To Enhance or Not

[allfornat]

I had Lasik back in March. I have had no major complaints. I experienced dry eye and good vision days and bad. My vision has pretty much stabilized at 20/30 in both eyes. I can see but I cannot see crisply. I cannot read the tv guide channel on tv, I cannot see people farther than 20 feet from me clearly enough to recognize them, and I cannot read signs until it is too late. However, I do not need to wear glasses and am enjoying not wearing them. Anyway, I am scheduled for an enhancement next Friday. As I was going through my packet I came across an Addendum which really scared me. I am now having doubts about getting an enhancement but getting glasses defeats the purpose of the surgery. Should I have one eye done at a time or both? What are the risks? Should I only have one eye done? I am 40 years old and can still read perfectly....should I just enhance one eye? Would that be beneficial to me? Please help. I decided I am going to go to the appt and discuss all this with the doctor and then decide but need some input from you guys PLEASE. I'm scared. Thanks...

[sere1]

What scared you so much?

Hopefully your doctor can answer your questions and reassure you.

It doesn't hurt to be prudent and do one eye at a time. However, you have functional vision right now (admittedly, not 20/20), and you have options, be it enhancement, contacts, or glasses, so if you feel uncomfortable, listen to yourself. You already have had this surgery once, so much of what happens shouldn't be a surprise.

[allfornat]

I guess what scared me so much is that when they sell you the liftetime acuity plan they don't tell you about the risks, etc. It just sounds like a glamorous easy "enhancement". Then I get this addendum that pretty much makes it sound like the enhancement is more risky than the initial treatment and it seems like the addendum is trying to convince people not to get it. I spoke to the vision place because I was so upset and they said that they have since stopped including that addendum because it has caused so many problems and that corporate made them take it out of the packet. That doesn't help though because I already read it.

[DryEye]

Go see one of the top refractive surgeons in the industry even if that means paying again for it again and going to another state for the consult.
That way you will know you are getting the most experienced and knowledgeable surgeon in the field.
Maybe even get another opinion from a top doc locally
You can then make an educated decision about it.
I would do one eye at a time and plan on doing that when I decide to go in
Let us know how things go after you decide and do it

[yawny]

I read all those things too, before an enhancement, and was a little nervous, but since I had a lingering astigmagtism, and not the sharp vision I had had right after the first surgery, went ahead and did it , and I couldn't be happier. I might add that I only had one eye done, because of the monovision affect, but my first surgery was only on one eye to retain my close up vision, and I have adapted well. The only thing that was different for me about the enhancement, was that they didn't have to cut a new flap, just lift the other one. That didn't hurt at all, but afterwards for the first 4-8 hours it was much more painful than the first time. My eye was just pouring out buckets of tearing. I took some Advil, and went to sleep, and when I awoke it was much better. I healed a lot faster the second time and didn't have the red rings and bruising, since they don't use that suction cup thing to help cut the flap again. I was really ready to go back to work much sooner, and it was overall much easier the second time. My vision now is between 20/15 and 20/20.

[Remander]

I was about like you and had the enhancement. I also read some scary warnings about risks of enhancements.

It worked great for me, and the recovery was much faster than the first Lasik, though the sting that evening was quite more.

I am VERY happy I had the enhancement to get that last -.75.

Here is a detailed history of both my operations:

http://www.usaeyes.org/ask-lasik-expert ... .php?t=820

[Judy]

Remander, you have given a great detailed view of enhancement. I am glad yours is working out. I wish more people had taken the time to post their enhancement stories as many of us are possibly going to have it and are concerned about outcome and pain and if we are going to have to go through the long process of healing we did with original surgery.

My doc said she would do one eye at a time. My worries are, if I get to 20/20 will I be more presbyopic than I am now. I am currently at 20/30. She says she will do one eye at a time which seems will put me in monovision somewhat. Will that help my presbyopia or just be one eye crisper.

