Overcorrection. now farsighted with poor vision

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Overcorrection. now farsighted with poor vision

Postby GeneralPatientInquiry » Wed Jun 28, 2006 9:07 pm

I had LASIK 5-20-06 at [redacted] near Chicago. by Dr DA & somehow have overcorrection to farsightedness making my work very difficult.

I am a 49 year old female. Prior to surgery I was OS: -3.75 2.25 @ 090 and OD: -4.25 2.25 @ 080. I am now OS: +2.25 2.00 @ 168 and OD: +2.00 2.00 @ 173.

My 4 week check was 6-22, the assistant who saw me gave me a prescription for glasses but kept making excuses "being farsighted is good" & won't listen to my concerns just says it's too early for an enhancement. I understand I need to heal & maybe the eyes will change somewhat more(I hope not to the worse). But I need to have a chance to ask if I am a candidate for enhancement; if this would endanger the depth of my corneas, what procedures are available such as do they only do LASIK even if EPI-LASIK or PRK might be better, & they gave me astigmatism in the opposite direction from the original & can that be fixed. Am very worried!
This post is a reprint of a previously requested inquiry received by USAEyes.org via email.
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Postby LasikExpert » Wed Jun 28, 2006 9:09 pm

Some quick clarification: Epi-Lasik cannot be performed after Lasik, however PRK and LASEK could be performed after Lasik (on the flap) but is probably not necessary. Your astigmatism has not changed direction. The first prescription was written in negative cylinder, and the second was written in plus cylinder. They seem incompatible, but actually are saying the same thing. See Read Eyeglass and Contacts Prescription

I have a question for the assistant who told you being farsighted is good. If it is good, then why do they provide surgery for farsighted people to remove their farsightedness?

Being farsighted is not good. Being farsighted at age 49 is especially not good because of presbyopia. Being very farsighted with significant astigmatism is downright bad and will provide poor vision quality at almost all distances. That is where you are today. Although your refractive error is lousy, your medical situation is much better.

Hyperopic (farsighted) Lasik removes tissue from a different area of the cornea than myopic (nearsighted) Lasik. The area where tissue is removed for hyperopic Lasik is the part of the cornea that is commonly thickest. Corneal thickness should not be an issue for enhancement surgery.

Hyperopic Lasik is not as predictable as myopic Lasik, although I don't think anyone would have predicted your myopic Lasik outcome. Although it is somewhat less predictable and will be made more difficult by the large amount of astigmatism, the relative benefit of not being hyperopic when you are presbyopic are great. If medically appropriate, you will want to seriously consider enhancement surgery.

Before having additional surgery you need to know why you were so far overcorrected. This is not a "things just happen" scenario. There is a reason and that reason needs to be resolved before you have additional surgery. I recommend that you seek a second opinion from a corneal specialist. If you would like a referral, just let me know.

Also, I very highly recommend that you provide to management of the facility where you had your surgery a letter explaining your experience with staff. Staff telling a patient in your circumstance that being hyperopic is good is doing a disservice to the patient and to the company s/he represents. Patients are not stupid, and even if they were the Internet makes them rather smart very quickly. That person needs to know that this is unacceptable behavior.
Glenn Hagele
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Postby GeneralPatientInquiry » Thu Jun 29, 2006 7:04 am

Glen , I really appreciate your advice.

Is the reason I need a cornea specialist because my situation suggests I have something possibly different or defective with my corneas that caused the unpredictable results, or are you more concerned that the bad results may have damaged my corneas? Do you think when I talk with the [redacted] doctor tomorow I should ask if the laser was incorrectly programmed or calibrated?

I was a 9am appointment on a Saturday, but may not have been the first procedure on that laser that day. Do you think that they will be forthcoming if there was a mistake?

Does health insurance generally cover medical care as followup to a complication of lasik if they didn't cover the lasik in the first place? Should [redacted] cover the cost of a cornea specialist (in your experience do the chains take responsibility better or worse than the independent doctors?) Thank you again.
This post is a reprint of a previously requested inquiry received by USAEyes.org via email.
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Postby LasikExpert » Thu Jun 29, 2006 7:09 am

There is nothing that you have said that would indicate your eyes are "damaged" other than having been overcorrected. I recommend a corneal specialist for a second opinion because that is the highest qualification of someone who would be appropriate to fully evaluate your situation. You want good advice about what to do next.

Your results are not what would be desired, but may not have been unpredictable. We don't know why you were overcorrected so it may have been a straightforward mistake/error. You may get the best answer by simply asking your doctor to explain fully and in plain language why you were overcorrected. They may have already determined what went wrong, if that determination is possible. Sometimes overcorrections occur when there is no clear indication that it should have occurred, but with an overcorrection this large there may be a direct reason.

Medical health insurance does not normally cover care required to resolve a poor result from a non-covered procedure, but you can always ask. The worst that will happen is that your request will be rejected. Of course if you use your medical insurance you will be restricted to their providers of care and the process by which you would get to that provider of care.

You should ask your primary Lasik surgeon to pay for a second opinion, but if they do they should also have the choice of who provides that second opinion. It is not likely that anyone would give you a blank check and tell you to go wherever you please. It may be better to select your own doctor so there is not even a hint of bias from your current surgeon. You would probably need to pay for the second opinion yourself.

Accepting responsibility runs the gamut. I have seen chains and individuals step up and care for patients when they really had no legitimate requirement to provide care, and others do what they can to deflect responsibility when they were clearly at fault. There really is no generalization, not even a generalization to the one chain that provided your care. Expect them to do what is right. They are in the business of Lasik and good business is always a satisfied patient. Give them the opportunity to be a hero by asking for their assistance where you think it is needed. You do your part by asking. By asking you also give them the opportunity to do their part by providing what you seek.
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


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