Enhancement, Contacts or Glasses

[goose11057]

I had Lasik performed 12/20/2007 after wearing glasses and contacts since third grade and I am now 52 years old. This message board helped me through the recovery and answered many of my questions during that time, thanks. Now it is my turn to post an entry since I need to make a decision regarding enhancement and wanted some opinions and comments to help as considerations. Below is the background information:

Original (prior to Lasik)
Right Eye OD -4.50 -1.25 x 90
Left Eye OS - 5.50 -1.00 x 185

After (4/28/08)
Right Eye OD -0.75 -.50 x 166
Left Eye OS -1.50 -.50 x 001

So after Lasik, Big Disappointment, reading the message board, understanding the healing time and the Dr. indicating everything is correctable gave me some peace of mind. I still had difficulty seeing distance and the doctor and I agreed that we should do an enhancement on the right eye. The Dr. took measurements using CustomVue and refraction and got slightly different results. With the CustomVue he got -0.42 0.47 x 156 and with refraction -0.75 0.50 x 166.

Since he thought the CustomVue wavefront would provide better results he used them for the enhancement. Unfortunately, this left me slightly off in the right eye with -0.25 -0.25 x 180. While this is a small amount it makes a big difference and I am at best 20/30 possibly 20/35 without correction. The Dr., while slightly disappointed with the right eye said this was a good monovision result and I should accept and leave it alone. After much discussion, he gave me new glasses and we tried some contacts in both eyes (multifocal) in left eye and that is where I am at currently.

The problem as I explained to the Dr. is that I feel I paid $5,000 for a new prescription. My options are to leave everything as is. Without contacts or glasses I do not feel comfortable driving, especially at night. While I can see the big stuff and can pick up a newspaper or magazine and read, I do not feel comfortable without glasses or contacts nearby. The second option is to continue to use contacts. It is very functional with the contacts but certainly not what I expected. I feel that I need the contacts in most situations unless I am in my home or familiar surrounding to get the clarity. Third option, have enhancement on left eye so that I can better see 20/20 even though I understand that I will probably be presbyopia and need reading glasses. I am leaning to this option. Both eyes would then be very close to each other in terms of results. This is more of a modified slight monovision. If I have the enhancement it will be about 16 months since the original surgery and I have some slight concerns with the flaps. I am also concerned that he has been unable to achieve the objective and should I give him a third chance. By having the enhancement in the left eye I will get closer to achieving my original results, which is to mostly be free from contacts of glasses. I understand that at my age it is a compromise and I will need glasses and/or contact on occasion. Right now I would say that 70% of the time I need some type of correction in terms of contacts or glasses. With the enhancement I think I will be able to function 70% of the time without contacts or reading glasses. Perhaps I am overly optimistic but I am trying to determine the best compromise for me.

Thanks in advance for your comments and opinions.
Thanks

[yawny]

One thing to consider is that you won't just need reading glasses to read, but probably to see your watch, cell phone, dashboard of car,, putting on makeup if you are female,,etc. I had laser surgery done in just one eye, and had very good results. I did have an enhancement about five months from the first surgery, to correct a lingering astigmatism, but overall I am happy. I sometimes have trouble in bookstores etc, reading titles unless I get really close, but I still read, drive etc. all without glasses. My situation may be different than yours, but you need to be aware that it isn't just reading you will need close correction for.

[goose11057]

Since my right eye is about 20/35 I can see my watch, speedometer and other things with some blurriness depending on lighting. At the same time because it does not have the crispness of 20/20 that is where my frustration lies. The monovision itself probably would not be as much of an issue if one of my eyes preferably my dominant right eye was 20/20.

I will admit it is good to be able to pick up the newspaper or magazine and be able to read. My left eye is about 20/80. I seem to be in this situation of not having 20/20 vision or a good monovision combination. Recently I have been using the multifocal contact in my left eye only which gives decent distance vision with the ability to see up close.

[yawny]

I think that you would find that you would really hate it if you could not see close up for the things I mentioned. When I cover my dominant eye ( the one I had surgery in) I cannot see well close up at all, and I would really hate having that vision in both eyes. Why not have the enhancement in only the one eye to get crisper far away vision and see how that works, before doing the other one. You can always go back and do the other one later if you aren't happy, but keep in mind the healing time. I would wait at least 8 months or so , to redo the other eye if necessary because my eye steadily improved after the last enhancement.

[goose11057]

The risk associated with such a small correction in the right eye would not be worth it. My understanding is that anything less than .50 should be left alone. I understand what you are saying with being able to see up close and not wanting to lose that. However the Dr. indicates that at some point (about 7 - 10 years) I would probably need reading glasses anyway due to my age (52). I think I would prefer to have two eyes with relatively the same vision and hopefully one with crisp 20/20 vision. Even is that does mean use of reading glasses.

[Walt]

I think I would prefer to have two eyes with relatively the same vision and hopefully one with crisp 20/20 vision. Even is that does mean use of reading glasses.

I agree with you if your left eye had no astigmatism and was closer to 20/20 then your current state would be fine. But as it is having the right eye done might be best.

Beware of one thing though, I am 50 and had both eyes done from -2.5. After the initial surgery my eyes ended up +1 and +1.25. This out come was horrible, between the induced farsightedness and the natural presbyopia because of my age I had horrible sight at all distances. Just letting you know that going too far can be disastrous. I ended up having them both redone and the result ended up fine.

Good Luck

[It's Just Me]

I WISH I would have read all this before having my lasik done.

I wouldn't be suffering right now...because I would have not had it done.

to wear contacts or glasses after the surgery...just seems too unbelievable. It MAY be what I end up doing though, as I can't deal with blurriness. I can't see a clock 10 feet in front of me. Can't see signs driving, and yet, they "passed" me for driving and gave me a special card saying I had just had lasik and was cleared to drive.

