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.

enhancement...

Postby elspeth » Tue Sep 12, 2006 6:09 pm

should i go for it ? considering the fact that i'm still suffering from haloes and starbursts around light sources at nite as well as the fact that i can't focus clearly on white images or words on a black screen like on the tv or in a cinema when its all dark.
should i choose the wavelight allegretto machine with custom wavefront lasik together with a truly reputable and renowned lasik doc
or go for epilasik, custom wavefront lasik with the nidek ec5000 machine with a not as renowned and reputable as the former mentioned.?

and also will it worsen my dry eyes. and will there still be a blurness of vision such that i can't even see immediately just after the enhancement op? just like what happened during the first time.
would i be able to adjust the second time rd considering thefact that i'm
i'm now about 10mths post op from the first lasik done. my vision is 6/6
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Postby LasikExpert » Tue Sep 12, 2006 6:15 pm

Only you can decide if the relative risk of enhancement surgery is worth the relative benefit. It sounds like you have many vision problems that are commonly helped with Complex Wavefront Retreatment, so you have a lot to gain.

Lasik enhancement will require lifting the flap and that will restart the healing process. Whatever dry eye issues you had the first time you will probably have the second time.
Last edited by LasikExpert on Wed Sep 13, 2006 6:50 pm, edited 1 time in total.
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Postby elspeth » Wed Sep 13, 2006 9:06 am

doc says its probably due to small ablation zone and a larger pupil at nite for the focusing part
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Postby elspeth » Wed Sep 13, 2006 11:20 pm

will it make a diff if i were to do epilasik for an enhancement?
even though the first one was standard conventional
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Postby LasikExpert » Mon Sep 18, 2006 1:19 am

Current recommendation is to not do Epi-Lasik for enhancement. To create the epithelium flap, the blunt blade relies on the density of the Bowman's layer. Bowman's is removed during the initial proceedure. Surface ablation enhancement recommendation would most likely be PRK or LASEK.
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Postby elspeth » Tue Sep 19, 2006 5:16 am

is the wavelight allegretto coupled with a reputable and competent surgeon in fact one of the top in the country a gd or better choice over another which isn't as recognized or known and using the nidek ec5000?

comparing the 3 wavelight allegretto, nidek, b&L zyoptix with XP blade
which is the best suited for my problem to be corrected? assuming its all has to be wavefront customised
and would intralase or a normal blade be better for the enhancement flap takin into consideration my fear of dry eyes, the current problem of having something stuck
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Postby LasikExpert » Tue Sep 19, 2006 3:24 pm

Wavelight is better by a very, very large margin.

I do not understand why Lasik is being considered for enhancment after Epi-Lasik for the primary surgery. Another surface ablation such as PRK or LASEK would be more consistent with Epi-Lasik and concerns with dry eyes.

The Wavelight Allegretto is now available in wavefront-guided configuration in addition to wavefron-optimized. Wavefront-guided would make it similar to the Bausch & Lomb Zyoptix. Nidek is much older technology.
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Postby elspeth » Wed Sep 20, 2006 7:17 am

no my initial treatment was normal standard conventional lasik
now thinking of epilasik coz read up it was better for people who couldn't stand dry eyes? well i'm one of them...
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Postby LasikExpert » Thu Sep 21, 2006 1:40 am

Epi-Lasik is not appropriate after Lasik. The pressure exerted by the blunt blade lifting the epithelium (outermost layer of 'soft' cells of the cornea) is too potentially disruptive.

PRK or LASEK may be appropriate.
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Postby elspeth » Thu Sep 21, 2006 9:25 pm

or would custom wavefront lasik with intralase coupled with a reputable surgeon and a wavelight allegretto be a better recommended option after the initial one was just normal conventional which was done using alcon ladarvision?

should i go for intralase if i were to do an enhancement? or just a microkeratome? what are the advantages?
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Postby LasikExpert » Fri Sep 22, 2006 12:02 am

Lasik enhancement does not normally require a new flap. The existing flap would be lifted. Both lasers did well (by medical standards) in the FDA clinical trials. Unless there is something very unique about your situation, your probability of a good outcome would likely be about the same with either one.
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Postby elspeth » Mon Sep 25, 2006 6:25 pm

immediately after an enhancement, would there be the same blurness of vision in the operated or corrected eye just like when i did lasik the first time rd? coz now the diff is that my vision has already been corrected unlike the initial op when it wasn't.

and why would you suggest tat the wavelight allegretto is a better option as compared to the nidek... i've just checked that the nidek-ec5000 has actually a narrower laser beam as compared to the wavelight.
therefore narrower laser beam = more precise app. of the beam onto the eye rite? resulting in better accuracy ...
are there any sources online that prove otherwise?

and when you say, "your probability of a good outcome would likely be about the same with either one.", are you referring to both the ladarvision and wavelight or the B&L and the nidek machines?
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Postby LasikExpert » Thu Sep 28, 2006 6:32 pm

Your doctor will be much better able to predict your probable experience with Lasik enhancement surgery. If it is a flap lift enhancement, vision recovery should be relatively quick and similar to initial surgery. If enhancement surgery is PRK on the Lasik flap, vision recovery will be slow. Poor vision for 1-3 days, "functional fuzzy" vision for 1-3 weeks, and crisp vision not returning for 3-6 weeks. Vision recovery time for PRK varies greatly, but is generally longer than for Lasik.

Nidek does not have a beam as narrow as the Allegretto, does not have tracking, and does not have wavefront-optimized ablation, and does not have wavefront-guided ablation.

Visit FDA Allegretto WaveLight approval.
Visit FDA LADARVision approval.
Visit FDA Nidek EC-5000 approval.

Compare the outcomes. You will see that the Allegretto and the LADARVision are very similar, whereas the Nidek is not nearly as good.
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Postby elspeth » Mon Oct 02, 2006 8:34 pm

doc said that my cornea is still numb and i should wait for quite some time before doing the enhancement
how long do u think is this 'sometime'?
he said i should let the minor or subtle scarring heal abit further...
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Postby LasikExpert » Mon Oct 02, 2006 8:39 pm

Three to six months is normal before enhancement surgery, however you can always wait longer and enhancement should not be performed before the eye has settled down.
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