Wrong direction for my mononvision?

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Wrong direction for my mononvision?

Postby lance » Sun Dec 17, 2006 9:07 pm

I went to have my monovision all-laser Lasik surgery done two days ago.

Before the surgery I have -4.00 (left) and -4.75 (right, dominated eye). I tried the contact lense to simulate the effect of monovision and decide to leave 0.75 under-correction in my left reading eye. In the surgery the doctor did customVue (using Visx) for my right dominated eye, and decided not to use customVue for my reading left eye (see explanation below).

One day after surgery during the post-op check up, I found out my two eyes got opposit results. Supposely my left reading eye should be under-corrected and leave some room for reading and my dominate right eye should be corrected in full. But instead my left reading eye can see 20/15, but my right dominated eye can only see 20/40 - 20/45! I was worried about the doctor might messed up the right and left eyes, but the doctor said he didn't. He indicated my both eyes are probably overcorrected a little bit causing some degree of farsightness. But he said both eye will "improve" to the same direction, and my reading eye will get "worse" and my distance eye will get better.

I am very confused, how can both my eye "improve" to the same direction with one get worse and one get better? Is this normal? Did it cuase by the fact, he used customized lasik for my distance eye, and regular lasik for my reading eye?

Questions about CustomVue for my reading eye:
Before the surgery I asked the doctor a couple of times about if he is going to use wavefront customized lasik (in this case Visx S4 customVue) for my reading eye. He assured me that he is going to do that so that both my eye will benefit from customized Lasik.

But right before the surgey when I was on the operatiing table, he told me that he couldn't do the customVue on my reading eye due to "too much gap". I didn't really understand it, but he didn't give me any chance to ask more questions about this by pressing on with the operation. I felt bad about this, but didn't want to harm my eyes by arguing with him at the surgery point. I thought with my minor undercorrection (0.75), any lasik machine (including the Visx CustomVue) should be able to handle it. I really like to have customeVue for my reading eye, as I was told it will help my vision. Plus I also paid for both eyes for CustomVue and it costs $500 more for each eye.

What did my doctor mean by "too much gap"? Was he misleading me by believing I can get customVue while he knew all along I can not get that via Visx S4 machine? Will it affect my vision (day and night) in my reading eye?

Thanks in advance!
lance
 
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more info

Postby lance » Sun Dec 17, 2006 9:26 pm

I forgot a couple of more factors:

During the surgery, when they use intralase to cut the flap, they had me lay on a bed to wait for more than 2 hours! I thought normally you have to wait for 15 to 30 min to let the bubbles settle down, but 2 hours seem to be too long! Will it contribute to the negative results I got?

Another factor is during my pre-op exam, I found out my eye is very dry (3 mm? with normal at 15). When asked doctor if I need to get my dry eye treated first befor surgery, he said don't worry. In the after surgery exam, he indicated the bad results I got might be cuased by my extrem dry eye condition. He implanted the temporary tear plugs for both my eyes. He also asked me to use Refresh P.M. lubricant eye ointment for 3 months, and start to take flexseed oil pills for 3 times a day. This is on top of my 12 to 16 time tear drops each day.

Do you think the long wait after my flap was created and my dry eye condition contributed to the poor reversed the results I got so far?

Thanks a lot!
lance
 
Posts: 20
Joined: Wed Dec 06, 2006 1:11 am

Re: more info

Postby LasikExpert » Tue Dec 19, 2006 4:12 am

I've responded to some of your concerns in other threads, so I will not respond to those same concerns here.

lance wrote:I am very confused, how can both my eye "improve" to the same direction with one get worse and one get better?


They may not, but you will need to wait and allow your eyes to heal and settle down before anyone will know what is reasonable to expect for your final outcome. After a few weeks your doctor will probably do a manifest refraction (which is better, one or two?) that will give you your current prescription. I suspect that you are overcorrected and hyperopic (farsighted, longsighted) in your dominant eye and close to plano (no refractive error) in your nondominant reading eye. This can change with healing. If both eyes regress enough, the hyperopia will move to plano and the plano eye will become myopic (nearsighted, shortsighted), which was the original target.


lance wrote:During the surgery, when they use intralase to cut the flap, they had me lay on a bed to wait for more than 2 hours! I thought normally you have to wait for 15 to 30 min to let the bubbles settle down, but 2 hours seem to be too long! Will it contribute to the negative results I got?


The flap does not exist until it is lifted and your flap would not have been lifted before your waiting period for the bubbles to dissapate. In theory this extended time should not have been problematic, however it is something that should be evaluated by the surgeon.

lance wrote:In the after surgery exam, he indicated the bad results I got might be cuased by my extrem dry eye condition.


The amount of tissue ablated per laser pulse is greater if the cornea is dehydrated. It may be that a combination of the extended waiting time and your pre-existing dry eyes contributed to the overcorrection. This is something to discuss with your doctor.
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