Beauty & Wellness

[Merged] laser eye surgery

  • Last Updated:
  • Nov 20th, 2017 9:13 pm

Poll: Mid twenties a good age to get it done?

  • Total votes: 196. You have voted on this poll.
Yes
 
100
51%
No
 
29
15%
Pizza is yummy
 
67
34%
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Oct 1, 2011
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VinceInSeattle wrote:
Nov 6th, 2017 6:33 pm
I've been reading the Lasik Complications Facebook group and I must say the stories there are concerning. I am trying to tell myself that these are the 100 people with the worst outcomes out of millions of laser surgeries performed. But still. Any comments? Did it shake any of you guys before you had surgery?
Yes. Did not like the LASIK complications at all. Modern LASIK is safer than it was in the past, and now we have more information on how patients should be screened for/against LASIK. For instance, the residual corneal tissue considered safe was 200um to 250um, and nowadays surgeons may prefer a more conservative 300um residual corneal tissue bed. However, I would rather "fearmonger" myself and realistically consider the worst possible outcome before deciding whether something is worth the risk, and PRK is even more conservative than LASIK for several reasons so that's why I chose PRK. (LASIK candidates are usually also eligible for PRK, but there are many people who can only do PRK.)

BTW, I posted here about at least two cases of chronic ocular nerve pain/extreme light sensitivity following PRK. In some rare, unlucky patients, and unpredictably, they end up with nociceptive nerve dysfunction, and we still do not know why. Just like some patients end up with chronic neuropathic pain following injuries or surgeries on the body, it seems that some people have gotten that in the eyes. The doctors and surgeons did not know why these individuals suffered from it, but it has happened...in the future we may learn to identify or prevent such occurrences but as of today I don't think the risk has been eliminated. I'd still take my chances, but I guess I like to know the worst possible outcomes before making a decision.
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Oct 6, 2015
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VinceInSeattle wrote:
Nov 6th, 2017 6:33 pm
I've been reading the Lasik Complications Facebook group and I must say the stories there are concerning. I am trying to tell myself that these are the 100 people with the worst outcomes out of millions of laser surgeries performed. But still. Any comments? Did it shake any of you guys before you had surgery?
I reviewed that site extensively, and came to the conclusion that most of the alleged problems were not applicable to PRK treatment performed within reasonable parameters. The only other "issue" for me was that the treatment must be adequate for my abnormally large blue pupils to avoid any night vision side effects, especially in low light situations (ie: looking at the stars or northern lights).
Newbie
Oct 2, 2017
11 posts
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Thanks peanutz & burnt. I'm a pretty conservative guy - don't drink or smoke, use seatbelts, still married to my first wife, etc. Taking a risk is out of character for me. But I'm in good physical condition, have some money and flexibility with time, am sick of running in the rain with glasses, and the technology seems to have made a leap with SmartSurface. I'll have to trust in the best tech and best doctor, and hope I'm not the 1 in a thousand who has a really bad outcome. I agree, most of the horror stories are Lasik-related, and often from surgery a while ago when patient selection was not as strict. Although I bet you could find a doctor who would zap anyone's eye, even now. But there are a few PRK horror stories - pain or debilitating dry eye. Not religious but I'm going to be praying on Dec 4!
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Jan 27, 2007
227 posts
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no mans land
How do you get the corrective lenses requirement removed from your driving license?
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Nov 21, 2014
186 posts
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Atlantic
To the people that got PRK Smartsurface, how likely is it that you can get to 20/20, 20/15, 20/10 after an adequate recovery time (like 6 months to a year)

Have you experienced any regression?

