PRK - Allegretto WAVEFRONT OR VISX STAR S4?

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PRK - Allegretto WAVEFRONT OR VISX STAR S4?

Postby Vijay » Wed Dec 12, 2007 4:50 am

This is my first post. At the outset, I want to thank everyone who has contributed to this forum. While I am still researching, reading the forum has been very educational and helpful.
Jumping into my situation. I have thin corneas/borderline (498 microns r eye, 501 l eye). My prescription is as follows
R eye: -2/-1.25 (refr/astigmatism)
L eye: -2/-1
pupil size: 4.5
(the above measurements, I believe are under dilation)
I am near sighted with astigmatism and have been recommended PRK by all three of the places I went to for my initial consultation. I am a 39 year old male. Would anyone do a lasik in my situation or go with prk?
One of the doctors is going to use Allegretto Wave and the other one VISX Star S4 (one is customized wavefront, while the other is not). Clearly the wave front is more expensive. My question is why are the two places recommending two different technologies (they both have/can do a wavefront).
Does anyone have any thoughts on the two and would recommend one over the other? Would one heal faster/better than the other?
Also, I am planning to do one eye at a time (which I found odd initially when it was suggested to me but reading this forum has solidified that thought in my head. My question is how much of a gap would one recommend is ideal between the two surgeries. 5 days/7 days/the more the better? Although it prolongs the recovery, I feel that at least I will have one functional eye, which is better than healing in both eyes simultaneously over a few days and being completely out of commission.
How soon can I drive/go to work if I do one eye at a time. Day 3 or 4? Sorry for the long note. Anything thoughts/suggestions would be greatly appreciated. Also, any thoughts on which eye should I do first ?
Also, given my age and the need for reading glasses in the near future (which sort of defeats my purpose of having it in the first place), would someone recommend monovision in my situation. I am leaning more towards distant eye correction in both and do another surgery/enhancement when I feel the need for it (doing a prk now would give me that option but lasik now won't as I am borderline with my thin corneas).
Thx a ton,
Jay
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Postby Vijay » Thu Dec 13, 2007 3:26 am

:cry:

Still waiting for someone to respond to my query. I have seen regular contributors - Glenn/Houstanmann ? anybody pls. I need to make a decision very soon. Any thoughts will be greatly appreciated.
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Postby beingbobbyorr » Sat Dec 15, 2007 11:00 am

Vijay wrote:... I am a 39 year old male. ... Also, given my age and the need for reading glasses in the near future (which sort of defeats my purpose of having it in the first place), would someone recommend monovision in my situation. ...


I'm no eye-care professional, but this layman can't imagine how a physician can do monovision for you if your presbyopia hasn't kicked in yet, which it's not supposed to until you reach your mid-40's +/- ___ years. Are all the candidate surgeons telling you they can 'pre-correct' for presbyopia?

Vijay wrote:... I need to make a decision very soon. Any thoughts will be greatly appreciated.


Why do you need to make a decision "very soon"? The worst decisions are made under artificial time constraints.
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Re: PRK - Allegretto WAVEFRONT OR VISX STAR S4?

Postby LasikExpert » Sun Dec 16, 2007 4:05 am

Vijay wrote:I am near sighted with astigmatism and have been recommended PRK by all three of the places I went to for my initial consultation.


Although your vision recovery may be a bit slower with PRK, you have several long-term advantages with a technique that removes tissue from the surface of the cornea rather than underneath a Lasik flap. With three different doctors recommending PRK, it seems to be the more appropriate choice.

Vijay wrote:One of the doctors is going to use Allegretto Wave and the other one VISX Star S4 (one is customized wavefront, while the other is not). Clearly the wave front is more expensive. My question is why are the two places recommending two different technologies (they both have/can do a wavefront).


The information you provide indicates that the probability of a good outcome is about the same with both systems. The difference is physician preference, which can be because of previous experience.

