Runboard.com
Слава Україні!

runboard.com       Sign up (learn about it) | Sign in (lost password?)

 
Myope5 Profile
Live feed
Blog
Friends
Miscellaneous info

Head Administrator

Registered: 05-2005
Posts: 816
Karma: 8 (+9/-1)
Reply | Quote
A guy's dilemna on lasik. Hes 20/15 BCVA with -6.5 contacts!


Thin corneas, LASIK vs. PRK"
Posted by Robert - Cupertino, CA on 12:30:56 9/20/2005
  Include Original
Message on Reply
Hi,
I've been through several LASIK screenings over the years and am getting conflicting advice ... I was hoping for another opinion here.

My contact prescription is -6.0/-6.5 D. I can see 20/15 with my left eye and 20/20 with my right eye with contacts - daily disposable. I have a small astigmatism that we don't correct in my right eye. I'm 44 and my vision has been stable for many years. My reading vision is still good. I stay active, Mountain biking, playing ultimate, volleyball, softball, etc.

At my most recent screening, my corneas were ~ 480 um and the Dr. suggested traditional LASIK with IntraLase for the flap. Correction would remove about 100 um, and wavefront would require another 20 um. He uses 250 um as a lower bound to prevent echnasia. My pupil's under standard lighting are 5.5 and 6.0 mm. The prescription from this exam was R:7.50+0.75, L:8.00+0.25. The Dr. had essentially no concerns about doing Lasik.

Dr. #2 suggested PRK. He siad I should be concerned about echnasia.

I checked back with another clinic that had turned me down a couple years ago to see if technology had changed and they suggested that I wait for the new microkeratome that does 100-120 um flaps and that I would be elligible with it (and also with the current microkeratome that removes 140-160 um).

I've had several discussions with Dr. #1 and he said he's seeing good results with wavefront PRK and that's now his recommendation. He wanted me to come in for another exam specific for that technique. I haven't done this yet. I have a feeling that he might be recommending PRK cause I told him Dr. #2 recommended it.

Anyways, I looking for a bit of guidance. My main concern with PRK is that, if I get eye surgery, I want good vision and would choose to have enhancements if things don't come out close to 20/20. With PRK, including the healing and stabilization time, and enhancements, doing 1 eye at a time, this could be a long process ...

A secondary concern is echnasia - I couldn't find any statistics suggesting how often this occurs, etc.

Sorry for the long email, but I tried to include all the essentials.

Thanks!

-Bob Estes, Cupertino
 
   

--------------------------------------------------------------------------------
1. "Thin Corneas. PRKvs LASIK"
Posted by Michael Furlong, MD on 13:26:40 9/20/2005
  Include Original
Message on Reply
Bob,
Ectasia is a very rare complication of LASIK (and even less common with PRK), but can be extremely difficult to correct if you get it.

ANY flap-making device has a standard deviation (including the Intralase and "newer" microkeratomes), so no surgeon can guarantee that you will actually get a flap of 100 microns (it could be as high as 140 or more!) when it is cut. Once it is cut, you are committed to LASIK.

I would recommend you consider PRK (wavefront or conventional), OR even an implantable lens inside the eye where no thinning of your cornea occurs at all. These have risks, too, but you can find additional information about these by going to http://www.staar.com/index.php?sitecode=US or http://www.amo-inc.com/site/products/verisyse.asp

Good luck!

Dr. Furlong


***and my reply to this***


The doctor has a valid point in surface ablation. If you were to get a flap, theres no guarantee itll be 100um. Intralase does produce very consisant flaps and usually varies little. Microketerome varies much more. Ive done the math and youd be at 280 cornea left with tradational lasik, 260 with wavefront *if* the flap is 100um and not more. You wont have enough for an enhancement or even think about one. Plus the doctors I know like to keep the minimum to 300um because its much safer than 250um. 1:5000 vs. 1:250 risk of ectasia.

Very nice BCVA! Of course the contacts help by not minifying things like glasses do. Im a -5 in glasses with BCVA of 20/30 +2 accroding to the optometrist. If I wore contacts, they would be -4 and I should be 20/25. Your -6 and -6.5 contacts would equal -7.5 and -8 glasses in which is the case due to vertex distance.

Your smaller pupils are a big advantage reguarding night vision and saving corneal thickness. You can do PRK, epi-lasek or clear lense extraction. There are risks to each. PRK and epi-lasik give you risks of corneal haze, especially for severe myopes. Are you a candidate for wavefront with your high pescription and low amount of high order aberrations due to 20/15 BCVA? Ask the doctors about clear lense extraction. This is where they remove your natural lense and put a clear lense in its place which will fully correct you without enhancements needed plus youll never have to worry about cateracts. Your gonna need reading glasses unless you opt for monovision or perhaps multifocal IOLs


*not a doctor, what I said is my opinion emoticon
 
9/21/2005, 1:33 am Link to this post Send Email to Myope5   Send PM to Myope5
 


Add a reply





You are not logged in (login)