Possible second enhancement...

Post your questions and start your research in this forum if more than three months ago you had any type of surgery to reduce the need for glasses and contacts.

Possible second enhancement...

Postby aspenice » Sun Mar 02, 2008 4:12 am

Well, I had Lasik on May 11, 2007 and am looking at a enhancement. Well, I want to be corrected .50 diopter. I would be overcorrected. I am really struggling with reading far away signs and the clarity of things. Really , my vision is bang on according to the machine that reads my vision. I have about . 25 astigmatism in my both eyes.

I went back to the doctor's and he said he would do it since my vision hasn't changed but I am so scared for some reason but I want my vision better and don't want to be put in glasses. I still suffer from dry eye but not really bad. I use drops. Does an enhancement make your eyes drier the seoncd time around?

I would like to get this done before the summer heat. I know the risks involved. Just wanted to hear from someone.

Thanks.
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Postby rosecmd » Sun Mar 02, 2008 4:33 pm

This would be your first enhancement, is that correct? your subject title says second enhancement. I had my first lasik on July 9, 2007 and was overcorrected into hyperopia by 1 dioptor in each eye. I had my enhancement surgery three weeks ago, on February 8, 2008.

You say you still have dry eyes, maybe that is the reason your vision is a little off. I, too, still had a little dry eye - but not much in the way of symptoms - when I went into my enhancement. I was very nervous about how my flaps would heal and how it would turn out.

I never expected to be completely free of glasses with lasik - I am 48 and need readers.

Personally, I would never have an enhancement to correct less than close to a dioptor of error. You say you are .5 dioptors off...well, with an enhancement, you could still be off by some amount. You do not want to end up overcorrected. Trust me on that. Being overcorrected adds eye strain and much worse vision as you age. In addition, with still dry eye, you risk flap issues with enhancements like loose epitelium, epitelial ingrowth, and slow healing. I had all of these in a minor way but it caused significant discomfort and stress for a couple of weeks. I will say with the Restasis on board for 7 months now, I believe my dry eye is less than original, but I still have a reduced tear film and "fragile epithelium" as my doc calls it from dry eye.

How about a second opinion? How about trying glasses for the things you can't do well with lasik? Consider carefully. Perhaps someone who had only .5 dioptors of residual myopia and .25 dioptors of astigmatism enhanced will weigh in. Honestly, those are small amounts that your eyes can just naturally change as you age. At some point, you will need glasses.

I am happy I did my enhancement, I see much better mid-range and somewhat near, and when I fully heal, I'll have 20/20 vision instead of 20/25 & 20/30 (supposedly). I still need readers, just less power than pre-enhancement. But, I had 1 dioptor corrected in each eye - 13 seconds of laser (longer as hyperopic lasik goes around the periphery of the cornea instead of the central part). Originally, I was about -3 in each eye.
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Postby aspenice » Mon Mar 03, 2008 2:28 am

Sorry, I meant first enhancement. I really have perfect vision as far as distance but I have .25 astigmatism left and when the doc put the little round eye glass to me eye it was pure heaven cause I can see perfectly. I really struggle with seeing far in the distance and I have to sqiunt alot. When they measured me in the machine it showed my eye and the way I see and it looked exactly like a star. Sorry but I am not up to the machine's names, etc.

He wanted to put me on restasis but I didn't want to cause I don't feel the dryness is that bad where I would need restasis. I don't want to wear glasses as I got lasik to get rid of them in the first place. I am 33 years old and if I was overcorrected which I prefer to be I would rather go into reading sooner and have that crisp vision then have the vision I have now and go into readers later. I am extremely picky and even the office said so but that is me.

I did go for another opinion and he said the same thing that he would correct me .50 to be overcorrected. He said that he would do the normal lasik and not the wavefront like I had. My present doctor didn't know if he would use wavefront or traditional lasik. Why would there be a difference?

