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Lasik Eye Surgery Message Board


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[QUOTE=Hoots711;4904392]Im scheduled to get PRK in about 2 weeks. At my pre-op visit yesterday the Dr mentioned i should consider 'corrective' Lasik/PRK as my eye scan show that i should be seeing glare and trails (like meteors) at night or when i drive.

I dont see either now, but to be fair I always have my glasses on when I drive and they apparently have a glare coating on them (which i didnt even know, ive been wearing glasses for about 5 years).
[/QUOTE]

What do you mean corrective lasik? custom guided lasik?
What is your prescription now?
My advice from my experience is that you don't do lasik. I mean don't do any corrective eye surgery. I was treated on allegretto and wavefront optimized, I have bad nightvision, can't watch tv easily as before. I am freaking out since I am multimedia guy, movies, games, pc work.
My eyes kinda go to cross when trying to focus in low light.
Anyways it's nice not to clean glasses every 30 minutes from smudges when out, but it wasnt my plan to half my quality of vision.

I only wanted as many to be free of glasses, easier to do sports and go in nature etc. Now I think it would be easier and cheaper than lasik to even use disposable contact lenses for some outside activity.
I still need to see what is wrong with my eyes now, maybe second surgery, but oh man this has taken some part of me, my anxiety is doubled.

So really think about do you need this procedure, and are you willing to take a risk. I think you can not compare benefits and risks and say oh it's okay i get benefit of this but maybe lose some quality of vision.
[QUOTE=MarioX2;4904608]What is your prescription?[/QUOTE]

right eye -.75, -.50 x 164
left eye -1.0, -.25 x 167

Not that bad.
Hoots that is really small prescription, you can even function without glasses, like swimming, running etc. I had -7, literally blind. I would advise not to let them cut your eyes. You can end up with bad low light vision, halos, starburst, it seems that kind of side effects are more common, but it also seems some clinics or majority of lasik industry doesn't make that to be serious complication. Surgery on eyes is big step with no return, and I know some peopel with minor prescription, now they have night issues and dry eyes. Belive me when I say I would take back my -7 and glasses, at least my cornea was intact and my eyes weren't dry and stable vision.
Hoots,

"Corrective" is an extremely vague term. You need to find out for sure what procedure the doctor is talking about. Since he mentioned "glare" and "trails", he is talking about higher-order aberrations of the eye. So most likely the procedure he is recommending is "wavefront-guided" (aka "custom wavefront") PRK. If you get bored reading the next few paragraphs, skip to the end....

The term "higher-order aberrations" (HOA) refers to the way the optical properties of the eye are modeled mathematically with Zernike polynomials. If you look up this term you will see it pictured like a pyramid. At the top are the lower-order aberrations, which are relatively simple and are what conventional glasses and contacts correct for. Below the first three rows are the higher-order aberrations, which become increasingly numerous and complex; they [I]cannot[/I] be corrected by conventional lenses. They have names like coma, spherical aberration, and trefoil. For example, when your doctor mentioned "trails" he could have meant coma (the term refers to a comet-like appearance, i.e. seeing a "tail" coming off of bright objects).

All eyes naturally have a certain amount of HOA because no cornea has a perfectly smooth, regular surface. Wavefront-guided (WFG) procedures attempt to analyze the HOA to provide a more detailed and precise map of the eye to guide the laser correction. In principle, WFG can be used with any excimer laser refractive surgery (Lasik, PRK, LASEK, etc.). WFG [I]may[/I] improve these naturally-occurring HOA. However, when you look at the medical literature, the doctors are really saying that WFG [I]may[/I] reduce existing HOA and [I]may[/I] induce [I]less additional[/I] HOA. So you could still end up with more HOA after WFG.