Are there any touch-ups for PLEC/NVISION?
Sr. Member
Oct 6, 2015
808 posts
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EasyCompany251 wrote:
Nov 8th, 2017 8:21 pm
To the people that got PRK Smartsurface, how likely is it that you can get to 20/20, 20/15, 20/10 after an adequate recovery time (like 6 months to a year)
I'm officially 20/12, and I believe my UCDVA has improved since. So probably 20/10 now or darn near it -- my 1 year check-up is scheduled for late December. But there is little to no published data. Probably the best published data for topography-guided LASIK available is the Alcon FDA T-CAT study which should be comparable to Schwind's Corneal Wavefront implemented by way of SmartSurfACE transepithelial PRK. The Alcon LASIK T-CAT study found ~15% of patients end up with UCVA of 20/10 after 1 year with a single treatment. PRK/SmartSurface/transPRK might improve slightly upon that. 20/20 rates approach 100% with re-treatment, but some patients are inherently limited due to other issues with their eyes.
Have you experienced any regression?
From my initial post-surgical refraction, yes. I am hoping for a little bit more regression as I am overcorrected at this point, but not severely so.
Are there any touch-ups for PLEC/NVISION?
Only 1 in 700 patients have actually required a touch-up at PLEC in their published data. Not sure of the exact metrics that would determine whether or not one is eligible for a touch-up many years down the road though. If I need a touch-up 10-15 years from now, it probably would only be in my dominant eye for a bit of monovision.
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EasyCompany251 wrote:
Nov 8th, 2017 8:21 pm
To the people that got PRK Smartsurface, how likely is it that you can get to 20/20, 20/15, 20/10 after an adequate recovery time (like 6 months to a year)

Have you experienced any regression?

Are there any touch-ups for PLEC/NVISION?
You can refer to PLEC's published data: http://pacific-laser.com/index-4.html. Interestingly, I was measured -0.50 astigmatism in both eyes before surgery. 1 month post-surgery I was -0.50 astigmatism in my right eye and -1.0 astigmatism in my left eye. 3 months post-surgery I am currently -0.50 astigmatism in my right eye and -0.75 astigmatism in my left eye. So my astigmatism actually got worse after the surgery. :|
Newbie
Oct 22, 2017
16 posts
15 upvotes
i'm sitting at 20/15 for both eyes since the 3 month mark. ill update once i do the 6 month. but yeah probably getting close to 20/12 as i can tell my vision is very sharp now. i don't remember if i had much of an astigmatism on the 3 month exam. i barely had any to start with so i think it may be corrected out?

btw. once of the other reasons i went with ccv/nvision was because they had a warranty. if i need a touch up or if my eyes change i just go back and request it. it's part of their warranty at no extra charge.

i forgot to add, that your eyes do change as you age, less frequently of course. they said something about pregnancy changes peoples eyes. cool fact. didn't apply to me though lol.
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Oct 6, 2015
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JustinLaw wrote:
Nov 10th, 2017 11:40 am
btw. once of the other reasons i went with ccv/nvision was because they had a warranty. if i need a touch up or if my eyes change i just go back and request it. it's part of their warranty at no extra charge.
Were you provided with any information on that 'warranty', ie: under what conditions you might be able to utilize it?

I'm just thinking, for instance, if someone's not happy because they have a higher than expected level of residual astigmatism, or they are a bit undercorrected and they end up at 20/20 instead of 20/15, for instance, what would trigger eligibility for a re-treatment. There's blatant cases that require re-treatment, but, for example, there's two previous posters to this thread who feel that their residual astigmatism is a bit on the high side.
Newbie
Oct 11, 2017
10 posts
12 upvotes
Hi all, had a few questions floating around in my head I wanted to pose here.
When people talk about having better than 20/20 - is this what 'overcorrection' is or is it just an outcome of being lucky and having an excellent surgery? Either way, does it affect your reading/close up vision in any way?

Are 'touch ups' in the future to be expected or even worth under going? I was informed that with my prescription, I have about a ~20-25% of slight regression in the future (I’m 31 and had a prescription of -4.50 /-4.75). I understand that the potential regression is probably going to be under -1.00 and may have an added benefit of compensating for presbyopia if it happens. Also, the warranty only really applies if it is -.75 or worse I believe. Plus risking surgical complications a second time around for something so minor may not be worth it.
To add, I saved about $300 from my procedure by opting out of the lifetime warranty with Lasik MD (this cost involved 2 year check ups), so wondering if that is a good idea. I can always just show up and pay a few $ extra for the individual check ups, which would reinstate my warranty
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Oct 6, 2015
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publicmanservant wrote:
Nov 10th, 2017 1:23 pm
Hi all, had a few questions floating around in my head I wanted to pose here.
When people talk about having better than 20/20 - is this what 'overcorrection' is or is it just an outcome of being lucky and having an excellent surgery? Either way, does it affect your reading/close up vision in any way?
Achieving better than 20/20 is a matter of correcting to, or close to "plano" (ie: 0.00 refraction), and correcting most, if not all of the astigmatism fully and properly. Additionally, your retina needs to 'support' the higher visual acuity, you need to have no lens opacification, no haze, etc.

