Post-LASIK overcorrected, now what?

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Post-LASIK overcorrected, now what?

Postby Butterfly » Tue Feb 17, 2009 11:27 pm

I had myopic LASIK 9 months ago and am overcorrected into hyperopia. I'm 49 years old.

Pre-LASIK: -650, -175, 04 and -650, -150, 180
Now: +1, -50, 125 and +175, -75, 25

I'm very happy with my distance vision 20/30 and 20/40. I get by fine with +150 readers for using the computer, cooking, etc. However, it would be nice to get some mid range crispness back. I am bothered by looking at blurry faces across the table or across the room. Outside in the bright sunlight, all is clear!

My corneal thicknesses are now 420 and 400 microns (down from 540). I am assuming that 160 microns of that is flap, so my untouched bed isn't extremely thick. I realize that the hyperoptic correction would be around the perimeter, but I'm a little concerned anyway. My doctor says PRK is option 2, but he is leaning toward recommending lifting the flap and using LASIK if I want the enhancement.

I'm having difficulty deciding on if I want to risk epithelial ingrowth (which he said is a 5% risk), corneal ectasia or some other nasty outcome. Maybe I should just be happy with the great distance vision that I am experiencing and not tempt fate.

I am going to have a cycloplegic exam next week to see how much I am accommodating around the farsightedness. (My vision is always blurry in the morning at all distances for about an hour.) Perhaps the exam results will help me decide whether to proceed with enhancement or hang tight, knowing that PRK is an option down the road, even after my flaps become unliftable.

Any comments or suggestions or insights would be so greatly appreciated!
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Postby SteveR » Thu Feb 26, 2009 9:49 am

I think Docs should impress more on patients that 20/20 isn't always such a great target to aim for (and possibly overshoot), especially after the age of 40. In my opinion a little myopia is useful thing to posses and a better pre-op expectation would be more in the 0 to -1.00D range rather than plano. At the very least to keep one eye a little myopic, as hyperopia offers no advantages as far as I am aware and its negative effects will become more noticeable with age (possibly including blurring at all distances), since at 49 years old you still have around 2D accommodation left in your visual system to work around it.

I can't say what I would do in your circumstances, except what you've already done and are planning to do. Previous case studies might help. I can say I was and continue to be happy to be left a little short-sighted after my op, but I can appreciate that other people prefer to reserve glasses use for close-up and mid-range work rather than distance.
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