Retreatments

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Retreatments

Postby SteveR » Sat Jun 23, 2007 9:23 am

Pre-LASIK prescription: -7.00, -8.00
Post LASIK prescription: -1.75, –3.00 (right, left)

Hi,

I had LASIK (+ intralase) treatment a little over 2 months ago, where the target was to be plano in the right (dominant) eye, and –1.25D in the left eye. This target was not quite met as can be seen from the figures above, and I may have regressed a touch from these month-old measurements.

My eyesight is sort of okay as things stand, though a little better would have been more than welcome. I get around mostly okay without glasses (when the light is good) though the left eye contributes little to vision at far or near. I am not keen on the idea of a flap re-lift, specifically on lifting something in the process of healing, but hopefully this feeling is unjustified. Having a surface technique over my LASIK flap does not appeal either, for other reasons, and I’m weighing up whether I should stick or twist, or perhaps even go for something in-between.

I am to shortly to go for my 3-month post-op consultation where the possibility of an enhancement will be discussed. I have a life-long warranty with the treating firm and my question relates to retreatments.

Questions:
1) Are the long-term risks associated with retreatments greater than for an original tretament (assuming LASIK both times)? I had no complications first time around though I do have some minor weird aberrations, which I guess is not totally to be unexpected. And is there research available on flap strength, nerve regeneration, etc after secondary flap lifts, as compared to single lifts?

2) I’m currently contemplating hedging my bets and having just the left (non-dominant and most myopic) eye retreated, to be –1.25D, as originally intended, since this eye is doing little at the moment and I miss the binocular vision. The question I have here relates to whether having the left (non-dominant) eye to have better vision than the right dominant eye (giving –1.75, -1.25, *if* all goes well) is likely to cause any kind of visual disturbances. Does the brain switch dominance or do something weird for example? If the left eye retreatment goes well I may choose to have the right done further on down the line , but am unsure about that. I do not mind some residual myopia, and in fact after trying out this monovision (admittedly to a degree that may not be a great test) my preference may well to be left mildly myopic in both eyes rather than having monovision. While I can currently focus to less than a foot with a full spectacle correction, myopia does make very extended close work sessions comfortable.

Many thanks.
SteveR
 
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Re: Retreatments

Postby LasikExpert » Sat Jun 23, 2007 9:33 pm

SteveR wrote:1) Are the long-term risks associated with retreatments greater than for an original treatment (assuming LASIK both times)? I had no complications first time around though I do have some minor weird aberrations, which I guess is not totally to be unexpected. And is there research available on flap strength, nerve regeneration, etc after secondary flap lifts, as compared to single lifts?


The long-term risks of Lasik enhancement surgery are virtually the same as initial Lasik. It is not much different than just waiting to the initial surgery 3-6 months later. The advantage is that the Lasik flap does not need to be recreated and the doctor knows how your corneas react to laser energy. The downside is that there is a slightly higher probability of epithelial ingrowth, which is a relatively benign condition but one that you would want to avoid.

SteveR wrote:2) I’m currently contemplating hedging my bets and having just the left (non-dominant and most myopic) eye retreated, to be –1.25D, as originally intended, since this eye is doing little at the moment and I miss the binocular vision.


One eye at a time makes perfect sense and doing the nondominant eye first also makes sense.

SteveR wrote:The question I have here relates to whether having the left (non-dominant) eye to have better vision than the right dominant eye (giving –1.75, -1.25, *if* all goes well) is likely to cause any kind of visual disturbances. Does the brain switch dominance or do something weird for example?


Yes, the brain can switch dominance, but what is probably more likely is that your very undercorrected dominant eye will be working overtime trying to focus on distant objects and your depth perception will be limited. This can cause headaches, dizziness, vertigo, and even nausea.

SteveR wrote:If the left eye retreatment goes well I may choose to have the right done further on down the line , but am unsure about that.


Having an open mind is probably the best decision for now. You can always have the other eye enhanced later.

SteveR wrote:I do not mind some residual myopia, and in fact after trying out this monovision (admittedly to a degree that may not be a great test) my preference may well to be left mildly myopic in both eyes rather than having monovision.


If you do a lot of near work, such as look at a computer all day, both eyes being about the same amount myopic may be preferred. Monovision is all about personal preference. Fortunately you can adjust correction with contact lenses to try out monovision.

SteveR wrote:While I can currently focus to less than a foot with a full spectacle correction, myopia does make very extended close work sessions comfortable.


This indicates that you may have some accommodation - ability to change focus. That is great for vision changes, but can also cause headaches if the eyes are too far imbalanced. You may want to read about Lasik eye strain concerns.
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Postby DryEye » Sun Jun 24, 2007 6:30 pm

How soon would one know after an enhancement if epithelial ingrowth was occurring?
Is it better to do an enhancement sooner rather than later after one's initial lasik procedure (i.e. 1 year out vs 3 years out)?
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Postby LasikExpert » Sun Jun 24, 2007 7:36 pm

Usually within 1-3 months you would know if you have epithelial ingrowth that requires removal. Not all epithelial ingrowth requires treatment.

As far as epithelial ingrowth is concerned, enhancement surgery earlier or later does not seem to make much difference.
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Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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