really thin cornea - can I even get lasek? and where?

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really thin cornea - can I even get lasek? and where?

Postby phazei » Fri Jun 05, 2009 11:59 pm

First, this forum times you out if you write a post and go to find something for too long, so it pops you to the login screen and you lose everything you've wrote. Moral: use notepad.

I had 2 lasik appointments yesterday that I setup back to back, one with [National Chain #1] and the other with [National Chain #2].

First I went to [Chain 1], when the guy did the cornea thickness test, he said 'wow'. Said it was ~255microns. He tried once more, then they sent me off.

Next I went to [Chain 2], they did the CustomVue test first, then had me sit at the same cornea thickness measuring machine. I knew they were too thin, but I wanted to see how it went. It had these black circles and light up yellow circles and a few leds. The first time she did it she thought something was wrong with the machine and tried it again, next she put tear drops in my eyes and did it again, finally she said my eyelashes were too long and had an assistant hold my eyes open wider. Next they took me to this other room where she said they had this ultrasonic measurement device. She put numbing drops in my eyes and poked them with this thing in a number of spots. Then the doctor came in and did it again. At least they were being thorough here.
So the final measurements were ~433microns in the center, and ~515microns at the edge.

It seems odd that one place gets ~255microns and the next ~433microns. Either way, still to thin for Lasik :(

I was really disappointed as I've been saving for months for this and I can't stand my glasses anymore. So I'm hoping I can perhaps get LASEK or Epi-Lasik?
This is my perscription:
OD -5.75 -1.5 017
OS -4.25 -1.75 164

Even if I can, I called a number of places here in Nevada and most of the people don't have a clue what either is. One even treated me like an idiot for even asking.

Do I have a chance?
Anyone know someone in Southern Nevada who can do LASEK/Epi-Lasik?

Thanks,
Adam

Note: Names of Lasik providers were redacted.
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Postby LasikExpert » Sat Jun 06, 2009 5:12 pm

If your corneas were actually 255 microns thick, then you would be an abnormality that would likely need to be reported to the medical journals. The 433 in the center is much more likely to be correct.

The chains you mentioned tend to do Lasik and Lasik only. Staffers may not even realize alternatives are available. That is the problem with a one-trick pony. You may need other tricks.

Your prescription indicates that you would need about 75-110 microns of corneal tissue removed to fully correct your myopia (nearsighted, shortsighted) and astigmatism (irregular cornea). This would make your corneas about 330 microns thick after a surface ablation surgery like PRK, LASEK, or Epi-Lasik. While this is well above the 250 micron minimum (more is always better), there are other concerns.

The fact that the ultrasonic devices had so much trouble getting a reading and your unusually thin corneas indicate that there may be something else going on. Check if your family has a history of corneal disease, transplants, etc. I recommend that you get an evaluation from a corneal specialist before any elective eye surgery. Also, that corneal specialist will probably know exactly who to see in Southern Nevada and - even more important - who to avoid.
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Postby phazei » Mon Jun 08, 2009 4:47 am

I saw another guy yesterday. An actual Dr. His office staff seemed incompetent, but he was much better. Was informative.

I went to him specifically because his website mentions he does Lasek, but when I called his offices none of them even had a clue as to what that was. When I talked to him he said he perfers PRK (and said it was basically the same as Lasek and Epi-Lasek) since replacing the epiphylium can interfere with the other cell regrowth.. I'm not sure how much I believe that, that's the whole point of Lasek and Epi-Lasik, isn't it?

He gave me about the same number, about 320microns. He said it was so close to the 300microns he likes to stay above that he didn't feel comfortable doing it. He did mention the lower limit of 250microns, but said he likes it over 300.

He said he also does IOL and suggested having that done with a little bit of PRK on top of it to fix the astigmatism since the IOL can't fit it. He said the way he cut it could help, but it wouldn't fix it all.

But he also charges $4k per eye for the IOL...

Is 320microns really that bad? It's over the 250microns. He said he's read lots of journals and from what he's gotten from them he likes it thicker. At 320microns minor enhancements would still be possible if needed, no?

Thanks,
Adam
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Postby LasikExpert » Mon Jun 08, 2009 5:02 am

phazei wrote:When I talked to him he said he perfers PRK (and said it was basically the same as Lasek and Epi-Lasek) since replacing the epiphylium can interfere with the other cell regrowth.. I'm not sure how much I believe that, that's the whole point of Lasek and Epi-Lasik, isn't it?


I agree with the doctor about PRK. In many circles, LASEK and Epi-Lasik are considered so much baggage.

phazei wrote:Is 320microns really that bad?


No, it is not really that bad and up to about 1.00 diopter of enhancement may be possible, but the doctor may also be concerned about what percentage of your overall cornea will be disrupted. Many are concerned when nearing the 50% mark.

You will want to read about Phakic Intraocular Lens (P-IOL) and Refractive Lens Exchange (RLE).
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Postby phazei » Thu Jun 11, 2009 9:50 am

Well, I don't know how that machine with the black rings with the yellow rings that light up works, but how ever it does, it doesn't on my eyes.

I went to another place. They had the same machine. At all of those places that machine had issues with my eyes. Maybe there's a divot or something on my cornea, but it read my right eye at 266microns one time and 300microns another.

They couldn't get any reading on my left eye with it, they tried 5 times and it just wouldn't scan right.

This place didn't use the manual ultrasonic measuring device. Just suggested implants.

I guess I'm SOL for any lasik or prk, sigh.
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