overcorrection enhancement

by cb » Sat Mar 15, 2008 6:42 pm

I'm in my early 30s & had lasik 3 months ago - pre-Lasik right eye -3, left eye -2.25, both eyes with astigmatism.

immediately after, noticed difficulty reading with left eye :( - turns out I was overcorrected to +.75 with 1 diopter of astigmatism. I went out and got glasses 2 wks after lasik and am fairly dependent on them for comfortable vision in the left eye, particularly for reading.

went recently for 3 month check-up - right eye is close to perfect. left eye is still overcorrected about the same (now ~1 diopter but has been that way since 1 month check-up). I see 20/30 without glasses, 20/20 with glasses.

A few questions:

1) is enhancement advised ? - my pre-Lasik expectation was no glasses until I reach my 40s, and I'm still dependent on glasses now, but I'm fearful of the outcome of hyperopic lasik enhancement since some people tell me it is not as accurate as myopic lasik enhancement
2) if yes, how long should I wait? The surgeon is happy to do it now, and my vision has been pretty stable post-Lasik, but this is definitely the last surgery I ever want to go through!

by **LasikExpert** » Sun Mar 16, 2008 6:54 am

cb wrote:1) is enhancement advised ? - my pre-Lasik expectation was no glasses until I reach my 40s, and I'm still dependent on glasses now, but I'm fearful of the outcome of hyperopic lasik enhancement since some people tell me it is not as accurate as myopic lasik enhancement

Hyperopic (farsighted, longsighted) correction is generally more challenging than myopic (nearsighted, shortsighted) correction, but you need to discuss with your surgeon your specific circumstances. 1.00 diopter is not a very large correction to attempt, but ask about the astigmatism.

After about age 40 lens within the eye is less able to change focus to see near objects. This is called presbyopia and is when reading glasses or bifocals become necessary. The combination of hyperopia and presbyopia often provides poor vision quality at all distances, sometimes even with glasses. Correction of this overcorrected state will be even more important in the future.

cb wrote:2) if yes, how long should I wait?

Wait until the refractive error is stable and you are willing to have elective surgery. Go through the evaluation process for enhancement surgery the same way you would go through the evaluation process for initial surgery.

by cb » Sun Mar 16, 2008 2:01 pm

Thanks Glenn!
Two quick follow-up questions:

1) What would you define as "stable"? Is no change separated by 1 month enough or should I wait longer? As you can tell I'm fairly nervous about this?
2) If my original surgery was wavefront, does it matter what type of surgery I have for my enhancement (e.g. wavefront vs. conventional LASIK)?

Thanks for your help! I have found this website very helpful.

by **LasikExpert** » Sun Mar 16, 2008 4:56 pm

cb wrote:1) What would you define as "stable"? Is no change separated by 1 month enough or should I wait longer? As you can tell I'm fairly nervous about this?

Each doctor will have his or her own parameters, but for me personally it is when there has been no change in refractive error for at lease six months.

cb wrote:2) If my original surgery was wavefront, does it matter what type of surgery I have for my enhancement (e.g. wavefront vs. conventional LASIK)?

Wavefront is simply a computer mapping system to guide the laser treatment. Additional surgery may use a conventional mapping system (your prescription), wavefront optimized (pattern optimized and standardized in the lab), or wavefront-guided (customized for your eyes).

cb wrote:Thanks for your help! I have found this website very helpful.

Thank you for the kind words. Be sure to read our article on how to help us help others. Lasik help.

by cb » Tue May 06, 2008 8:56 pm

Hi Glenn:

I had hyperopic lasik enhancement after 4 months for a +1 sphere/-1 cylinder residual refractive error. I am now 10 days out. The surgery was much easier than the 1st time (no flap cut, quick recovery). The refractive outcome at my 1 week follow-up was excellent (+.25/-.5) but my vision in the eye still isn't. I'm 20/25, but only 20/40 in lower light conditions like at work. It bugs me in large part because my other eye is perfect. My doctor told me to wait it out. Two questions:

1) Are night vision problems more common with hyperopic corrections?
2) Is this expected to improve?
3) I've read on this site about Alphagan P as a pupil-constricting agent to help with night-vision problems. Should I ask about this?