The bottom line is that even though WFG is superior in theory, in reality there are many factors that can compromise your outcome. These include:
(1) Accuracy of the wavefront scans. How advanced is the aberrometer being used? How well is it calibrated? Is every effort made to ensure optimal scan conditions, which include precise alignment of the aberrometer to the eye and discarding results when you move your eye or blink? Most likely the doctor has delegated these tasks to a staff person with no medical degree - how much do you trust that person to perform an excellent job?
(2) Repetition and stability of the wavefront scans. The eye is a living organ and changes to its aberrometry can occur from day to day. How many quality scans have been taken? What is the variation between them? If they are averaged together, will the result truly be a "best fit" for your eye?
(3) Healing of the individual eye. Every eye responds differently to the laser and heals differently afterward. The surgeon uses a "nomogram", which means that s/he makes assumptions about how your eyes will respond depending on your age, sex, prescription, HOA, and even the temperature and humidity of the operating room. These are statistical assumptions and may correspond very well, or may not, to your individual response. This is why advertisements guaranteeing 20/20 vision are fraudulent. Indeed, after your own surgery, your results will be factored into the nomogram in an attempt to improve its accuracy.
(4) Surgical complications. These are simply too numerous to mention.

I had WFG Lasik in my left eye and WFG PRK in my right eye in May 2011. The procedure was performed by my regular ophthalmologist, who is board certified, has been involved in refractive surgery for 15+ years, and has contributed to numerous medical articles and books. I had no surgical complications, but eight months later I still have halos, starbursts and ghosting, and they have not improved in seven months. True, at my last exam both of my eyes were 20/15, but there was a big f****** streak of light coming off the bottom of the eye chart, as wide as the chart and perhaps a quarter of the height. I do not call that success.

Let me show you how the money adds up:
$3,400 - Surgery
$1,500 - Medical texts on ophthalmology, eye optics, corneal topography, and refractive surgery (for research)
$ 410 - Second opinion on the outcome of my surgery and the benefits/risks of an enhancement (this is for two hours of consultation only)
$ 230 - Pair of iZon custom wavefront-guided eyeglass lenses, to see if this will correct my HOA (not including cost of frames)
$ ? - Pair of custom wavefront-guided contact lenses (if the iZon lenses don't work)

So that's at least $5,540 for now, the vast majority not covered by insurance. Please keep in mind that like you, I thought I was getting the most advanced procedure from an excellent surgeon. My HOA are not so bad that I can't drive at night, but they are very noticeable, upsetting and bothersome. I can't enjoy seeing the city at night anymore. I work in film industry post-production, in a dark environment, so the HOA are quite noticeable and bothersome there as well. I have a difficult time enjoying movies anymore (yes, the Lasik brochure never tells you that halos and ghosting will also occur with reflected light, such as a movie screen or road sign). Some HOA are still visible in broad daylight, by the way (just not as prominent), which the Lasik brochure also won't tell you. I will go back to wearing glasses or contacts in a heartbeat if these WFG lenses work. If not, I don't know what I'll do.

If you are still going to go ahead with the surgery, wavefront-guided PRK is in my opinion the only option. PRK offers several advantages to Lasik. The only disadvantages I've been able to find are:
(1) Removal of the Bowman membrane of the cornea - I still haven't been able to figure out if that's significant or not, but it certainly seems preferable to the Lasik flap, which severs the corneal neurons and creates a structural weakness in the cornea which may be permanent. There are cases of Lasik flaps getting dislocated after trauma as long as seven years post-surgery.
(2) Small risk of corneal hazing in the months after surgery - vitamin C is thought to help prevent corneal hazing, and you should avoid smoking, which depletes vitamin C.
(3) Longer recovery time and more discomfort. Expect pain and an inability to keep your eyes open during the first few days. Depending on the healing time of your epithelial defect, you should plan on not leaving your house on your own for several days and not driving for 1-2 weeks. And if that makes you too impatient, just imagine living with vision problems for the rest of your life....
Angst, just an absolute great imforative post! I am just about 15 months out from this disaster. No change in my starburts and halos at all. I drive for a living so it's been pretty bad but I am pushing forward. Like you I did the second opinion routine also. But what people need to realize is that when problems arise there are no cures or fixes. I'm planning on traveling to Miami to visit an expert in post LASIK contacts. Most likely scleral contact lenses that can possibly help with my hoa s. This will cost an arm and a leg to afford but thats how desperate we are to find help.
Thanks R.E. I am planning on doing as much research as I can and I will ask as many detailed questions as I can of as many doctors as I can. Don't feel bad about not doing research... I did a decent amount of research prior to the surgery, and I knew about the risk of higher-order aberrations, so just imagine how shocked, upset and stupid I felt when it happened to me.

