Enhancement consideration

Post your questions and start your research in this forum if more than three months ago you had any type of surgery to reduce the need for glasses and contacts.

Enhancement consideration

Postby Wsyes » Wed Sep 20, 2006 7:01 am

Hi Glenn,

I had wavefront guided lasik 6 months ago. I’d like to seek your independent advice before my appointment with the surgeon next week.

I was 36 and my original prescription was OD: –7.75, -1.00 x 165, OS: -6.00, -1.00 x 180. Pupil size is 8mm. My surgery said that I was suitable to do wavefront lasik. Vision was blurred in the first few weeks after operation but has been improving. In the 3rd month, my prescription was about –0.6. Until now I have glare and starburst and eyes are dry and tired at night. Though it is not intolerable but I feel unhappy as I lost my best corrected vision and I hope that I had not done the surgery. My surgeon said the HOA is elevated but not too serious. And he suggested me to do enhancement on my right eye on the 6th month.

My questions are:
1. In my case, the poor low light vision is mainly caused by HOA. I’ve read an article in your website which said that elevated HOA cannot be treated by wavefront retreatment. Why did my doctor propose a retreatment then? I’m confused.
2. Based on past statistic, will the vision for elevated HOA be significantly improved after retreatment?
3. If no, are there other options? (my doctor said there is no other option but to accommodate)
4. During enhancement, I believe that more tissue will be removed and less remain for possible regression. Is the chance of regression high in my case?
5. Considering the risk and benefits, do you think I should take the risk of enhancement?
Wsyes
 
Posts: 1
Joined: Mon Sep 18, 2006 6:12 am

Re: Enhancement consideration

Postby LasikExpert » Thu Sep 21, 2006 4:46 am

Wsyes wrote:1. In my case, the poor low light vision is mainly caused by HOA.


Higher Order Aberrations (HOA) are a system of measurement of imperfections in optics. HOA do not cause poor vision, they are simply a way to measure poor vision. This is the same as your prescription for glasses does not cause poor vision, but is just reporting how poor it is.

Wsyes wrote:I’ve read an article in your website which said that elevated HOA cannot be treated by wavefront retreatment.


There appears to be some confusion. Complex Wavefront Retreatment may reduce the aberrations that provide poor low light vision, but every case is unique. If the reported aberrations are primarily Spherical Aberration (as defined by Zernike polynomials) then the likelihood of improvement is probably pretty good. Spherical Aberration simply means that the center of the cornea has a different refractive error than the outer edge. If the problem is at the level of Secondary Astigmatism, Trefoil, Quatrafoil, or Tetrafoil, it is much less likely that Complex Wavefront Retreatment will help much, if at all.

Wsyes wrote:Why did my doctor propose a retreatment then? I’m confused.


I assume that in your surgeon's experience Complex Wavefront Retreatment has improved vision for patients with your particular aberrations. This is an issue that you need to discuss in detail with your surgeon.

You also should read about Lasik pupil size issues to better understand the likely reason why your vision is poor at night.

Wsyes wrote:2. Based on past statistic, will the vision for elevated HOA be significantly improved after retreatment?


Depends on which aberrations are affecting vision and to what amount. This is a level of detail that makes it difficult for me to provide a response. Your doctor will have better answers than me.

Wsyes wrote:3. If no, are there other options? (my doctor said there is no other option but to accommodate)


Custom fitted Rigid Gas Permeable (RGP) contact lenses have been very helpful for many patients with your symptoms. The reduction of the size of the pupil can reduce or eliminate the symptoms. Two eye drop medications can achieve this. Pilocarpine strongly reduces the size of the pupil, but can cause headaches and other problems. Alphagan P is actually a glaucoma medicine, but it too reduces the pupil size and seems much more benign than pilocarpine. Ask your doctor if any of these alternatives are appropriate.

Wsyes wrote:4. During enhancement, I believe that more tissue will be removed and less remain for possible regression. Is the chance of regression high in my case?


Any enhancement surgery would remove a relatively small amount of tissue and regression would be unlikely.

Wsyes wrote:5. Considering the risk and benefits, do you think I should take the risk of enhancement?


Try the alternatives first, discuss the potential risks with your doctor, get a second opinion, and decide what you believe is best for you. It is your opinion about the relative risk v. the relative benefit that counts, and only your opinion.
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


Return to Had It A While Ago

Who is online

Users browsing this forum: No registered users and 1 guest