Surgery in Japan

[travellingred]

Hello allI have been on these boards for a while now and am seriously considering having surgery, but just a couple of things I need answering first if anyone can help?

I currently live in Japan and am looking into having LASIK surgery. I have been to two different clinics and have been told I am suitable for surgery by both. Although they speak English it is rather limited and I just wanted to know a few things if you can help.

I am near sighted -1.25 in both eyes and have astigmatism in both eyes. 1.50 and 1.80. I have a low cell count in both eyes 2500 and 2050 which will make me more suceptible to dry eye? Not sure if low cell count is the right terminology (it's what they told me) but the average is 3000 per eye, and I was told that I should be careful with contacts because of this.

My other question is I am 28 and live an active lifestyle, surfing and scuba diving to name a few activities, but no real contact sports apart from soccer - do you think that intralase and the Technolas 217 are a suitable option for me? Do you think this will achieve a good result? I have been told that I should get bettr than with my glasses which is 1.2?

I would really appreciate any help you can give.

Thanks in anticipation.

Matt Seary :)

[LasikExpert]

I have a low cell count in both eyes 2500 and 2050 which will make me more suceptible to dry eye?

The only cell count that makes sense with the information you have is an endothelium cell count. The endothelium is the innermost layer of cells on the back side of the cornea. It is unusual for a clinic to do an endothelium cell count when the patient is considering Lasik or PRK because the endothelium is not normally disrupted by surgery. You need to ask the clinic which cells they are counting and why this is a concern.

...do you think that intralase and the Technolas 217 are a suitable option for me?

All-Laser Lasik with the Intralase femtosecond laser may be an appropriate technique, however you should also consider a surface ablation technique like PRK, LASEK, or Epi-Lasik. Surface ablation techniques do not create a Lasik flap. No flap means no possibility of flap related complications during surgery or for the rest of your life. Although Lasik flap complications are relatively rare, no possibility is almost always better than low probability.

[travellingred]

Thanks for your reply. I'm not sure why they have done this cell count, but I am getting a japanese speaker to ask them some questions on my behalf. Like I said I have been to two different clinincs and they both tested me for the same thing, so maybe it's just standard over here?

As for the laser it has been suggested to me on another forum that with astigmatism I should consider having custom Lasik or wavefront.The laser they have is the tecnolas 217 which is wavefront capable, does this mean they would automatically use this? or would I have to ask specifically? I had many tests at the clinic but am not sure if they did a wavefront test.

Anyway, thans very much again for your help! :)

[travellingred]

I have been told that everyone recieves these endothilium tests in Japan as this is directly related to dry eye syndrome. The lower the count the higher the possibility.

Another question - is everyone tested for diseases such as keratocunus as standard when you for a consultation? The reason I ask is that the research I have read suggests that it can be difficult to detect as if oftens accompanies myopia and astigmatism, I have both - and you are not suitable for LASIk if you have this disease.

Thanks for any help :)

[LasikExpert]

The laser they have is the tecnolas 217 which is wavefront capable, does this mean they would automatically use this?

Not automatically, and you may not want wavefront-guided custom Lasik. As a general rule wavefront-guided laser ablation provides a better outcome, but not for every patient in every case. It may be that conventional would be better for you. Only a comprehensive examination by a competent surgeon would be able to determine what is most appropriate for your eyes. See wavefront custom lasik.

is everyone tested for diseases such as keratocunus as standard when you for a consultation?

I comprehensive evaluation would included evaluating for pre-existing conditions such as keratoconus.

The reason I ask is that the research I have read suggests that it can be difficult to detect as if oftens accompanies myopia and astigmatism, I have both - and you are not suitable for LASIk if you have this disease.

Myopia and astigmatism alone do not indicate keratoconus. Astigmatism associated with keratoconus is very specific and generally well defined. An elevation map of the front and back of the cornea (Orbscan) helps determine if there are signs of keratoconus. Keratoconus tends to run in families. You would be at an elevated risk if your family has a history of keratoconus and/or corneal transplants due to disease. Keratoconus normally presents before the fourth decade of life. See keratoconus.

[Betty39]

What is an endothilium test? Why is this not done in the united states? Does this really predict dry eye syndrome?

[LasikExpert]

The endothelium is the innermost layer of the cornea. It is primarily responsible for providing nourishment to the cornea. Counting the number of cells per square centimeter can determine if the endothelium is healthy or distressed. A damaged, diseased, or defective endothelium can contribute to a host of problems.

Lasik does not normally disturb the endothelium, however an endothelium cell count as a part of a comprehensive examination is a good idea. In the US it is common to do a cell count if there are any other indicators of a endothelium problem. It is not, to my knowledge, a routine test.

[Betty39]

I think if this test can be a way to possibly determine whether a person might suffer from long term dry eye that it should be routine. I wonder if I had a low cell count pre surgery and nobody checked. Maybe I should have my corneal specialist test me on my next visit?