Candidate for LASIK?

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

Candidate for LASIK?

Postby aarond38 » Sun Dec 31, 2006 8:48 pm

I am a 62 year old male with a recently developed floater problem.
My recent RX for glasses was:

Distance R sphere -4.25, cylinder +2.00, Axis 175
L sphere -3.00, cylinder +1.50, Axis 165

Add - R sphere +2.50
L sphere +2.50

I have no earthly idea what that means other than I wear bifocals and am in healthy condition.

I recently went to my local Opthamology Clinic for a consultation with a LASIK Specialist (not a doctor but very professional) and was told it appeared I was a candidate for LASIK (had various eye tests, measurements etc. performed on three different machines)!

The Web site for the doctor indicates that they utilize the VISX Excimer Laser System (S2).

I have an appointment set up to meet with the Opthamologist that will perform the LASIK Surgery if he considers me a candidate for LASIK.
I was advised he may perform additional tests on me and will discuss his findings at that meeting.

The Opthamologist has listed on the clinic's web site the following resume:

Residency in Opthamology: Eye Foundation Hosp. Univ. of AL
PhD, Chemistry: Univ. of SC
BS, Univ. of VA
Board Certified, Amer. Academy of Opthamology
Alpha Omega Honor Medical Society
American Society of Cataract and Refractive Surgery

My questions are:
Am I a candidate for LASIK?
Will the floaters in my eyes be affected by LASIK?
Does my doctor's qualifications suffice to perform LASIK?

I have printed the 50 questions you suggest I ask of my doctor and intend to question him at length with them.

I have read most of the posts on this forum that I felt pertained to my situation and thank you and all the folks that have participated to make this forum a great place where people like me can come for in depth information so we can become better informed about these procedures.
I anxiously await your reply.
aarond38
 
Posts: 1
Joined: Sun Dec 31, 2006 4:37 am

Re: Candidate for LASIK?

Postby LasikExpert » Sun Dec 31, 2006 11:35 pm

aarond38 wrote:I am a 62 year old male with a recently developed floater problem.
My recent RX for glasses was:

Distance R sphere -4.25, cylinder +2.00, Axis 175
L sphere -3.00, cylinder +1.50, Axis 165

Add - R sphere +2.50
L sphere +2.50

I have no earthly idea what that means other than I wear bifocals and am in healthy condition.


You are moderately myopic (nearsighted, shortsighted) and have significant astigmatism. Astigmatism is when the cornea is not spherical like the top of a ball, but is elliptical like the back of a spoon. Myopia means that without corrective lenses you can see objects close well, but cannot see objects distant very well. Astigmatism commonly presents as a doubled or ghost image in each affected eye - if correction is not provided.

You are also presbyopic. Presbyopia is when the natural lens within the eye is not able to change shape and thereby change focus to see objects near (accommodation). Presbyopia is why you need strong bifocals.

You are within the treatable range of Lasik, howeer I recommend that you consider Refractive Lens Exchange (RLE) as an alternative to Lasik. RLE has advantages and disadvantages.

RLE is exactly the same as cataract surgery. A cataract means that the natural lens in the eye has become cloudy. The surgery is a process of removing the natural lens and replacing it with an artificial intraocular lens (IOL). The IOL will be of an optical power targeted to correct all of your myopia.

RLE may be considered appropriate for someone who is presbyopic because the natural lens is not changing shape. When presbyopic, the function of the natural lens is virtually the same as what would be provided by an IOL except the IOL would be able to correct your myopia.

Virtually all of us will develop cataracts if we live long enough. RLE would eliminate the need for later cataract surgery because you are essentially doing the cataract surgery before the cataracts develop. Consider RLE a pre-emptive strike against cataracts.

Three IOLs may be able to provide near and distance vision. The Crystalens is an IOL designed to change shape and provide some accommodation. The ReSTOR and ReZoom lenses are multifocal lenses. Each emphasizes a different range of focal length. You would need to discuss with your doctor which, if any, specialized IOL would be appropriate.

There are some issues that may make RLE inappropriate.

RLE is an invasive procedure and carries what most would consider more risk than Lasik, however if you eventually develop cataracts you would probably need this procedure anyway.

You mentioned an increase of floaters. Floaters can be an indication of a compromised retina. The retina is the membrane in the back of the eye that is sensitive to light. Before any surgery you should be evaluated by a retina specialist to determine if you have an elevated risk of retina problems during surgery. Because RLE is more invasive than Lasik, a compromised retina may be a contraindication for RLE.

RLE will not correct your astigmatism. To correct both myopia and astigmatism, RLE with a laser procedure to resolve the astigmatism may be recommended. This combination of RLE and Lasik is common.

If you elect to have laser assisted surgery (with or without RLE) I recommend you consider a surface ablation technique such as PRK, LASEK, or Epi-Lasik rather than Lasik. These techniques provide equal or better long-term results, but eliminate the Lasik flap and thereby eliminate any possibility of a Lasik flap related complication. Lasik flap complications may be rare, but impossible is always better than rare.

aarond38 wrote:Residency in Opthamology: Eye Foundation Hosp. Univ. of AL
PhD, Chemistry: Univ. of SC
BS, Univ. of VA


A doctorate in chemistry is not required to become an ophthalmologist. This is something extra, but I cannot see how it is directly related to a surgeon’s ability to perform refractive surgery.

aarond38 wrote:Board Certified, Amer. Academy of Opthamology


This may not be artfully written. The American Academy of Ophthalmology (AAO) does not certify surgeons. The AAO is a membership society of ophthalmologists. There are no evaluations of proficiency. Any ophthalmologist that pays the membership dues can join. There is absolutely nothing about AAO membership that indicates quality of surgery or surgeon.

The American Board of Ophthalmology (ABO) does evaluate a surgeon, but does not provide evaluation specific to refractive surgery. ABO certification is valid for a lifetime if the doctor was certified before 1992, or 10 years if certified after 1992. In relation to conventional or custom wavefront Lasik, PRK, LASEK, Epi-Lasik, or other refractive surgery techniques, ABO certification would be conspicuous by its absence, but not terribly important by its presence.

aarond38 wrote:Alpha Omega Honor Medical Society


Means that the doctor was in the top 25% of his class during the final 16 months of postgraduate education. This honor may have been attained for his PhD doctorate in chemistry and has nothing to do with his medical degree or refractive surgery. Depending upon when the doctor graduated, today’s refractive surgery techniques may not have been taught where he received his medical degree. This may be an important indication of the surgeon’s understanding of ophthalmology, but also may have limited value.

aarond38 wrote:American Society of Cataract and Refractive Surgery


Like the AAO, the American Society of Cataract and Refractive Surgery (ASCRS) is a membership society of ophthalmologists. There are no evaluations of proficiency. Any ophthalmologist that pays the membership dues can join. There is absolutely nothing about ASCRS membership that indicates quality of surgery or surgeon.

aarond38 wrote:I have printed the 50 questions you suggest I ask of my doctor and intend to question him at length with them.


We very highly recommend that you submit the 50 Tough Questions For Your Lasik Doctor in advance. Many of the questions may need to be researched and answers may be prepared in advance. This will also allow more time during your exam spent discussing your individual circumstances.
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 Thinking About It

Who is online

Users browsing this forum: No registered users and 1 guest