*shrug*

[goose11057]

I have pretty much decided to go ahead with the enhancement to the left eye. I am scheduled to meet with the doctor in early April to discuss and will keep you updated. I really believe having both eyes closer to 20/20 will allow me to function without contacts or glasses most of the time. I will miss my close up vision, however prior to considering Lasik I felt it was better to have good middle and distant vision and just accept that I would need reading glasses. Besides according to the doctor in about 5 - 10 years the left eye would probably need reading glasses anyways since presbyopia is progressive. In the end I cannot accept paying over $5,000 and not having at least one eye 20/20, it doesn’t seem right.

Thanks for the comments and reply's

[DocH]

Did you decide to go with the enhancement? if so what was the outcome?

[goose11057]

4/29/10 Update
After much agnst and discussion with the Dr. I decided to leave well enough alone and not get another enhancement. I do use a 1.25 multifocal contact in my left eye most of the time at work and on weekends. Because of newer contact technology and since it is much thinner I hardly know it's there. I function very well since the contact provides good distance vision in both eyes and with the multi focal component and slightly myopic (20/30) in right eye, I can read computer screens and print material. When I take the contact out in the evening or some days do not use at all, I can still function reasonably well.

While I would have liked for the surgery and mono vision to be 100% successful, variations and other things do not allow it to always work out the way we want. In the end I was more concerned about problems with a small correction than adjusting to about 90% of my expectations. In addition, I have not worn glasses (reading or regular) in almost a year. When I think of others with much more serious vision problems, inlcuding loss of vision, I consider myself very fortunate. As is said many times on this site we have to do what is "best for us", and this works for me.

[LasikExpert]

Thanks for reporting back with your current condition and decision. Yes, all must do what is best for themselves. It looks like you have explored your options well and found what it best.

[PRKorIntacs]

Thanks for sharing your story. I was wondering what reasons you had for laser surgery if contact lens(es) work for you? I am looking into PRK myself because contact lens can be felt and dry/irritate my eyes. Id like to reduce my dependancy on glasses and don't expect perfect vision(if I did, I would be unrealistic) I have several threads in the "thinking about it" I am aiming for a -1.5 both eyes(no monovision) and will be happy to end up between -0.5 and -2.5 which is way better than the -5.5 I have. Itll keep me out of readers and greatly reduce my dependancy on distance glasses.

[goose11057]

Good Question - The reason I had the Lasik surgery was that I felt the technology and results were matured enough to provide consistently good results, and NASA had just approved it for some pilots. I never liked wearing glasses and did not really mind the contacts although at the end of the day my eyes were tired and dry. The biggest problem was that in addition to wearing contacts, I now needed reading glasses to see anything up close. I tried some new multifocal Toric contact lenses, but since I had an astigmatism and big correction (-4.5 and -5.5) they did not seem to help. The Lasik surgery would at least allow me not to get rid of the reading or regular glasses, and they have. I would say that monovision works pretty well and is better than I would have expected, I got used to it fairly quickly. I think having one eye 20/20 is very important for monovision and would not have considered an enhancement, or this posting, if we had achieved that goal in the first place.

[PRKorIntacs]

Good Question - The reason I had the Lasik surgery was that I felt the technology and results were matured enough to provide consistently good results

Lasik/PRK is a mature technology but results are still not 100% guaranteed. How long had you researched this? My research lets me know that the PRK im getting can improve my vision and reduce my dependancy on glasses, but that I must have realistic expectations. I would consider it a good result if I need glasses much less than I currently do. If they can get me in the -1.5 ballpark without overcorrecting me to hyperopia, ill be happy.

I never liked wearing glasses and did not really mind the contacts although at the end of the day my eyes were tired and dry.

Contacts cause my eyes to feel dry within minutes and they feel like an eyelash. I tried contacts 20x and they are not for me, this is why im looking into PRK to help me reduce my dependancy on glasses. Your contacts did a great job, im hoping PRK can offer some improvement. I don't expect perfection, that would be unrealistic.

The biggest problem was that in addition to wearing contacts, I now needed reading glasses to see anything up close.

That is why I am aiming for -1.5 with PRK in both eyes. Monovision isn't for me.

I tried some new multifocal Toric contact lenses, but since I had an astigmatism and big correction (-4.5 and -5.5) they did not seem to help.

Did monovision work for you before lasik? If not, youd have to accept still needing glasses part time with contacts(or lasik) or wear progressive glasses fulltime.

The Lasik surgery would at least allow me not to get rid of the reading or regular glasses, and they have.

I thought your contact lens did that. Contacts aren't compatable with my eyes and I let the surgeon know this as a reason. He agrees my expectations for improving my vision and reducing my dependancy on glasses is realistic. He understands that I don't want reading glasses and is why I am aiming for a slight undercorrection of -1.5

I think having one eye 20/20 is very important for monovision and would not have considered an enhancement, or this posting, if we had achieved that goal in the first place.

Perhaps lasik wasn't for you if you insisted on 20/20. Isn't your vision good enough to legally drive without correction? Couldn't you function without correction? I feel that I could at -1.5. Most people do end up that way but it's not a guarantee. I don't get 20/20 with glasses and besides, 20/20 for distance would only mean id need reading glasses many hours a day. So to avoid this, I have elected for a slight undercorrection of -1.5 and have accepted the fact ill occasionally need distance glasses(I don't drive)

[batista]

Hello,

Buddy thanks for sharing the nice information about the Enhancement, Contacts or Glasses which is good to see

thanks!!

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