But, I truly understand what you say as far as complications go. I am concerned alot. I really never wanted lasik in the first place and rushed into it entirely. I was happy with glasses but could never wear contact lenses b/c of the dryness. Are there other options for me besides lasik and glasses and contacts? Maybe a better and new procedure will come later and make the complications less. Does having an enhancement make you more prone to epithtiea growth than just having lasik?

I truly appreciate your view and I am leaning towards not getting it down and being happy but deep down I am not happy. I think my numbers are 0.02X.24X104 and the other eye is almost the same.

Thanks,
Aspen
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Postby aspenice » Mon Mar 03, 2008 3:40 am

I am wondering if I have gotten the astigamatism from alot of computer work after the first surgery???
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Postby croanster » Mon Mar 03, 2008 9:47 am

Hi Aspen – are you sure those numbers are right? I’m not sure you could get much closer to plano than that... or even accurately reduce the astig by much. I can relate to how you feel but I’m a bit further off than that. Glenn replied to one of my posts that 0.75 diopters of astig is around 8-10 microns of cornea so 0.24 would be only around 2-3 microns of cornea. I’ve read that a tear film can be around 4-5 microns thick..

http://www.math.udel.edu/~braun/Eyes/BlinkCycleBraunFinal.pdf

Maybe you should give the restasis a go? Anyway, I’m keen to hear how things turn out for you.
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Postby Walt » Tue Mar 04, 2008 10:10 am

aspenice wrote:I am 33 years old and if I was overcorrected which I prefer to be I would rather go into reading sooner and have that crisp vision then have the vision I have now and go into readers later.


Over corrected doesn't equal "crisp vision". If at -.5 you are 20/25 this means most everything within 17 feet is clear and it blurs beyond that distance. If you are over corrected to +.5 you will most likely be about 20/25 except now things inside of the 17 feet mark will be a little blurred just like things beyond 17 feet now.

I started at -2.5 in each eye and was over corrected to +1 and +1.25. I can no longer read the computer without glasses and need glasses to clear up the TV. Sure the trees in the distance look nice but this is definitely more of a pain. Even my food looks blurry now.

I personally would prefer to have a set of glasses in the car for driving and attending the theater and not need them for anything else.

Good Luck in whatever you choose to do.
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Postby aspenice » Wed Mar 05, 2008 6:29 pm

I thought about trying restasis but didn't and maybe I should give it a go but I am already 10 months out. Would it help at this time? And wouldn't the astigmatism already be indcued from the dry eye?

Walt, I agree with you about not risking the procedure but I do not want to go to glasses again, unless I need reading glasses later in life. I do have vision problem less than 17 feet away and I don't understand if I get over corrected how that can make my vision worse up front than far away? When I was in my glasses, I was overcorrected for years. I just saw on the today show how they are doing the contact lens surgery. I wished I would have done that b/c it seems I don't have a choice now. i.e. glasses or enhancement surgery.

It sounds as if I will have to think on this one. My doctor said he would do the surgery and I even went for a second opinion and he said the same thing. Thanks for all the advice.

Aspen
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Postby rosecmd » Wed Mar 05, 2008 8:52 pm

Holy, moly!!! Let's clear this up...overcorrected does not mean that you will see sharper. It means that you will see WORSE, or a different kind of worse than you have now. It means that if you have .25 dioptors of nearsightedness/myopia left, and you are overcorrected past 0, or plano into hyperopia you will be farsighted!!! Not a good thing. Farsighted means blurry near and mid range vision.

You do not want to end up overcorrected. Have the doctor simulate what overcorrection will do to your vision. As you get older, it will make the effects of presbyopia worse.
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Postby rosecmd » Wed Mar 05, 2008 10:54 pm

I meant to add that if you have dry eye, please try Restasis, and give it a good 3-6 months to work. Restasis is for anyone with dry eye not just those who had lasik. It's supposed to work best on people with dry eye due to inflammation. It really helped me. If I were you I'd optimize what I have by treating my dry eye. Dry eye can really affect your vision.
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Postby aspenice » Wed Mar 05, 2008 10:56 pm

Question: The doctor did put a lens up to my eye and it was awesome! I saw so clearly. I don't understand how I can see worse when I saw perfectly when he put me .50 dioptors
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Postby Walt » Thu Mar 06, 2008 4:19 am

If you are blurry from 17 feet in then I guess your astigmatism is causing quite a bit of blurriness. If this is the case then getting an enhancement might be for you.

