Spoke directly with Dr. [P] this morning

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.

Spoke directly with Dr. [P] this morning

Postby jcarrey4 » Fri May 21, 2010 3:17 pm

And we had a long talk about statistics and rationality and sensational internet websites and technology.

As it turns out, my prescription (-2.5, .3 astyg, NEGATIVE spherical aberrations in one eye, -2.75, .6 astyg in the other, slight higher-order aberrations, 620+ micron thickness, 6.5mm dilated pupil) statistically results in a 97% 20/20 rate with the machinery he uses when dealing with surgeries he performs himself. We had a long discussion about perceived success rates, older technology, LASIK flap complications, how the military is moving to LASIK from PRK, how the flap heals, and the statistical significance of each of those factors.

On a side note, for those, especially on this board, who think that just because they've done the research for their specific situation and concluded on specific technology or procedures, does not mean it applies to everyone. Case in point: Dr. [P] told me I am in the 5% minority that has a negative spherical aberration. For this reason, the Allegretto machine would be the worst possible machine to use, as it is based upon an average spherical aberration, and therefore would _worsen_ my spherical aberration. The VISX S4 Star IR is _truly_ custom, and therefore will help reduce the negative aberration instead of making it worse. He also informed me, similar to subsidized cell phone plans, the Allegretto, since it is trailing the VISX brand, is given away to doctors with a higher lease payment to lessen the upfront machine cost, so as to increase market reach. Companies do this all the time, but Dr. [P] talked about the differences, and I'd suggest anyone looking at LASIK to really look at the differences between the two before making any decisions. The whole 'iris recognition' technology makes me feel a lot safer that the eye that was scanned is, in fact, the eye being operated on, and that if i move my eye at all during the procedure, it tracks it, too.

All-in-all, I have been convinced that for my specific situation, this technology, this office, and this doctor are perfect for me and will result in the highest chance for a low-prescription, low-complication outcome. Obviously, I understand statistics, and it's not guaranteed, but this will give me the highest chances of success.

If anyone has any other questions about our specific conversation, let me know, but i highly suggest everyone meet with your doctor before the surgery itself.

Note: Doctor name redacted.
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Re: Spoke directly with Dr. [P] this morning

Postby jcarrey4 » Fri May 21, 2010 3:25 pm

By the way:


" Our referring doctors instigated the shift, and our staff endorsed it wholeheartedly as they had fewer and fewer enhancements and complaints to deal with. The WaveLight basically put a standard spherical equivalent coefficient into every single treatment, simply adding additional pulses in the periphery to compensate for the induced spherical aberration. The Wavefront optimized approach did not adjust the number of pulses based upon the amount of spherical aberration present pre-operatively, nor did it treat coma, trefoil or any other asymmetrical higher order aberrations of clinical significance. Furthermore patients with negative spherical aberration were worsened by the Wavefront Optimized ablation (WFO) pattern and these patients along with those with significant or induced coma became a growing source of retreatments and complaints for my staff and I to manage. Lastly, we had no way to effectively retreat these unhappy WaveLight patients other than to utilize VISX CustomVue. While we still today have our WaveLight laser it has been over a year since my partners and I have used the laser and I suspect that it will find another home where it is wanted. Today, we are 100% VISX CustomVue with IR combined with IntraLase for corneal flap creation, and night vision complaints are virtually non-existent. "
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Re: Spoke directly with Dr. [P] this morning

Postby LasikExpert » Wed May 26, 2010 11:02 pm

You have demonstrated clearly the limitations of a forum like this and why it is always best to rely on a trusted surgeon over the information provided on the Internet. Indeed, negative spherical aberration is unusual and the custom wavefront mapping of the Visx may provide a better result. It appears you have completed your due diligence well.
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Re: Spoke directly with Dr. [P] this morning

Postby davidmartinomalley » Thu May 27, 2010 10:11 pm

Sounds like you're in a good place! The only other advice I'd give based on my personal experience is to prepare yourself for the recovery process. Like the surgery itself, everyone has a personal situation. I was surprised at just how emotionally taxing the process was (then again, I had a setback, and a 3 year old daughter that demanded the attention of...well, a 3 year old!) Those first few days, when you're told do this/don't do that, and a general feeling of vulnerability because your eyes are sensitive - it's just something extra you have to deal with, on top of every day events. Again, none of that may apply to you, but I thought I'd throw that out there.

Stock up on the eye drops - you'll need them! (I bought in bulk at costco, much cheaper, FYI). Best of luck, and let us know how it works out.
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