I will ask her these questions on the 18th when I go for my almost 2 month checkup. By the way, I refuse to go and speak to anyone but the surgeon....so I go when she is available. I found the regular optomotrist I saw once or twice was incapable of giving answers to my questions. I would suggest that anyone having this surgery that is having any problems insist on being seen by the surgeon on checkup evaluations.

[LasikExpert]

The risk for enhancement surgery is nearly identical to the risk for initial Lasik. You do have the advantages that the doctor knows how your cornea will react to the laser energy and a new flap will not need to be created - the existing flap will be lifted. To decide about whether or not to have enhancement should be the same process you used to decide to have the first surgery. Your doctor can provide details about any elevated risks that are unique to your situation.

When you are at or past age 40, being a little myopic (nearsighted, shortsighted) can reduce or delay the need for reading glasses. The monovision effect works for many people, but it is normally best to try monovision with contact lenses before having surgery.

[DryEye]

Is microstriae fixable with an enhancement and if so what is better lasik or prk over flap?
Would be going in for residual astigmatism and hopefully the starbursting around LED lights goes away and car headlights go away along with better overall crispness and clarity.
Current vision 16 months out of customvue is pretty much the same it was right after the procedure - not crisp and clear like my contacts and glasses.
Can one expect the same exact result with dry eyes and healing if the flap is lifted?
I still use artificial tears albeit less throughout the day than first 6 months.
Thanks

[Remander]

So, how did it turn out?

[Mr_Kravitz]

Well, after much wailing and gnashing of teeth, I'm going in for an enhancement on my right eye tomorrow. I had CustomVue lasik in February to correct -6.00 in that eye and was corrected to +1.25 and never had any regression. My recovery from the first was unremarkable except for halos for about 2 months and I'm not really looking forward to having to do it all over again. And I'm afraid of another "over-response" that will put me back into myopia, which would make it worse since my left eye is about +.50 (hyperopic). I'll let you all know how it turns out.

[Judy]

Much good luck Mr. Kravitz and we all hope the experience will be a good one for you. Keep reporting as we are all anxious to hear how your results are. Thinking about you.......fingers crossed!!!

[Mr_Kravitz]

I had the enhancement two days ago and it was different this time around. It's been 10 months since the initial surgery and I went from -6.00 to +1.25 in my right eye.

The surgeon first has to "pop" the flap and it took him a few tries but finally got it after about 15 seconds. Then I went to the laser suite and he manipulated the flap back and gave me about 10 seconds under the laser. Because of the probing to pop the flap, it left a small abrasion so I needed a contact placed in. I had a lot of pain in the hours following the initial surgery but this time around I had absolutely no pain whatsoever, probably due to the contact.

The biggest difference for me this time was that there certainly was no "wow" factor immediately following the laser- in fact, my vision was horrible. Even after my nap, I woke up hardly being able to see anything although that evening my vision did improve somewhat.

Next morning, I tested 20/25 in that eye but with a lot of difficulty. Halos were not as bad as before and my near vision is pretty good but my distance vision is still a little fuzzy. I could actually see the dashboard in the car!! Best of all, so far no evidence of any cell ingrowth.

Today the contact came out and the vision is about the same- good near and medium distance but still fuzzy at long distances. I hope the regression following hyperopic surgery is true although it is great being able to type this without my reading glasses!!

The enhancement procedure, I was told, is even more invasive than the original so I'm not going to jump to any conclusions for a while about the results but I'll let you all know how it's going.

[AprilH]

Just wondering, Mr. Kravitz, how the vision is going? I had my lasik 5 weeks ago to correct my -10 eyes, but only was corrected to about -2, and will be making enhancement decision in the next couple of months. I still need glasses to drive and watch tv. :-(

[Mr_Kravitz]

Vision is improving every day (I read 4 out of 5 at 20/15 after one week!). There was a couple of cells evident at the flap edge (where the surgeon "popped" the flap) and they are going to check it again in two weeks. So far I'm glad I did the enhancement.