Preparing for the first consultation

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.

Preparing for the first consultation

Postby sunshine885 » Thu Jun 15, 2006 7:52 pm

I have read through the 50 Q&A and note that you suggest not wearing contacts for 4 weeks prior to the exam that determines the final calculations for surgery. Have initial consultations set up with to surgeons next week. One requested that I not wear contacts for 3 days prior, the other 1 week prior. Both requested that I use refresh tears 4xdaily during the time without contacts. I know they both plan to dialate my eyes and the appointment will last ~1.5hours. Will this be the exam that determines the final calc for surgery? if so, they don't seem to have provided enough time, but meet all of your other criteria. Should I reschedule/cancel with these surgeons.
Second question: why the drops? will they still be able to assess my chance of developing dry eyes post surgery?

Thank you for your advice.
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Postby LasikExpert » Fri Jun 16, 2006 2:41 am

If you read any of the articles at our website and my comments in this forum you will see that we are a rather conservative bunch. It is possible that three days is enough time out of contacts, or that one week is enough time. It is possible, but four weeks out of soft contacts provides near absolute certainty that your corneas will have returned to their natural shape. The extra time is always a benefit, while too little time can be a detriment. No matter how long it takes, what is required is for the cornea to return to its natural state.

Depending upon the exact treatment and laser equipment used, the final calculations may be determined immediately before surgery or days/weeks in advance. You need to ask the doctors if the calculations created at this exam are the final calculations, or if a subsequent examination will determine the final treatment plan. This may be a comprehensive evaluation to determine if you are an appropriate candidate, but not the final treatment plan.

Temporary induced dry eyes are a common complication of Lasik and IntraLasik. They usually resolve during the normal six-month healing period, but determining any pre-existing dry eye or dry eye related problems, such as blepharitis, is important. Refractive surgery can exacerbate existing problems. Something that is marginal now may be pushed over the threshold and become problematic after surgery.

It would seem that artificial tear use that is out of your normal routine would make diagnosis of pre-existing dry eye difficult – your eyes would be artificially hydrated. Stable natural corneal hydration is important for evaluating the appropriate surgery plan. Unless you intend to use artificial tears 4 times a day after surgery, this is not a stable environment to measure for dry eyes.

I recommend that you ask each doctor their theory behind artificial hydration before evaluation for Lasik.
Glenn Hagele
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