Overcorrection

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Overcorrection

Postby horw933 » Tue Oct 03, 2006 7:44 am

Had LASIK 1 month ago and have some problems. Before the surgery my diopters was R -7.25 L -6.75, and now it's R +1.0 L +1.0. 1-day and 1-week post-op it was R +1.25 L +1.00, i.e.: Both eyes are overcorrected and stayed that way since op. Also I see all the starbursts, glare and halos at night and low light environment. While I can see 20/20 line under normal daylight, the overall quality is pretty bad and my eyes easily feel tried.

However, what annoyed me most was the doctor. He never mentioned any intention for overcorrection before the surgery. 1-day post-op he said the long-sight should go away in a week or so. 1-week post-op he said I should give it 2-3 more weeks. 1-month post-op he said the overcorrection is indeed good for me, as a little bit long-sight helps to look better at night time (direct quote from him). He doesn't seem to be concerned at all, but I do, especially after browsing through this forum.

Questions:

1) What's the chance that my eyes will regress back to normal in the normal 6 months healing period?
2) If regression doesn't happen and my eye stayed that way (+1.0) for next 5 months, would enhencement be preferred?
3) I understand that enhencement will NOT improve HOA, but it is likely that it will worsen it?

Thanks a lot for your advices!
horw933
 
Posts: 2
Joined: Fri Sep 29, 2006 5:28 pm

Re: Overcorrection

Postby LasikExpert » Tue Oct 03, 2006 5:06 pm

horw933 wrote:1) What's the chance that my eyes will regress back to normal in the normal 6 months healing period?


It is still possible that they will regress. Most people regress within the first 1-3 months, but many have reported late regression. Only time will tell for sure.

horw933 wrote:2) If regression doesn't happen and my eye stayed that way (+1.0) for next 5 months, would enhencement be preferred?


Lasik enhancement surgery should be considered. The preference will be yours. If you are well under age 40, then being slightly hyperopic (farsighted, longsighted) may not be a tremendous problem, but after age 40 when presbyopia (need for reading glasses) becomes problematic, the combination of hyperopia and presbyopia often provides poor quality vision at all distances.

Your current prescription is undoubtedly from a manifest refraction (which is better, one or two?). A cycloplegic refraction would paralyze the natural lens within your eye and determine your refractive error without “focusing around” the hyperopia. This measurement is just as important in determining what correction would be appropriate.

horw933 wrote:3) I understand that enhencement will NOT improve HOA, but it is likely that it will worsen it?


As a general rule, refractive surgery increases higher order aberrations (HOA), however if certain HOA are elevated it is probable that wavefront-guided enhancement will lower that particular HOA. As an example, poor vision quality at night is often indicated by the HOA Spherical Aberration. Spherical aberration means that the refractive error at the outside of the cornea is different than in the middle. Wavefront-guided enhancement is relatively successful at resolving this particular aberration effect. Whether or not you can expect improvement depends upon the findings of a wavefront diagnostic.

You really should not consider an enhancement until at least three months postop and six months postop would be better. You may also want to get a second opinion before making a final decision.
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Re: Overcorrection

Postby horw933 » Wed Oct 04, 2006 2:45 am

LasikExpert wrote:
Lasik enhancement surgery should be considered. The preference will be yours. If you are well under age 40, then being slightly hyperopic (farsighted, longsighted) may not be a tremendous problem, but after age 40 when presbyopia (need for reading glasses) becomes problematic, the combination of hyperopia and presbyopia often provides poor quality vision at all distances.



I'm now 28 so it may not be an immediately problem, but I'd definitely like to plan for future ... and it sounds like being slightly hyperopic does no good to me by all measure.

LasikExpert wrote:
Your current prescription is undoubtedly from a manifest refraction (which is better, one or two?). A cycloplegic refraction would paralyze the natural lens within your eye and determine your refractive error without “focusing around” the hyperopia. This measurement is just as important in determining what correction would be appropriate.



Does it mean that cycloplegic refraction is better in determine hyperopia?

I feel pretty hard to answer the "which is better, one or two?" quuestion as some of the images look very similar to me. However I'm now wearing a ready-made presbyopia glass and it does help a bit.

LasikExpert wrote:
As a general rule, refractive surgery increases higher order aberrations (HOA), however if certain HOA are elevated it is probable that wavefront-guided enhancement will lower that particular HOA. As an example, poor vision quality at night is often indicated by the HOA Spherical Aberration. Spherical aberration means that the refractive error at the outside of the cornea is different than in the middle. Wavefront-guided enhancement is relatively successful at resolving this particular aberration effect. Whether or not you can expect improvement depends upon the findings of a wavefront diagnostic.

You really should not consider an enhancement until at least three months postop and six months postop would be better. You may also want to get a second opinion before making a final decision.



Thanks a lot for your advice! All you provided in this forum and the website is extremely valuable for us!
horw933
 
Posts: 2
Joined: Fri Sep 29, 2006 5:28 pm

Postby LasikExpert » Wed Oct 04, 2006 5:26 pm

Thank you for your kind words about our website. I'm glad that our information is helpful.

At age 28 you have a lot of accommodation - the ability of the natural lens in the eye to change focus. That accommodation will allow you to "focus around" some refractive error. This seems to almost always be the case with hyperopia. When you have a manifest refraction, your eyes will be accommodating and that accommodation can mask some refractive error.

A cycloplegic refraction will not allow your eyes to focus around refractive error. The refractive error determined with cycloplegic refraction is in my opinion a more accurate representation of refractive error for the purpose of surgery, however manifest refraction must be considered as well. Ideally, manifest and cycloplegic would be very close. For someone 28 years old, most ideal would be manifest and cycloplegic refraction showing plano – no refractive error.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Posts: 3309
Joined: Fri May 12, 2006 6:43 am
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