Someone can't merely be overcorrected and achieve better vision. A surgeon can't "give" you 20/10 (or 20/8) vision arbitrarily by simply putting a higher 'correction' into the laser. The best possible vision is achieved with a good retina, good vitreous, a clear lens, no corneal haze, no corneal or lens astigmatism, a plano spherical refraction, and a proper tear film.

And yes, myopic LASIK/PRK definitely affects one's close-up vision. Before surgery, a myope can remove their glasses and see extremely fine details, such as micro-printing on cheques, fine details, etc. After refractive surgery, a myope would need a specific set of magnifiers to see such, because the optical power of their eye has been lessened. Yes, myopia is literally a condition in that that one's eye has grown to be too strong!!!

Are 'touch ups' in the future to be expected or even worth under going? I was informed that with my prescription, I have about a ~20-25% of slight regression in the future (I’m 31 and had a prescription of -4.50 /-4.75). I understand that the potential regression is probably going to be under -1.00 and may have an added benefit of compensating for presbyopia if it happens. Also, the warranty only really applies if it is -.75 or worse I believe. Plus risking surgical complications a second time around for something so minor may not be worth it.
You likely would be overcorrected to being a +0.5-+0.75 or so at the time of surgery, deliberately overcorrected. This should take care of a few decades of regression. If you undergo PRK, you will be deliberately overcorrected even further than +0.75, simply because PRK itself involves some regression due to the procedure itself. A competent doctor will look at your long-term records, your age, even your occupation, gender, and race, and make some professional judgement as to what numbers to key into the laser. This is part of what is known as a 'nomogram'. Doctors who do a lot of surgery have a lot of data to establish these tweaks. Doctors who rarely do surgery don't, so their results aren't as good. This is often why refractive surgeons are big computer nerds -- they have to spend a lot of time analyzing data!!!!

When you are in your 70s, for instance, many people develop cataracts, and will require lens replacement. It is at this time that the surgeon and you would pick a lens implant that compensates for the regression you may have experienced.

Also, if you do experience higher than predicted regression, treating only a single eye, your dominant eye, is an option in your 40s and 50s. For monovision. So if both your eyes regress to say, -1.00, and you're unhappy with your distance vision, your dominant eye would be re-treated and your other regressed eye would be left untreated for close-up vision.
To add, I saved about $300 from my procedure by opting out of the lifetime warranty with Lasik MD (this cost involved 2 year check ups), so wondering if that is a good idea. I can always just show up and pay a few $ extra for the individual check ups, which would reinstate my warranty
Warranties are only as good as the warrantor. $300 isn't much in the whole scheme of things, but how long will Lasik MD be around as a chain? Does the warranty cover you if you have to get a lens implant put in, and need some touch-up PRK?
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Hmm...speaking of warranty, I forgot to ask Pacific Laser about theirs, if any. Does anyone know? Not that I'm considering it at the moment, but just curious.
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Oct 2, 2017
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Aznsilvrboy wrote:
Nov 8th, 2017 11:08 pm
You can refer to PLEC's published data: http://pacific-laser.com/index-4.html. Interestingly, I was measured -0.50 astigmatism in both eyes before surgery. 1 month post-surgery I was -0.50 astigmatism in my right eye and -1.0 astigmatism in my left eye. 3 months post-surgery I am currently -0.50 astigmatism in my right eye and -0.75 astigmatism in my left eye. So my astigmatism actually got worse after the surgery. :|
How does this level of astigmatism affect you? Do you need glasses to correct? I don't recall, how far out from surgery are you?
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VinceInSeattle wrote:
Nov 10th, 2017 6:26 pm
How does this level of astigmatism affect you? Do you need glasses to correct? I don't recall, how far out from surgery are you?
It's been about 3.5 months since I had the surgery. I'm right eye dominant, and my right eye is 20/20 with -0.50 astigmatism. So the fact that my left eye is has -0.75 astigmatism doesn't really bother me. I still have great vision with both eyes combined. Even if I close my right eye and only use my left eye, the vision is still very good. I don't feel like I need any correction at the moment. However, I am also wondering why my residual astigmatism seems to be such an anomaly among those treated by SmartSurfACE PRK.

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