High Astigmatism Fears

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High Astigmatism Fears

Postby Laramie » Tue Aug 14, 2007 2:28 pm

I have been considering Lasik for almost 10 years now. I recently went to my second consultation and as before I was told that I am an acceptable candidate. I have a high astigmatism of about 5 dioptoers and I am 2.25 diopters nearsighted. Also, I compete in martial arts and there is a high probability that I will be hit in the eye at some point in the future.

The doctor recommended the use of the Visx Star S4 non-wavefront guided laser and he stated that I have a 50% chance of needing an enhancement surgery.

When doing an enhancement, how much additional tissue is removed compared to the original surgery?

Is it safe to continue with martial arts if there is a possibility that my flap could become dislodged? What are the complications of a dislodged flap?

Is the Visx Star S4 the best laser for high astigmatism? If I were willing to wait a few years are there any new technologies coming down the pipe that would make this procedure safer with a higher likelyhood of a positive outcome?

Thanks,

Laramie
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Re: High Astigmatism Fears

Postby LasikExpert » Thu Aug 30, 2007 4:58 pm

Laramie wrote:I have a high astigmatism of about 5 dioptoers and I am 2.25 diopters nearsighted.


Astigmatism of 5.00 diopters is astronomically high. What is also important is that your astigmatism is more than twice as high as your myopia (nearsighted, shortsighted) vision. This creates a very challenging refractive error.

Laramie wrote:Also, I compete in martial arts and there is a high probability that I will be hit in the eye at some point in the future.


Between the high astigmatism and the elevated probability of trauma to the face, you should probably only consider a surface ablation technique like PRK, LASEK, or Epi-Lasik.

Laramie wrote:The doctor recommended the use of the Visx Star S4 non-wavefront guided laser...


Wavefront-guided would not be able to resolve that amount of astigmatism. Conventional would be required.

Laramie wrote:...and he stated that I have a 50% chance of needing an enhancement surgery.


You should fully expect to need enhancement surgery, however you would likely be able to have wavefront-guided enhancement surgery as the first surgery should reduce the refractive error to treatable levels.

Laramie wrote:When doing an enhancement, how much additional tissue is removed compared to the original surgery?


The total amount of tissue removed is the same whether it is completed in one surgery or in two. The reason there is a probability of enhancement surgery is that regression of astigmatism correction seems likely and it is simply difficult to correct that much astigmatism all at once.

Laramie wrote:Is the Visx Star S4 the best laser for high astigmatism?


This depends upon many other factors, but here is an important one. The tissue removal pattern for astigmatism is elliptical, not round. The widest point of the full optical ablation zone for astigmatism will be about 1.0mm narrower than for the myopia (about 5.0mm). If your naturally dilated pupils are larger than 5.0mm, then you have an elevated risk of night vision problems after surgery. Read our article about night vision problems and laser eye surgery.

Laramie wrote:If I were willing to wait a few years are there any new technologies coming down the pipe that would make this procedure safer with a higher likelyhood of a positive outcome?


There is nothing in the process of FDA approval that would be relevant to your situation. The biggest challenge you have to a good result are the laws of physics.
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