Lasik vs. P-IOL for high myopia & moderate astigmatism

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.

Lasik vs. P-IOL for high myopia & moderate astigmatism

Postby PCL » Tue Mar 25, 2008 5:50 pm

Hi all,

I'd like to say that this forum is fantastic - I've had a lot of questions answered by browsing through it! I still have a few about my specific situation though. I'm currently considering Lasik, and went for a pre-screening a couple weeks ago, which consisted of three or four quick tests - this included checking my eye pressure and corneal thickness, but unfortunately I've forgotten the others. I was told I *should* be fine to do Lasik (I'll undergo more extensive testing should I decide to) and IntraLasik was specifically recommended, but after doing more research, I'm having several reservations.

First my background - I'm 24 and have been wearing soft contact lenses fairly regularly since I was 17. My prescription has been -10.5 for almost two years (it was -11.5 previously, the first time I'd been able to decrease it), and my astigmatism is 225 (I hope that's correct - the units are slightly different here). I'm not 100% on my corneas, but I believe they're somewhere in the 450-550 range. (I wasn't actually told my corneal thickness after the tests, just that it was not a problem. I'm a little skeptical of this however - unless my numbers are *completely* off, it seems doubtful I could retain 250 after surgery?)

Recently I found P-IOL mentioned as an alternative - is this comparable to Lasik in my case? P-IOL seems more suited to my degree of myopia; I'd also feel slightly more comfortable not having my eyes permanently reshaped, and knowing I could adjust/reverse the procedure down the road. I'm a bit unsure as to my astigmatism though - I've read both that P-IOL can correct moderate astigmatism, and that it won't and I might require a second surgery afterwards (which mostly defeats its purpose in this case). Or does that depend entirely on the individual in question?

Any input would be appreciated. Thanks in advance for your time!
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Postby Pappy » Tue Mar 25, 2008 9:13 pm

From what I've read for that degree of myopia you should fully investigate the P-IOLs although depending on how it's done it might be irreversible (I'm not knowledgeable enough to tell you which is which).

There are some studies (old though about 10 years) about lasik and long term effects (don't have the link, it was a spanish clinic) and it seems for that degree of myopia 60% had satisfactory results. Statistics so that could mean anything.

Unlike lasik/prk though IOLs is a full blown surgery thing (anesthesia) at least here in the states, so the cost is greater. I don't know numbers off hand but with your myopia + astig you'd be talking about a substancial amount of tissue being removed.

One nice thing about the IOLs is you won't have the corneal surface issues (and if my doc had said he'd do it I would have gone that route my self). If money is not the limiting factor I'd say with your perscription it's a no brainer if you decide to have corrective surgery :)
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Re: Lasik vs. P-IOL for high myopia & moderate astigmati

Postby LasikExpert » Thu Mar 27, 2008 1:47 am

PCL wrote:I was told I *should* be fine to do Lasik ...but after doing more research, I'm having several reservations.


Your very high myopia makes you a less than ideal candidate for Lasik.

PCL wrote:...unless my numbers are *completely* off, it seems doubtful I could retain 250 after surgery?)


It may be possible, depending upon the actual amount of tissue to be removed and the thickness of the Lasik flap, but it does not seem likely you would be able to have enhancement surgery after regression, which you would undoubtedly need.

PCL wrote:Recently I found P-IOL mentioned as an alternative - is this comparable to Lasik in my case?


About the only similarity is the intended result: a reduced need for corrective lenses. Other than that, the two proceedures have almost nothing in common.

PCL wrote:P-IOL seems more suited to my degree of myopia; I'd also feel slightly more comfortable not having my eyes permanently reshaped, and knowing I could adjust/reverse the procedure down the road.


"Removable" is not the same as "reversable". Some of the changes necessary for P-IOL will be permanent, as will its effect on the endothelium.

PCL wrote:I'm a bit unsure as to my astigmatism though - I've read both that P-IOL can correct moderate astigmatism, and that it won't and I might require a second surgery afterwards (which mostly defeats its purpose in this case). Or does that depend entirely on the individual in question?


It depends upon the individual's astigmatism, type of astigmatism, amount of astigmatism, and where you are located. Astigmatism correcting P-IOLs are more available outside the US. You would need a comprehensive evaluation by a competent surgeon to know if this would be appropirate for you.

Many doctors will combine P-IOL with PRK or even Lasik to resolve astigmatism and high myopia.
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