Good Luck
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Postby croanster » Thu Mar 06, 2008 10:59 am

If you can see a big difference when the doc puts a lens up, I’d suggest the numbers you have are not right. Zero sphere and 0.24 astig is pretty darn good. Either that or you might have a focusing issue / dry eyes etc. Do you notice the blur more at night? Both astig and myopia are more noticeable in low light.

Get a script of your doc and spend $50 on a cheap pair of specs and see how much better it is in the real world for a week or 2. I know you’re not keen on glasses but might help you decide if it’s worth going ahead with the enhancement or not. Cheap, easy and most important NOT permanent!!

As far as being overcorrected sharpening things up, rosecmd is right. You cannot get sharper than plano. If you are plano, your optical system is perfect. That’s why I think there might be something wrong with the measurements / numbers you have.

As far as being hyperopic go’s, a 33 year old at +1.0 (or even +2.0 for that matter) can accommodate back down to plano and see a sharp 20/20 quite easily! (I was +3.5 and could see a beautiful 20/12.5 until I reached 30 odd...) A 40 or 45 year old can’t.

Also, a 33 year old can usually focus around a bit of astig. What that means for you is, if your sphere is zero (plano) and your astig is really around -0.25 to -0.5 say, and the doc corrects you to +0.5 either through a corrective lens or lasik or whatever, chances are you can pull that error back in including some of the astig through accommodation (basically the lens in your eye changing the refraction) and get a nice sharp 20/20. Again, a 40 - 45 year old won’t have as much success with this and things will look fuzzy again.

If you make yourself aware of what the possibilities / repercussions are and you can notice a big improvement with the lens / glasses and also if the doc is happy to do it, well maybe it is a good idea. Only you can decide if it’s worth it ultimately... Personally – I’d rather be +0.5 than -0.5. I like my trees in the distance nice and clear!! (I spend alot of time outdoors)

Keep us up to date with your decision!
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Postby aspenice » Fri Mar 07, 2008 7:46 pm

I really thank you for giving me your views. I feel much more better b/c of the info you gave to me.

Croanster, Thanks very much for the in detail info. Makes things easy for me. I called the office today and they are calling in a script for restasis and I am seeing them next Wed. to get a pair of cheap glasses to see if they really work. I will give it a couple of weeks but will post on how I am doing.

isn't wise for me to use Restasis for 3-6 months before I make a decision?

Also, I am wondering did I cause myelf an induced astigmatism by doing computer work and not taking care of my dry eye? he wanted to give me restasis months ago but I declined hoping they would get better with drops but I need something more. Since I am using drops so late in the game, will they help my blurriness and make my astigmatism go away?


Again, I am not rushing into this at all. Have a great weekend!

Aspen
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Postby croanster » Sat Mar 08, 2008 5:30 am

No worries – I don’t have any experience with Restasis directly. Its almost impossible to get in Australia. Don’t know why. Guess we just haven’t caught up with you guys yet. ;) but yes I believe it takes around 3 months to reach full effectiveness.

I don’t really know about the astigmatism. I doubt very much you would’ve made it any worse from using the computer. Dry eyes can definitely make it worse though. Any sort of healing is slower if the wound is constantly irritated. The only way to answer the question is to give it a go and see. If you remember, get a copy of the glasses prescription when you get them – I’d be interested what it actually was.
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Postby croanster » Sun Apr 06, 2008 12:46 am

Hi aspenice - Just wondered how you're doing now?
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