Healing/recovery following Lasik enhancement

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Healing/recovery following Lasik enhancement

Postby ntbaker » Fri Feb 23, 2007 6:25 pm

Just a quick question about "enhancement". I underwent custom wavefront zyoptix lasik on both eyes over 4 months ago. At my last exam, I was told my eyes have been stable for the last month or more but exhibit induced astigmatism (0.75) in one eye and residual Rx -0.50)in the other. I experience terrible night vision since the surgery and it has not improved, resulting in the inability to drive at night. I have been scheduled for "enhancement" (using the same technology and surgeon) at about my 6 month post-op point. I understand that the existing flap is "lifted" for the enhancement, so the physical process is somewhat different than the original surgery.

My question is whether the healing/recovery time following "enhancement" is often similar to that of the original surgery or is it quicker/slower?

Thanks
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Postby LasikExpert » Fri Feb 23, 2007 7:25 pm

As a general rule enhancement Lasik surgery recovery is virtually the same as initial Lasik surgery. Your surgeon should be able to advise you if there are any unusual circumstances that would make the recovery different.
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Postby DryEye » Fri Feb 23, 2007 8:32 pm

How can one tell induced astigmatism vs residual astigmatism?
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Postby LasikExpert » Sat Feb 24, 2007 12:58 am

If it was not there before surgery and is there now, it is induced. Temporarily induced astigmatism is somewhat common in the first few weeks/months after surgery because of the healing response. It normally resolves on its own.

If it was there before and is now less (but still there) it is residual.

As far as what it looks like to the doctor, they are essentially the same thing.
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Postby maria22 » Sat Feb 24, 2007 10:45 am

Glenn, do you think it would be reasonable to undergo an enhancement for residual astigmatism between 0.5 and 0.75?
I am somewhat torn because I do see so much better than before, but I also think that maybe things could still get better than what they are now.
I also have nystagmus, which makes it more difficult for the procedure to be really accurate, and my doctor has not been very helpful (he tells me 'maybe we could do better but maybe we should leave it'...)
Due to chidhood strabismus, my left ey still only gets up to about 50-60% whereas my right eye can now see about 80%. I was hoping to get my left eye into the 70% range, it actually was almost there right after surgery but the astigmatism seems to have increased slightly since then.
I am so torn between just being grateful for what has been achieved and considering another chance to get even better results...what is your opinion? (my initial lasik was on 11/21/06)
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Postby LasikExpert » Sat Feb 24, 2007 4:50 pm

You are asking for my opinion, which by its very nature will hold my personal bias. In my opinion the probability that attempting to correct less than a diopter of astigmatism for a patient with nystagmus and ambylopia will cause more problems than resolve them seems much too great. In my opinion you should rejoice in the improved vision you have, and not risk it trying for something better. I, however, am not you. As your doctor has said, it is possible to have improvement with surgery. My concern is that possibility is not the same as probability.

As an alternative you may want to consider the technique Orthokeratology (Ortho-K) or its derivative CLAPIKS. These are a process of wearing a rigid gas permeable (RGP) contact lens at night to reshape the eye, and that shape stays during the day. Ortho-K may be very successful for your residual astigmatism and would not carry the risk of surgery.

This is, of course, only my opinion. It is your opinion that is important.
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Postby maria22 » Sun Feb 25, 2007 3:10 pm

Thank you so much for your response.
I was really sceptical as well, and with my current vision, I don't even need corrective lenses.
I am mainly worried that my weak eye will regress further, since I got better results on the vision test one days after surgery than what I do now.
Still, I think it is better to be safe...!
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Postby DryEye » Sun Feb 25, 2007 5:58 pm

Glenn:
The overnight wears that reshape one's cornea for better vision during the day is expensive - correct? I believe it runs almost the same as lasik.
Perhaps, another opinion and some more time wouldn't hurt before anything is decided?
It does ultimately boil down to each individual whether settling with the result, wearing glasses, contacts or doing an enhancement is the best route.
Another opinion and more time probably doesn't hurt anyone.
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Postby LasikExpert » Sun Feb 25, 2007 7:02 pm

I'm not sure of the cost of Ortho-K, or if it would be included in the Lasik surgeon's fee, or if it would be appreciable less expensive for one eye only. It is just a possibility, but may turn out to not be a practical one.
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