High hyperopes@ +6 and lasik surgery

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High hyperopes@ +6 and lasik surgery

Postby stangreen » Mon Jan 15, 2007 11:21 pm

My son is 22yrs old. He just had a consult and they told him his hyperopia
was a +6 diopters. Originally they told him he wasnt a canidate for surgery. He was devastated. He has been wearing glasses since age 2. Started wearing hard contacts at about age 7.
We (my wife and I) went in to speak with the doctor as we had little knowledge of the factors involved. We advised her that because of this condition he has, if he has no contacts or glasses on, his eyes cross. With correction they are normal. It is not a lazy eye. It is a vision focusing problem that causes them to cross because of his high level of hyperopia. He also has minor astigmatism.
The eye crossing is a great embarassment to him. Because of it he will leave his hard contacts in for extended periods and sleep in them.
He also wants to be a police officer, which requires at least 20/70 vision without correction (which this doctor says he now has).
With our conversation with the doctor, she changed her mind and stated she would do the surgery for him. She stated that she still believed that with this +6 level he may still need glasses for driving or reading etc. But that his general vision would improve to wear he would not need them for doing normal daily activity. Best case situation he may even end up close to 20/30 20/40 and not need them at all. SHe advised with hyperopia of this level you just couldnt gaurantee anything.
After doing some internet research however Im wondering now if its a good idea for him to do this. I am a father desperate for some good advise. Should I allow my son to get this surgery?
THey would use the intralase method for what it is worth.
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Postby LasikExpert » Tue Jan 16, 2007 1:11 am

The hardest part is that you need your son to really understand the limitations of Lasik and make his decision himself. You advice is undoubtedly appreciated, but he will be the one who will live with the results and if something goes wrong...you may find it hard to live with yourself if you feel like you promoted elective surgery.

Your doctor is correct that the probability of resolving all 6.00 diopters of hyperopia (farsighted, longsighted) vision is not good. Regression is common in hyperopes and would be all but assured in your son's situation. It may be reasonable to expect 3.00-4.00 diopters of correction, but it would also be reasonable to expect 1.00-2.00 diopters of regression.

A phakic intraocular lens (P-IOL) is a "helper" lens that is placed inside the eye just in front or just behind the iris, but a hyperopic P-IOL is not currently approved in the US.

Refractive Lens Exchange (RLE) does not seem appropriate because your son would lose his ability to accommodate (focus on objects near) and would be required to immediately use reading glasses.

A laser assisted surgery such as Lasik, IntraLasik, PRK, LASEK, or Epi-Lasik may be considered appropriate, but they are not going to correct his vision as well as his current contacts and glasses and may induce other problems.

Your son is not an ideal candidate for any type of currently offered refractive surgery. He is perhaps a marginal candidate for a procedure that will undercorrect him and regress with time.
Glenn Hagele
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