concerns about PRK

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.

concerns about PRK

Postby questionkid » Sun Jan 27, 2008 8:40 am

I've been considering and researching this for a while, have gone to 3 clinics and spoken to their surgeons, and have decided to go for PRK this spring.

However, I have some concerns. I emailed a surgeon 10 questions (taken from the 50 Tough Qs to ask your surgeon), and his reply was that my expectations are too high and I'm not ready for surgery. His reason is "Refractive surgery is to help patients be less depend on glasses and not to think that they will total be free of them."

My prescription is:
OD: -9.00-0.50X166
OS: -8.25-1.00X180

My questions:
(1) Is this surgeon's statement true? According to the clinic's website, he was involved in the original research of excimer laser surgery and corneal topography. With my prescription, I heard I can't expect 20/20 vision even after correction, but I'm okay with 20/15 ~ 20/30.

(2) Does custom wavefront get rid of "halos" or night vision problems?

(3) The same surgeon above recommended Restasis for my dry eyes, which I'm to use 3 months prior to surgery, and then he'll put plugs in my eyes before surgery. I consulted an optometrist and he said Restasis has side effects... and advised me to take Theralase. What should I do?

(4) Are VISX newest models better than the Allegretto Wave EYE-Q 400 Hz?

Thanks for your help.
questionkid
 
Posts: 5
Joined: Wed Jan 02, 2008 8:14 am

Re: concerns about PRK

Postby LasikExpert » Mon Jan 28, 2008 5:01 pm

questionkid wrote: His reason is "Refractive surgery is to help patients be less depend on glasses and not to think that they will total be free of them."


Your surgeon is doing you a service by evaluating not only your eyes and the probability of successful surgery, but evaluating also your expectations and probability of being happy with the results. Patients need to be 20/Happy. Your surgeon does not believe that you will, in the long term, be or continue to be 20/Happy. Consider this advise carefully.

questionkid wrote:My prescription is:
OD: -9.00-0.50X166
OS: -8.25-1.00X180


You are very myopic (nearsighted, shortsighted). You will undoubtedly experience regression. Initial deliberate overcorrection and/or enhancement surgery is all but guaranteed.

questionkid wrote:Does custom wavefront get rid of "halos" or night vision problems?


Possibly, but not every time. If you currently have halos at night, then you will likely continue to have halos at night after vision correction surgery.

questionkid wrote:(3) The same surgeon above recommended Restasis for my dry eyes, which I'm to use 3 months prior to surgery, and then he'll put plugs in my eyes before surgery. I consulted an optometrist and he said Restasis has side effects... and advised me to take Theralase. What should I do?


Theralase is a laser manufacturer, so I don't know exactly how that would apply to dry eye.

Unless teh two treatments are contraindicated, do both.

questionkid wrote:Are VISX newest models better than the Allegretto Wave EYE-Q 400 Hz?


All lasers have their advantages and disadvantages. The doctors who use these tools know first-hand how well they perform for individual circumstances, such as a dry eye high myope, and can properly advise you.

You have dry eye, high myopia, and (in the opinion of one doctor) unreasonable expectations. This is a recipe for a very unhappy patient.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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Re: concerns about PRK

Postby questionkid » Tue Jan 29, 2008 5:18 am

Thank you for your response Glenn. I really appreciate your objective and well-informed insight.

At one of the consultations, I was advised that with my prescription, I should expect around 25% regression. In your opinion, what would be reasonable expectations for someone with my prescription and dry eyes?

Emotionally speaking, I'd willingly give up a year of my life to have freedom from glasses, but I understand that it's not feasible. I also understand that regression is hereditary (?) and my mom and siblings are all very myopic. To me, minor regression after surgery (up to -3 diopters) is acceptable. Is this reasonable? Will my vision regress back to what to -8 or -9?

After surgery, if my vision does regress back to -3, -4, will I be able to wear contacts?

Theralase is a laser manufacturer, so I don't know exactly how that would apply to dry eye.
Unless teh two treatments are contraindicated, do both.


Sorry, I meant THERALIFE, not theralase. Have you heard of this natural treatment? Does it work?
http://www.theralife.com/enhanced.html

You have dry eye, high myopia, and (in the opinion of one doctor) unreasonable expectations. This is a recipe for a very unhappy patient.


The reason I'm asking so many questions beforehand is so I can mentally prepare myself for the outcomes. I will undergo the procedure after I am physically and mentally ready.

Do you think the surgeon's education and training make a significant impact on the results of refractive surgery?

Thank you again for your help.
questionkid
 
Posts: 5
Joined: Wed Jan 02, 2008 8:14 am

Re: concerns about PRK

Postby LasikExpert » Tue Jan 29, 2008 5:42 am

questionkid wrote:At one of the consultations, I was advised that with my prescription, I should expect around 25% regression. In your opinion, what would be reasonable expectations for someone with my prescription and dry eyes?


Initial surgery brings you down to plano (no refractive error) and you regress back toward myopia to about 2.00 diopters. This seems about right. You would then need to consider enhancement surgery to resolve the regression.

questionkid wrote:Emotionally speaking, I'd willingly give up a year of my life to have freedom from glasses, but I understand that it's not feasible.


Not necessarily. With a comprhensive treatment plan and multiple surgeries, it is possible to have vision without glasses. Your surgeon can better advise you on the probability.


questionkid wrote:I also understand that regression is hereditary (?) and my mom and siblings are all very myopic.

The regression to which I refer is regression of effect after vision correction surgery. It is a part of the natural wound response.

questionkid wrote:To me, minor regression after surgery (up to -3 diopters) is acceptable.


Ask your eye doctor for some disposable contact lenses that will correct you to -3.00 diopters and wear them around the house for the day. You will find that you will not be able to function all that well. Although your vision will be better, decide after experiencing -3.00 for a day if that is worth the risk - no matter how small - of surgery.

questionkid wrote:Will my vision regress back to what to -8 or -9?


That is not at all likely.

questionkid wrote:After surgery, if my vision does regress back to -3, -4, will I be able to wear contacts?


Yes, this is highly probable.

questionkid wrote:Sorry, I meant THERALIFE,.


Supplements can be very important of a comprehensive dry eye treatment plan.

You have dry eye, high myopia, and (in the opinion of one doctor) unreasonable expectations. This is a recipe for a very unhappy patient.


questionkid wrote:The reason I'm asking so many questions beforehand is so I can mentally prepare myself for the outcomes. I will undergo the procedure after I am physically and mentally ready.


That is the way to do it. Ask all the questions before surgery. Be prepared for the worst. Expect the best.

questionkid wrote:Do you think the surgeon's education and training make a significant impact on the results of refractive surgery?


It is the single most important factor between success and failure. See our 50 Tough Questions For Your Doctor.

You should also researche Phakic Intraocular Lens implants.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby questionkid » Tue Feb 05, 2008 4:51 am

Thank you for your response Glenn.

What do you think would be the worst possible outcome if I went to a top surgeon and followed all his/her precautions and advises and post-op maintenance?

Will the surgeon be able to foresee some complications while they assess my eyes and suitability for surgery?

Thanks again,
questionkid
 
Posts: 5
Joined: Wed Jan 02, 2008 8:14 am


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