You just assume that the bad things won't happen to you.... I don't know if you signed an "informed consent" form, but I did, and if people believed that [I]anything[/I] in that form would actually happen to them I'm sure no one would get the procedure (or ANY procedure that is not absolutely necessary).

Mario, if you haven't sought help for anxiety and depression, you really should if at all possible. Medication and therapy have really helped me cope. Hang in there.
putting my two cents in....

- it was exactly three weeks ago I got PRK surgery done, and it was only a couple days ago that I could watch predominantly-white tv or computer screens without wincing. Hockey games were the worst, because of the white ice rink taking up most of the screen, and opening up a new computer screen - all white - was harsh. (and still slightly is, but definitely not as bad as previous weeks.)

The tests on my vision have turned out well. Can read small magazine text within 18 - 24 inches, slightly blurry, perhaps, but still doable. Night and distance vision perfecto. My right eye is still predominant.

The final hurdle is outside (and with sunglasses always on). As a gardener, Iím usually looking down at green lawns, while mowing, or at dark earth, while weeding and plant-tending in beds, which I can deal with - quite comfortably, actually. But when I hop back in my truck and drive to my next destination, the driving makes me wince, especially on sunny days.

In these situations, if my eyes sting enough, my slightly weaker left eye becomes impossible to keep open, and I have to squeeze it shut, as tears squeeze through, while I continue to drive, one-eyed. In this predicament, no matter how hard I force my left eye open, thereís a sea of stinging tears that cloud its vision and I have to close that eye shut again - with more tears streaming down my face. (oh - and donít worry - this usually impatient, tailgating driver has learned to drive, now, with utmost caution. A long-time passenger wishes I had this procedure sooner! *L*)

Even indoors Iíll wince if thereís a lot of daylight coming into the room, but that is gradually getting better. Turning on lights first thing in the morning can still be rough going, and again, improving, albeit more slowly.

All those different drops didnít really provide much relief.

So - sure - I'm making a little headway, slow as it may be. I'm anticipating at least several more weeks of stinging eyes outside, and if it takes longer, then I'll just simply continue wolverining my way along

Also - reminding myself how much more devilisihly handsome I am without the goggles will have ultimately made it all worth it.

Of course - if I check back in here in three or four months' time with the same vampire eyes, it's possible I might be a little on the disenchanted side, perhaps.

Hope any of this helps
I got PRK surgery done three weeks ago, and it was only a couple days ago that I could watch predominantly-white tv or computer screens without wincing. Hockey games were the worst, because of the white ice rink taking up most of the screen, and opening up a new computer screen - all white - was harsh. (and still slightly is, but definitely not as bad.)

The tests on my vision have turned out well. Can read small magazine text within 18 - 24 inches, slightly blurry, perhaps, but still doable. Night and distance vision perfecto. My right eye is still predominant.

The final hurdle is outside (and with sunglasses always on). As a gardener, Iím usually looking down at green lawns, while mowing, or at dark earth, while weeding and plant-tending in beds, which I can deal with. But when I hop back in my truck and drive to my next destination, the driving makes me wince, especially on sunny days.

In these situations, if my eyes sting enough, my weaker left eye becomes impossible to keep open, and I have to squeeze it shut, as tears squeeze through, while I continue to drive, one-eyed. In this predicament, no matter how hard I force my left eye open, thereís a sea of stinging tears that cloud its vision and I have to close that eye shut again - with more tears streaming down my face. (oh - and donít worry - this usually impatient, tailgating driver has learned to drive, now, with utmost caution. A long-time passenger wishes I had this procedure sooner! *L*)

Even indoors Iíll wince if thereís a lot of daylight coming into the room, but that is gradually getting better. Turning on lights first thing in the morning can still be rough going, and again, improving, albeit more slowly.

All those different drops didnít really provide much relief.

Hopefully I'm not back here in four or five months reporting the same thing, though.
I could get disenchanted.





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