Advanced Surface Ablation (PRK) - ADVICE!!

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.

Advanced Surface Ablation (PRK) - ADVICE!!

Postby gocats7 » Sun Jan 18, 2009 7:25 pm

I was scheduled for Advanced Surface Ablation as they call it, but basically it is PRK. Because of a work situation, I had to cancel. My evaluation showed the following:

corneal thickness right eye 436 left eye 438 on ORB scan
right eye 483 left eye 485 manual Pachs
pupil size 6 mm both eyes (dark)
5 mm both eyes (light)

dry refraction right eye -2.00-0.50x085
left eye -1.50-1.00x005

cylco refraction right eye -1.25-0.50x085
left eye -1.25-1.00x015

red thread test right eye 25mm
left eye 23mm

I would appreciate advice based on my specific situation. The Dr said I was a good candidate. He said the only thing that prevented me from being a great candidate was that he saw some type of butterfly pattern in my eye. He explained it, I still didnt get it.

I am also considering whether my current myopia would be a benefit later in life as others have told me. Meaning if I was willing to wear glasses instead of contacts for my myopia, then I could take them off when I get to the point of needing reading glasses (Im 38 now). I am debating which situation would be better for me. My job is computer based, but my enjoyments are sports and outside activities and I just hate glasses period.

Anyway, any help you can provide would be appreciated. I am looking at about 3 weeks from surgery at this point.
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Postby LasikExpert » Thu Feb 05, 2009 2:37 am

Did your doctor say "bow tie" or did he say "butterfly" pattern. This is commonly a color pattern analysis print-out that is created when the Orbscan is used to map the topography of the cornea. A bow tie indicates normal astigmatism. A butterfly indicates an irregular astigmatism pattern.

The concern with a butterfly pattern would be an underlying corneal abnormality. If you have worn rigid gas permeable (RGP) contact lenses for many years, then they may contribute to the butterfly or hide an underlying problem by reshaping the cornea. If you have been using soft contacts or were out of contacts for a while before your exam, then your cornea is probably already relaxed and contacts are not causing changes.

The cycloplegic and manifest (dry) refractions are very close to the same, indicating that you may be already starting to show the effects of presbyopia. Presbyopia is when the natural lens is less able to change focus and thereby less able to focus on near objects. This is when reading glasses are necessary.

Your myopia (nearsighted) vision is quite low. It is, in fact, almost ideal for near vision as presbyopia becomes more of a problem. If you were to have this removed, you would likely suffer the full effects of presbyopia a bit early. Or another way of saying it, if you do not remove the myopia, you will delay the need for reading glasses or bifocals.

The astigmatism is enough that it likely causes poor vision quality if not corrected. Your doctor could simulate this for you. The negative effect would be greater in low light environments, such as driving at night.

Your pupils are average in size. This may reduce any night vision problems.

Lasik is always about risk v. benefit. Your benefit at this point in your life would likely be short-lived. You may be able to get rid of distance glasses now, but you would need reading glasses a bit earlier than if you did not remove the myopia.

The question to ask yourself now is if you would prefer to wear reading glasses or distance glasses. If you have Lasik, you will need reading glasses later (rather soon, but later). If you do not have Lasik you will need distance glasses, but you can remove them to see near objects. If you don't wear glasses and only wear contacts, then you would be using reading glasses over contacts to see near objects.

If you do not have any problems with wearing contacts, you may want to discuss Orthokeratology (Ortho-K) with your doctor. This is a process of wearing RGP contacts to reshape the cornea at night, and then wearing nothing during the day. For your small amount of myopia and astigmatism, Ortho-K may provide what you desire.

Some articles you may want to read are near vision after Lasik, monovision, age and lasik, and lasik and astigmatism.
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