Had it a looong time ag0

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.

Had it a looong time ag0

Postby BobD » Thu Mar 08, 2007 4:00 pm

I am 67 and had PRK done on both eyes in 1994. At that time I had -4.75 left and -5.25 right with some astigmatism in both eyes. At the time the surgeon stated that he could not perform a wide area ablation because I have wide pupils and thin corneas, his rule at that time being not to take more than 20% away. For the first year I had good vision, but in the meanwhile my eyes have slowly but steadily regressed to -2 right and left. The good news is, I don't need reading glasses. I also tend to dry eyes still, and for instance, skiing without eye protection results in extremely blurred vision. I still have some starring and I am not delighted with my low light or night vision.

The question is: has the state of the art advanced to the point where I could get rid of my glasses or should I just be happy with what I have? Could the dry eyes be a part of the problem?
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Postby LasikExpert » Thu Mar 08, 2007 6:50 pm

There have been tremendous advances in refractive surgery technology and technique since 1994. The difference could be measured in light years. Whether or not these advances mean additional surgery would be appropriate could only be determined after a comprehensive evaluation from a competent eye doctor.

Your progressive myopia (nearsighted, shortsighted) vision may not be entirely because of regression from your PRK. As we age age there are many changes in the natural crystalline lens within the eye. One of the first noticeable changes is presbyopia, which is the lens becoming less able to focus on objects near and reading glasses become necessary. Another natual change is the development of cataracts.

An early stage of cataract development is a thickening of the center of the crystalline lens. This thickening can induce myopia and is often called "second sight" because myopia better allows you to see objects near. As you said, you now don't need reading glasses.

Cornea-based refractive surgery like Lasik, All-Laser Lasik, PRK, LASEK, and Epi-Lasik do not resolve the cataract development issue. If this is a part of your vision change and you do not yet have mature cataracts, then you may want to consider Refractive Lens Exchange (RLE).RLE is exactly the same as cataract surgery and may resolve both early stage cataract development and your refractive error problem.

Of course, if you fully correct your refractive error you will be back to wearing reading glasses. You may want to investigate monovision correction as a possible alternative. You can have monovision with contact lenses, cornea-based refractive surgery, or RLE.

If you actually have cataracts, then the cost of surgery would be covered by your medical insurance including Medicare. RLE is considered elective and would not be covered by most insurance plans, including Medicare.

Dry eyes will contribute to poor vision quality no matter what the refractive error. You may want to read our article regarding dry eye treatment for ideas that may be helpful.
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Postby BobD » Thu Mar 08, 2007 8:16 pm

Thanks for the quick answer.

I had an eye examination (Eye Doctor) in December, no sign of cataracts or any other eye problems. I have one stable floater that has not moved for over two years.

I do not believe monovision is an alternative for me as I am a Golfer and Target Shooter (Pistol & Revolver). And I am not vain enough to worry about reading glasses :wink:

At least someone can have an input as to what happens long term after PRK.
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