Low myopia, higher 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.

Low myopia, higher astigmatism

Postby PLee1980 » Thu Nov 08, 2012 7:20 pm


I've been reading a lot of info on this site (it's great, BTW) while I am looking into getting Lasik or PRK (learning towards PRK).

My glasses prescription is left: -.5 sph -1.0 cyl, right: -.25 sph -1.0 cyl. I've only had glasses for 2 years now and my prescription was the same 2 years ago as it is today (just had an exam a couple months ago).

I went in for a Lasik consult this week and they determined my prescription to be left: -.25 sph -1.25 cyl, right: plano -1.5 cyl. I was told this variation against my eyeglass prescription is considered normal due to normal eye fluctuations.

My concern is obviously the laser coupling affect and possibly correcting sphere which doesn't exist. I spoke with the surgical tech (in person) regarding the laser coupling issue and she told me "it's not an issue, we use the latest technology and are able to correct astigmatism without affecting myopia.". This particular center uses the Allegretto laser.

I spoke (on the phone) with another Lasik center and they told me the exact same thing, they could correct astigmatism without affecting myopia.

Now I'm not talking to the doctor in these cases, rather what amounts to a sales person. Obviously this doesn't give me a comforting feeling. Should I press to talk to the doctor on the issue or keep calling until I find a clinic which at least acknowledges the issue, so I can at least be comfortable they know what to do about it.

I realize I'm right on the edge of where laser coupling could be an issue. Perhaps I am over thinking this?
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Re: Low myopia, higher astigmatism

Postby LasikExpert » Thu Nov 08, 2012 8:32 pm

Both you and the technicians are correct. There is a coupling effect when the astigmatism is higher than the myopia. Newer lasers attempt to counteract the coupling effect during the ablation process.

I highly recommend PRK over Lasik. Although the healing time is longer, with this very small amount of correction and really only astigmatic correction, a surface ablation makes much, much more sense. The creation of the flap can induce enough refractive change as to overcorrect you into hyperopia.

Something else that is important is that a comprhensive evaluation of your cyclopedic refraction is needed. You may have more myopia that is shown in a manifest refraction because accommodation is "focusing around" the myopia.
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