overcorrection

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overcorrection

Postby jameswt » Mon Mar 17, 2008 11:47 pm

Had Lasik Nov 07

Glasses prescription from June 2005
L eye -3.00 -1.50@170
R eye -2.25 -1.50 @20

Pre op Lasix optician reading used for surgery Nov 07

L eye -4.00 -2.00@175
R eye -2.75 -2.00 @17.5

3 month post op (over correction)

L eye +1.00 -0.50 @145
R eye +1.25 -0.50 @155
Reading vision difficult post op
Enhancement booked for End of march 2008

Asked surgeon to aim for -0.5ds both eyes to extend my years of good reading vision .

CONCERNS

I am concerned regarding the accuracy of the pre -op Lasik prescription which was significantly worse than my glasses prescription from 2005 and I did not notice any problems with the vision with my glasses. Also my own optician who examined me in 2005 stated the deterioration was unlikely in my age of 39years.

I am concerned that my consultant will reduce the Laser energy used in the enhancement based on the overcorrection figures after the first surgery. If the pre-op readings were wrong this may lead to an undercorrection after the enhancement.


Does the consultants normally adjust the Laser energy used in an enhancement based on the eyes response to LASIK in the initial surgery?
(For example- reduce the energy per dioptre in an enhancement if an overcorrection occurred in the original surgery)?


[b]If the pre op prescription was accurate , then my vision was not stable. Should this not have been contraindication?


Glenn, could you please advise on these concerns
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Postby Walt » Tue Mar 18, 2008 6:32 am

I'm interested in this too. I started with-2.5 in each eye and my eyes are currently +1 and +1.25 and I'm looking toward another surgery in April. I too would love to be -.5 in each eye.

Glenn when I had my initial surgery I was consuming about 3 liters of diet cola a day. This had a lot of aspartame in it. One thing aspartame has recently been found to effect is the onset of cataracts, a recent study found that cataracts are delayed by about a decade in people that use aspartame.

Has there been any study between aspartame or caffeine use and "over-responding" in Lasik? Since this surgery I have stopped using both caffeine and aspartame. Will my eyes be affected differently this next time around?
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Postby overcorrectedjw » Tue Mar 18, 2008 1:40 pm

I am currently overcorrected as well and have done some research on this topic. The term "secondary hyperopia" describes situations where those with myopia are overcorrected into hyperopia. It appears that proper correction requires nomogram adjustments to take into account age, preoperative vision, and prior surgical procedures that influence response to hyperopic lasik procedures. In other words, is no easy matter. I found one article that I can no longer access (as it requires registration). The link is: http://medscape.com/viewarticle/560881_5
The recommendation given is as follows: "Thus, for levels of hyperopia overcorrection between 0.75 and 2.0 diopters, we recommend a decrease of 0.5 diopters in the attempted retreatment." I suggest that you do some research and ask the doctor about his plan for your enhancement.
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Re: overcorrection

Postby LasikExpert » Tue Mar 18, 2008 4:28 pm

jameswt wrote:I am concerned that my consultant will reduce the Laser energy used in the enhancement based on the overcorrection figures after the first surgery.


There is no doubt that the surgeon will want to use what was learned about how your corneas react to the laser energy for any subsequent laser surgery. This will help reduce the probability of missing the target again.

jameswt wrote:If the pre-op readings were wrong this may lead to an undercorrection after the enhancement.


There are two issues here. One is that your preop readings when you were myopic were probably not so far off. It is common for a patient at or beyond age 40 to find glasses that provide a small amount of myopia (nearsighted, shortsighted) vision to be preferable to ones that eliminate all refractive error. A small amount of myopia can make near and mid-distance vision more clear, even if sacrificing a small amount of clarity in distance vision.

You will have a totally new evaluation of current refractive error. None of the previous eye prescription information is valid now.
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Postby LasikExpert » Tue Mar 18, 2008 4:38 pm

Walt wrote:Glenn when I had my initial surgery I was consuming about 3 liters of diet cola a day.


Good heavens that is a lot of diet cola.

Walt wrote:Has there been any study between aspartame or caffeine use and "over-responding" in Lasik?


The go-to source for online medical articles is PubMed.com, where I could not find anything that was directly relevant to Lasik and aspartame. I did find where aspartame had some effect on the natural crystalline lens of the eye, but all Lasik and similar laser vision correction surgery is performed on the cornea. I can find nothing at this time that indicates an aspartame cause and effect on the cornea.

An important over-all point that you have raised is that what we consume can often have a direct effect on how our body reacts to surgery. All doctors make small adjustments to the treatment plan based upon the results of previous patients and published studies. As an example, the cornea tends to become a bit tougher as we get older. A person of age 55 will likely require more laser energy for the same effect as a person of age 25, however not in every case. I am familiar with at least two instances of adult men who led very, very healthy lifestyles with massive doses of vitamins and supplements for decades. Their corneas reacted like the corneas of much younger patients. The hard part is predicting this phenomena.
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Postby SteveR » Tue Mar 18, 2008 4:57 pm

Nice research, though I’m not sure it will do you much good unless you plan on operating the LASER yourself.

I spend months figuring out my ideal prescription following under correction after the first surgery, and learnt a lot, but think the surgeon did what he thought was best in the end despite our pre-op chat. Best laid plans etc. Still, longsightedness is the thing to avoid IMO. Even my (–1.75, –1.25) is okay most of the time. The docs plan is probably that I would have the second eye enhanced too, but I’ll probably stick with what I have.
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