Am I a candidate? Pre_Op Exam Numbers posted.

[chucklee]

I am scheduled to have procedure done tomorrow on 8/30/12 with a nationally known company. I'm 28 years old and this is second major company I have consulted with (the other company also said I am a good candidate)
I am concerned about three things.

1. Am I truly a good candidate???

2. Which procedure will give me the best vision results LONG TERM (i don't care about the short term pain)

3. Based on my numbers, what can I realistically expect providing the Dr. knows what he is doing?

I have myopia and astigmatism.
Uncorrected VA: OD: DV 20/CF NV 20/30 OS: DV 20/cf NV 20/40
Corrected VA: OD: 20/20 NV 20/ OS: DV 20/25 NV 20/
Current RX: OD: -3.50-75x/75 OS: -4.5sph
Motility: OD: EOM OS: EOM
Confrontations: OD: FTFC OS: FTFC
Dom. EYE: OS
Pupils: OD: dim_6.5 Bright_4.5 OS: dim_6.5 Bright_4.5
Keratometry: OD: 45.4/46.3 x 092 OS: 45.60/46.0 x 0.96
Pachymetry: OD: orb_528 OS: orb_520
AR: OD: -3.00 -75 x 179 OS: -375 -50 x 178
MR: OD: -3.25 - 1.25 x 180 20/20 OS: -4.25 - .75 x 175 20/20
Cyclo Ref: -3.25 - 1.00 x 180 20/ OS: -4.25 - 050 x 180
Cornea Elevation_ FRONT: OD: BFS=7.44, Dia-8.00
OS: BFS=7.43, Dia-8.00
Cornea Elevation_ BACK: OD: BFS=6.00, Dia-8.00
OS: BFS=6.01, Dia-8.00

I also have the data and charts with info on corneal thickness and eye curvature on each eye. I don't know which of the hundred values are needed to give a basic judgment, so maybe I could send them as attachments or something?

[LasikExpert]

There is nothing in the measurements you report that indicate you are a less than ideal candidate for Lasik or PRK, but remember I'm not a doctor. The only issue that might be marginal is your pupil size, but if this measurement was made with an infrared pupilometer, you probably do not have a problem there. You may want to look at our articles about Lasik results, Lasik and pupil size. You may also want to read our articles about All-Laser/Bladeless Lasik and wavefront optimized Lasik.

I am biased toward the surface ablation techniques of PRK, LASEK, or Epi-Lasik over Lasik. The reason is the Lasik flap is eliminated with the surface ablation techniques. Even though the probability of a Lasik flap problem is relatively low, no possibility of a problem is almost always better than a low probability. PRK has a much slower recovery and more discomfort. Discuss the options between Lasik and PRK with your doctor.

BTW: Keratometry shows corneal curvature and pachymetry shows the corneal thickness.

[chucklee]

Very well put and easily understood. Thank you very much for the help. Though I have been consulting with my doctor on this, it is much appreciated to hear from an UNBIASED person with no real "agenda" regarding my particular needs.
After all the read ups and articles, I just don't see any real advantage to LASIK over "non-flap" procedures except for quicker recovery and less pain. It seems that many say that better results will follow a PRK procedure....?

On my first post I wanted to simply post my info for others to look at without directing them to the info I have already been told. Now that I have a reply, may I pick your brain just a tad further?

I have been told that my pupils are a bit larger than normal, and for that reason PRK would be a better choice for me. Is that True?

However, from what I understand, patients with astigmatism usually have better results with LASIK procedure? Is that true?

If so, obviously there is a decision to make here, as I have large pupils and astigmatism. In your non-professional opinion (but clearly very well informed and probably better than professional advice), what would you recommend for me and why?
Put it this way, and I plan on asking my doctor this tomorrow morning, "If I were your child or spouse, would you encourage me to have any of these procedures, and if so, which procedure would you recommend for me?"

THANK YOU SO MUCH! You have no idea how much you have already helped me. (reading those articles, very helpful and well put)

[LasikExpert]

I have been told that my pupils are a bit larger than normal, and for that reason PRK would be a better choice for me. Is that True?