Vijay wrote:? Would one heal faster/better than the other?


There would be no difference in healing time from one laser to the other.

Vijay wrote:My question is how much of a gap would one recommend is ideal between the two surgeries. 5 days/7 days/the more the better?


At five days postop you will likely have "functional fuzzy" vision in the eye with surgery, but not great vision. You may want to plan for more time between surgeries with the option of having the second surgery earlier if vision recovers faster.

Vijay wrote:Although it prolongs the recovery...


It prolongs the time before you have both eyes recovered, but it assures you of having one functional eye at all times.

Vijay wrote:How soon can I drive/go to work if I do one eye at a time. Day 3 or 4?


Your depth perception will be negatively effected so you would need to be careful about driving, but 3-4 days does seem reasonable.

Vijay wrote:Also, any thoughts on which eye should I do first ?


Nondominant eyefirst.

Vijay wrote:Also, given my age and the need for reading glasses in the near future (which sort of defeats my purpose of having it in the first place), would someone recommend monovision in my situation.


You may be more presbyopic than you realize. Read about sudden presbyopia for why monovision may make more sense than is obvious at first thought.

In a few years your small amount of myopia would reduce your need for bifocals or reading glasses, but monovision now may be more of an imbalance than advantage.

I recommend that you try monovision with contact lenses to see how you do. If it is tolerable, then you have your answer.

Keep in mind that you could do monovision correction and wear a contact lens in the uncorrected eye. As your presbyopia progresses you can stop wearing the contact.

Vijay wrote: I am leaning more towards distant eye correction in both and do another surgery/enhancement when I feel the need for it...


No way.

It would be foolhardy to remove your natural myopia with the intent of trying to put it back later. You incur the risk of multiple surgeries and more than doubling the chances (albeit relatively small) of a poor outcome because hyperopic (farsighted, longsighted) correction that would be needed to return the myopia is much less predictable than myopic correction.
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Postby Vijay » Mon Dec 17, 2007 5:37 pm

Thanks Glenn and beingbobbyorr for your responses.
Beingbobbyorr - I was told by one of the places that they deliberately undercorrect (by 0.25 to 0.5 D) to adjust for future presbyopia that will set in. I found that odd initially but was given similar responses by the other places.
Glenn - great points. Thanks for pointing out Sudden Presbyopia. It is now making me revisit the monovision correction idea. I wanted to clarify that when I said distant eye correction (was a typo), I was trying to say I am leaning away from monovision and correct my refractive error (myopia that is and not farsighted correction) in both eyes. I am sure you fell off the chair reading that !!!! Thanks again.
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Postby LasikExpert » Mon Dec 17, 2007 6:06 pm

Vijay wrote:I wanted to clarify that when I said distant eye correction (was a typo), I was trying to say I am leaning away from monovision and correct my refractive error (myopia that is and not farsighted correction) in both eyes.


Just to make sure we are on the same page. If you are plano (no refractive error) and you want to induce myopia to be able to see near objects better, then the laser correction used is for hyperopia correction. Hyperopic correction induces a myopic shift.
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Postby Vijay » Wed Dec 19, 2007 6:01 am

Glenn:

Not sure if I am missing anything there in your note. I do have refractive error and am myopic with astigmatism as my prescription indicates. So, my correction, in layman terms, would allow me to see distant objects without the need for glasses and I am thinking about doing that in both eyes as opposed to monovision (dominant right eye for distance vision and nondominant left eye for near vision).
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Decided to go with custom view allegretto for my prk

Postby Vijay » Thu Dec 27, 2007 4:07 pm

All -
Just a quick post. I am going for my PRK today, Dec 27 at 12:30. I am doing my right eye first and will go for my left eye on Jan 3. I will post my experience in the Just Had it section soon.
Thx,
Vijay
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Postby LasikExpert » Thu Dec 27, 2007 6:30 pm

Thanks Vijay. We will be looking for your post at "Just Had It"
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