Hyperopic with Astigmatism

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

Hyperopic with Astigmatism

Postby gkrogers » Wed Aug 16, 2006 12:55 pm

I have really bad farsightedness(+4.75 to +4.50 approx) with really bad astigmatism (-1.50 to -2.0 approx) in both eyes. I have always also had one eye dominant over the other. I went to a couple clinics and one said my eyes were just too bad and I should have the lens replacement procedure. The other office (LASIKPlus) said I was just barely a candidate but that they actually might do PRK once the surgeon re-checks my eyes. They said that my pupil size and cornea thickness were not a problem. I have read a lot of articles stating both positive and negative support for my eye sight and Lasik. What do you recommend.
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Postby LasikExpert » Thu Aug 17, 2006 2:29 am

The least invasive techniques would be, of course, glasses and contact lenses. If you are motivated to have surgery, you should research lens procedures. Refractive Lens Exchange is essentially cataract surgery and your natural lens would be replaced with an artificial lens if you elected to have this kind of surgery. A phakic intraocular lens is a "helper" lens that does not require removal of the natural lens.

You have been advised accurately that your high hyperopia (farsighted, longsighted) vision and high astigmatism would be difficult if not impossible to fully correct. Do not be surprised if what is recommend is no surgery at all.
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Hyperopic with Astigmatism

Postby gkrogers » Thu Aug 17, 2006 2:52 am

Thanks for the reply so quickly. I forgot to mention that I'm almost 50 and also wear strong bifocals. The RLE may be a better answer. Cataracts do run in my family. The RLE won't correct my astigmatism so possibly PRK could be performed for that. Should it be before or after the RLE?
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Postby LasikExpert » Thu Aug 17, 2006 4:20 am

In nearly all cases, the lens-based surgery (RLE, P-IOL) should be first. That way the cornea-based surgery (Lasik, PRK, LASEK, IntraLasik, Epi-Lasik) would be able to correct any residual myopia (nearsighted, shortsighted) or hyperopia (farsighted, longsighted) vision.

At age 50 RLE may be considered by your doctor the best alternative. You will be almost fully presbyopic, so the loss of accommodation (ability to focus on items near) would be minimal.

You should consider monovision to help reduce the need for reading glasses.
Glenn Hagele
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more info

Postby gkrogers » Tue Aug 22, 2006 4:22 pm

I have spoken more indepth with a couple Lasik doctors here in Virginia [] verbally or by email. They all agree that I'm at the outer edge of acceptable patients. They were straight with me, told me there would be no correction for the presbiopia and that I would need reading glasses. They do feel I have a decent chance of attaining uncorrected 20/40 or maybe better. For some one who can't hardly get across a room with out glasses, that sounds pretty enticing. I will still have the same possible side effects as most other patienst but some not as much as others due to how they will actually correct my vision. They did say I would have probably a 50/50 chance of needing an enhancement later on to tweek it to a better un-corrected vision due the severeity of my refractive error. I used the questioaire your site provides. I am having my eyes thoroughly checked by my regular optometrist before I do anything though to get his perspective. The machines used at thier clinics are the VISX S4 and the LADARVision 4000. I have heard of the lawsuits and reports of equipment defects in the LADARVision which all seemed to occur prior to 2003. I also read that ALCON sent out two field changes or upgrades to address some equipment malfunction issue with the machines. Has there been any recent incidents of the LADARVision 4000 malfunctioning reported?

Note: Post edited to remove doctor's names.
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Postby LasikExpert » Tue Aug 22, 2006 10:56 pm

I'm sure that the lawsuits to which you refer relate to alleged undercorrection problems with the laser. The lawsuits were actually countersuits by the two laser owners when the laser manufacturer sued them for collection of usage payments. The suits and countersuits were all settled out of court with no systemic problems proven and the laser owners agreeing to pay their royalties. In other words, a lot of smoke but no fire.

All mechanical devices are subject to failure When problems arise, the manufacturers tend to be quick to get them resolved. We have seen nothing that indicates any of the currently manufactured and FDA approved lasers have any unusual systemic problems.

I think it is fair to say that you are an informed patient. It is a difficult decision, but you are arming yourself with what you need to decide what is acceptable for you.
Glenn Hagele
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LasikExpert
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Location: California

Postby gkrogers » Wed Aug 23, 2006 12:39 am

Thanks for the comments. I do appreciate your honest appraisal of my chances. I am trying to look at it from all sides. There does come a point where you have to quit reading all the postings and other research and make a decision. I plan to make that decision after my appointment with my optometrist tomorrow. With my eyes as bad as they are, if I go forward I don't expect a miracle or perfect sight, just less dependency on glasses. I am more concerned with the side effects, starbursts...halos...hazy...etc., than most other things, especially the dry eye problem. I am border line dry eye. I will definitely pursue one of the surface procedures over LASIK if I do get it done. You have mentioned that you are more in favor of that for most folks. I won't actually get it done if I decide in favor of it until after Jan 07. Gotta wait for my Flex Spending Account to kick in for next year (tax free). I appreciate your responses and all the other posts from actual Lasik patients. It gives a good perspective on things, both pros and cons. It does seem that not to many folks with Hyperopia with or with out Astigmatism get Lasik based on the numerous postings I've read. I will re-post if I go forward with the Lasik and report my success or failure. Thanks again.[/img]
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