Your refractive error is low and your corneas are not overly flat. I suspect you will have the same result with Lasik or PRK.

However, from what I understand, patients with astigmatism usually have better results with LASIK procedure? Is that true??

Your astigmatism is relatively small and well within the treatable range for both PRK and Lasik.

...what would you recommend for me and why??

I still have my bias toward PRK, although there is nothing about your situation that indicates PRK is required. There is more discomfort with PRK and your vision recovery will be slow, but I personally believe it is worth it in the long term. I like to say that for the first few weeks you will wish you had Lasik (quick vision recovery and virtually no pain) and for every day thereafter you will be glad you had PRK. Once you get through the recovery, you never need to worry about a Lasik flap.

THANK YOU SO MUCH!

I'm glad to be of service.

[chucklee]

PRK it is my friend. God bless you for your help, and God please guide the doctor's mind and hands

[LasikExpert]

Be sure you post in the "Just Had It" section to tell us of your journey.

[chucklee]

Sounds good. Will do!

[karishma]

Hi I am from India, I just wanted to know if i can even go for Ilasik with my thickness and power.

my cornea thickness is 510

EYE POWER:

LE: -9.25/-0.75*80"
RE: -10.50/-1.00*135''

As of now i have got mixed opinion, as one doctor has said that the number can not be removed even with Ilasik completely since ablation required is 12 microns per dioptre.
And the other one said its possible with Ilasik, since ablation is 8 microns per dioptre. Please advice what is best for me or if I am even a candidate.
Also what exactly is VISX lasik???

[LasikExpert]

Namaste,

Lasik for someone with very bad vision is fraught with danger.

The Munnerlyn Formula determined that a minimum of 12 microns of corneal tissue must be removed to effect a 1.00 diopter change of refractive error. If a wavefront-guided ablation is used, this can go up to 18 microns per diopter.

You use the term iLasik, which is the marketing term used by a laser manufacturer to indicate Bladeless Lasik. This is regular Lasik with a femtosecond laser created flap. This type of Lasik flap can be created about 110 microns thick.

Let's do the math. In the worst eye the spherical equivalent is 11.00D/SE diopters. The amount of tissue to be removed is 132-198 microns. We will assume that the flap will be 110 microns. The corneal thickness is 510. Subtracting the amount of tissue to be removed and the depth at which it will be removed from you corneal thickness allows for 202-268 microns of untouched cornea. Many studies have shown that if at least 250 microns of cornea remain untouched, a healthy cornea will remain stable. You may think that you might be able to have iLasik if you do not use wavefront, but we are not finished.

It is common for a large change in refractive error to regress. It would be reasonable to expect about 2.00 diopters of regression for an 11.00D/SE correction. This means you would need enhancement surgery to resolve the 2.00 diopters of regression, which means an extra 24-36 microns of tissue removal. Now your untouched cornea would be 166-244 microns.

Although studies are less conclusive, it appears that the cornea will not remain stable if more than half its thickness is removed. iLasik would affect more than half your corneal thickness.

Your cornea after iLasik would be too thin and too compromised to remain stable. You would likely suffer from corneal ectasiaand would require a full corneal transplant. iLasik would not be safe for you.

The alternative laser vision correction technique would be PRK and it does not require the Lasik flap. This would eliminate the need to disrupt 110 microns of cornea for the flap, but even without the Lasik flap you would have only 276-354 microns of untouched cornea. This is so marginal as to be unsafe. Furthermore, PRK would be more likely to cause corneal hazing. There are workarounds for the haze concern, but you are at risk of your corneas changing from clear to white.

Another issue is the resulting curvature of the cornea. After removing 11.00D/SE your corneas would be very flat. This is likely to cause severe halos around light sources at night. You would probably not be able to drive at night.

Before any elective eye surgery you shoulde have an evaluation of your retina by a qualified specialist. High myopia places a lot of stress on the retina and can lead to retinal detachment.

Corneal vision correction surgery is too risky for you. You way want to consider Phakic Intraocular Lenses (P-IOL) or Refractive Lens Exchange (RLE) instead.

[Brad555]

I think you would be the next...