surgeries after LASIK

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surgeries after LASIK

Postby Marcella » Sun Apr 01, 2007 9:12 pm

Does having LASIK surgery rule out the possibility of later undergoing SRP or IOLI ?

Thank you.
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Postby LasikExpert » Sun Apr 01, 2007 11:46 pm

Surgical Reversal of Presbyopia (SRP) is a general term and can mean several different techniques, none of which have been proven to actually reverse presbyopia. All are some sort of compromise workaround.

The calculatons for intraocular lenses (IOL) can be more difficult after refractive surgery, but your doctor can take the needed measurements before surgery and use them later.
Last edited by LasikExpert on Mon Apr 02, 2007 5:05 pm, edited 1 time in total.
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Postby Marcella » Mon Apr 02, 2007 1:13 am

Glenn

Thanks--most helpful----I'll ask my surgeon about taking the measurements for IOL.

I was referring to this newish SRP procedure--don't know its official name-- I learned about at ihateglasses.com/html/healthscout.html


"In the operation, doctors insert four tiny implants into pockets created in the sclera, or white part, of a patient's eye. The implants stretch the sclera over the muscle that pulls on the lens to adjust focus. With more room to work, Schachar says, the muscle exerts a more powerful pull, allowing the eye to focus once again at close range on small objects like words on a page."

"Doctors have been taught since the mid 1800s that presbyopia was caused by a progressive hardening of the lens as people age. That theory made little sense to Dallas ophthalmologist Dr. Ronald A. Schachar, who had treated many elderly patients whose lenses showed no hardening. He theorizes that presbyopia occurs because the lens, like fingernails or hair, grows throughout a person's life, eventually crowding and hampering the muscles that control it."

"There is some skepticism," says Schachar, who developed SRP. "This (procedure) is the proof."

Note: This post was edited to alter an external link.
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Postby LasikExpert » Mon Apr 02, 2007 2:25 am

I am very familiar with Dr. Schachar's theory of accommodation and scleral implants. To answer your question directly, scleral implants would probably not be problematic after laser assisted refractive surgery like Lasik, PRK, LASEK or Epi-Lasik. To respond more generally, scleral implants are still implanted with success, but have generally fallen out of favor do to relatively unreliable predictability.
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newer prccedure

Postby Marcella » Mon Apr 02, 2007 12:49 pm

I know I read a press release about a newer procedure that uses only incisions rather than implants. Have you heard anything about that?
Just curious.
Thanks.
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Postby LasikExpert » Mon Apr 02, 2007 5:17 pm

Scleral Relaxing Incisions (SRI) is another technique. Laser Relaxing Incisions (LRI) is another. Many different kinds of inserts. There have been a lot of attempts to perfect presbyopia correction.

Dr. Schachar's theory of how we change focus (accommodation) is virtually the opposite of what has been held for about 150 years. Many doctors and researchers are attempting to apply this new theory to a practical application for the reduction or reversal of presbyopia. None have found a reliably predictable method, but it is not for a lack of trying.

As you can probably tell I'm not personally terribly excited about the current state of presbyopia correcting surgery. There is one very strong reason. In many of these techniques a patient will have surgery in only one eye, but report improved near vision in the eye without surgery. If surgery improved accommodation, then the other eye should not be affected. This indicates that there is something else going on. What that is I have no idea, but it is clearly not just the surgery.

Presbyopia correction is the Holy Grail of refractive surgery. The market is huge, ever expanding, generally affluent, and the demand can be measured in light years. The folks who figure this out will be well rewarded, and the race has been running for a few hundred years.
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Postby Marcella » Mon Apr 02, 2007 10:15 pm

Ok--well to your knowledge, would these type of surgeries still be possible after LASIK, to restore near vision?
Once LASIK has removed the near or far vision from an eye, is it gone forever?
Thanks again.
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Postby LasikExpert » Mon Apr 02, 2007 11:10 pm

To my understanding all scleral relaxation methods would be able to be performed after Lasik or similar laser eye surgery. Lasik should not be a problem for SRP inserts. Multi-focal IOLs are appropriate if the patient's contrast sensitivity is good and is no pre-existing halo or ghosting (with or without Lasik). The intracorneal implants in development should be okay with Lasik.

I'm not recommending any of these techniques, but they would likely be possible after uneventful Lasik, PRK, LASEK, or Epi-Lasik. Whether the ablation was conventional or wavefront-guided or wavefront-optimized would not make any difference for presbyopia correcting techniques.
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Postby Marcella » Tue Apr 03, 2007 11:02 pm

So...
(I'm sorry if I'm belaboring the point here)

If I were to lose my close vision in one eye ithrough an uneventful monovision LASIK, it might be restorable through one of these techniques?

I'm not holding you to anything here, just trying to understand how it works.

Thanks
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Postby LasikExpert » Wed Apr 04, 2007 5:13 am

After Lasik you would probably be eligible to attempt to restore near vision with one of these techniques. Whether or not it would actually work is another issue.
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