyl approx 20/40 to 20/30

I am coming up to my last checkup and signoff and wondered whether it is technically possible to have an enhancement to correct the remaining astigmatism in my LEFT eye as it is quite noticeable and causes blurriness at all distances and especially when reading up close. My right eye is sharp at all distances so with both eyes I'm at approx slightly better than 20/20 vision, with my RIGHT at slightly better than 20/20, and my LEFT at approx 20/30 to 20/40. I find that the blurriness in my LEFT eye is there most days although it varies from very noticeable and blurry to not bad at all. Also some mornings the LEFT eye is very blurry for a while as if it's tired from straining the day before, even after a good nights sleep.

My question is thus whether my astigmatism can be corrected in my LEFT eye (my RIGHT can be left alone) or would this push me into far-sightedness (eg. +0.25 or more)?

Many thanks for your help on this.
David
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Re: Is enhancement technically possible in my case?

Postby LasikExpert » Wed Apr 14, 2010 6:36 pm

It appears that you are knowledgeable of the laser coupling effect when astigmatism is corrected. See Lasik and astigmatism. What would be necessary is for the surgeon to adjust the treatment to resolve the astigmatism and at the same time resolve the expected hyperopic shift due to the coupling effect. It is technically possible.
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Re: Is enhancement technically possible in my case?

Postby PRKorIntacs » Thu Apr 15, 2010 5:04 am

skenehouse wrote:I had intralase lasik (all blade procedure) about a year ago and my current prescription is:-
R plano, -0.75 cyl approx 20/20 to 20/15
L plano, -1.0 cyl approx 20/40 to 20/30

I am coming up to my last checkup and signoff and wondered whether it is technically possible to have an enhancement to correct the remaining astigmatism in my LEFT eye as it is quite noticeable and causes blurriness at all distances and especially when reading up close. My right eye is sharp at all distances so with both eyes I'm at approx slightly better than 20/20 vision, with my RIGHT at slightly better than 20/20, and my LEFT at approx 20/30 to 20/40. I find that the blurriness in my LEFT eye is there most days although it varies from very noticeable and blurry to not bad at all. Also some mornings the LEFT eye is very blurry for a while as if it's tired from straining the day before, even after a good nights sleep.

My question is thus whether my astigmatism can be corrected in my LEFT eye (my RIGHT can be left alone) or would this push me into far-sightedness (eg. +0.25 or more)?

Many thanks for your help on this.
David


I read your other post.

Your pre-lasik prescription was:-
L -4.5 sph -1.5 cyl
R -4.25 sph -0.75 cyl

You say it's micro striae. This may be the case why one eye is so much worse despite very similar astigmatism. Your surgeon should take care of both your astigmatism and micro striae should he decide to enhance you and you are willing to go thru a 2nd round of lasik.
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Re: Is enhancement technically possible in my case?

Postby skenehouse » Thu Apr 15, 2010 1:43 pm

LasikExpert wrote:It appears that you are knowledgeable of the laser coupling effect when astigmatism is corrected. See Lasik and astigmatism. What would be necessary is for the surgeon to adjust the treatment to resolve the astigmatism and at the same time resolve the expected hyperopic shift due to the coupling effect. It is technically possible.


Thanks for both your responses, as it all helps to improve my knowledge before I go back to discuss with my eye surgeon. However, I'm still not fully understanding what may be possible in my case.
For example, with regard to the above quote from LasikExpert.......what do you mean when you say the surgeon has to "at the same time resolve the hyperopic shift"? Can the surgeon just try to reduce the -1.0 astigmatism without the coupling effect of pushing me into far-sightedness and how would he do that?

Many thanks again,
David
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Re: Is enhancement technically possible in my case?

Postby LasikExpert » Thu Apr 15, 2010 7:14 pm

The coupling effect is a part of the physics of laser vision correction. It will occur ever time. What the doctor can do is project how much hyperopia will be induced, and then at the same time correct the hyperopia. As an example, if you have 1.00 diopter astigmatism and the surgeon expects 0.25 diopter hyperopia after correction of the astigmatism due to coupling, then the surgeon would program the system to provide 1.00 diopter astigmatism and 0.25 diopter hyperopic correction.
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Re: Is enhancement technically possible in my case?

Postby skenehouse » Thu May 13, 2010 8:42 pm

Thanks for the responses and I'll discuss with my eye surgeon. If I do have an enhancement in one eye are there any problems with lifting the flap as it will well over a year since my initial procedure (April 2009) if I eventually get it done? Also should I get it done sooner rather than later or will the flap not get any harder to relift over the next few months?

Thanks,
David
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Re: Is enhancement technically possible in my case?

Postby LasikExpert » Thu May 13, 2010 9:18 pm

"Lifting the flap" is a bit of a misnomer. It is more like separating the cornea at the location of the original flap incision. The flap heals somewhat like a tupperware lid. It is tight at the edges all the way around, but less adhered in the middle. The surgeon is able to break the bond at the edge and the remainder will lift. I know of a case study of a flap lift at 12 years postop, so I'd say you probably have plenty of time to consider your decision.

Also, your doctor may recommend PRK on the Lasik flap. This procedure, which does not require a flap lift, tends to work well for smaller enhancements.
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