Health & Wellness

[Merged] laser eye surgery

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

  • Total votes: 376. You have voted on this poll.
Yes
 
198
53%
No
 
58
15%
Pizza is yummy
 
120
32%
Member
Jan 22, 2017
311 posts
203 upvotes
GTA
burnt69 wrote: Dry eye is greater with LASIK than with PRK. PRK, especially at those higher prescriptions, allows for larger treatment error. PRK is less susceptible to technical error. If there's slight overtreatment or undertreatment, steroid drops can be individually adjusted to shift the result, while LASIK, once the treatment is locked in, its done, and further surgical intervention would be required. And less risk of the dreaded side effect of ectasia wih PRK.

PLEC, which used to do most of its procedures as LASIK, actually found statistically better visual results with PRK:

http://www.pacific-laser.com/statistics
Just to play devil's advocate:

However, the higher the refractive error, the greater the risk of post operative corneal haze with PRK.

How common is ectasia now that laser centers screen everyone with corneal topography? I would imagine very low. Any sign of abnormal corneal thinning is flagged and disqualifies you as a candidate.
Newbie
Jan 6, 2020
6 posts
4 upvotes
LASER questions for anyone who feels like answering (I'm thinking of SmartSurfACE)
Does anyone have details on the functional difference of the schwind 1050 versus the 500 and 750 with the software upgrades?
This is helping me to make my decision between PLEC and LASERVue for SmartSurfACE.
I am really torn between them. LaserVue has lower price and offers "warranty" on a 500 w/ 750rs software. PLEC has later equipment that seems to be better.

  • What are the tracking speeds after upgrades?, I assume the pulse speeds for ablation are not changed by software. Tracking speeds seem to be upgraded to 1050hz.
  • Do the eximer LASERs have the same "resolution"/precision on their zaps of the stroma layer for all 3 models?
    • they say 0.54mm laser for the 750 and the 1050, and the 750 has 2 strengths.. 200mJ and 400mJ. I don't know if the 500 is worse or the 1050 is better.
  • Do all 3 have same ablation zone size?
  • Re. the 6th and 7th "Dimensions" of tracking, does the software add those tracking features to the 750 and 500?
  • Does the 500 upgrade include this "online pacheametry" which is supposed to be a safety thing? this is found on the 750 and the 1050.

===things I know already from research (so you don't have to tell me again :) )===
  • "clinical results are the same" across all 3 models.
  • Time in chair staring the the blinky green light is shorter for higher frequency.
  • Healing time and discomfort may be lower if ablation time is lower.
  • a warranty is only as good as the company.
  • PLEC is not known for their friendly up-front engagement or pre-op support, but people love them.
  • The 7th D is predictive movement and the 6th D is Z axis, and this all may be marketing puffery.
  • Price difference for me is ~USD1500/eye at LASERVue vs ~USD1900/eye at PLEC.

Thanks in advance for anyone who answers.
Newbie
Jan 6, 2020
6 posts
4 upvotes
Probably not cool to reply to myself, yet I found the following, answering most of my questions:

http://www.oftaltech.com/wp-content/upl ... 2017-E.pdf
  • What are the tracking speeds after upgrades?, I assume the pulse speeds for ablation are not changed by software. Tracking speeds seem to be upgraded to 1050hz. Correct assumption
  • Do the eximer LASERs have the same "resolution"/precision on their zaps of the stroma layer for all 3 models? The same size and strength LASERs
  • they say 0.54mm laser for the 750 and the 1050, and the 750 has 2 strengths.. 200mJ and 400mJ. I don't know if the 500 is worse or the 1050 is better. They are the same
  • Do all 3 have same ablation zone size? still open question, I can't find the specs of optical zone size
  • Re. the 6th and 7th "Dimensions" of tracking, does the software add those tracking features to the 750 and 500? appears to be hardware restricted, so not added
  • Does the 500 upgrade include this "online pacheametry" which is supposed to be a safety thing? this is found on the 750 and the 1050 this feature is on all 3 models

So my current leaning is re-enforced. I'll probably go to PLEC simply because of the later-built equipment with slightly better tracking capabilities and presumably higher accuracy.
I'd still welcome opinions.
Deal Addict
Oct 6, 2015
2463 posts
1361 upvotes
jaychee wrote: Probably not cool to reply to myself, yet I found the following, answering most of my questions:

http://www.oftaltech.com/wp-content/upl ... 2017-E.pdf
  • What are the tracking speeds after upgrades?, I assume the pulse speeds for ablation are not changed by software. Tracking speeds seem to be upgraded to 1050hz. Correct assumption
  • Do the eximer LASERs have the same "resolution"/precision on their zaps of the stroma layer for all 3 models? The same size and strength LASERs
  • they say 0.54mm laser for the 750 and the 1050, and the 750 has 2 strengths.. 200mJ and 400mJ. I don't know if the 500 is worse or the 1050 is better. They are the same
  • Do all 3 have same ablation zone size? still open question, I can't find the specs of optical zone size
  • Re. the 6th and 7th "Dimensions" of tracking, does the software add those tracking features to the 750 and 500? appears to be hardware restricted, so not added
  • Does the 500 upgrade include this "online pacheametry" which is supposed to be a safety thing? this is found on the 750 and the 1050 this feature is on all 3 models

So my current leaning is re-enforced. I'll probably go to PLEC simply because of the later-built equipment with slightly better tracking capabilities and presumably higher accuracy.
I'd still welcome opinions.
9.8mm max optical zone, 10mm total ablation zone on all the Schwind Amaris lasers. Actual treatments would be considerably smaller in nearly all cases, as selected by your doctor.
There are two fluence levels, one for bulk removal of tissue, and other for fine tuning. The laser's software automatically will switch between them based on the treatment dispensed.
I believe the differences in tracking are mostly software related.
Online pachymetry is in all 3 models, but not really relevant to single-step transPRK treatment. Its more relevant to LASIK, for which there can be variability in the size of the LASIK flap, or alternatively, in treatments where PTK is being used manually or interactively.

Personally I wouldn't hesitate to undergo treatment on either of the 3 lasers based on their technical specs, but I can only personally speak to my experience with Dr. Lin, and not to the other clinics.
Deal Addict
User avatar
Apr 3, 2006
2597 posts
629 upvotes
Has anyone undergone the custom lasik at TLC?
Newbie
Jan 20, 2020
1 posts
Any one do smile at clearview ? if possible to share some experience, and how much it cost?
Newbie
Jul 29, 2017
83 posts
22 upvotes
jaychee wrote: LASER questions for anyone who feels like answering (I'm thinking of SmartSurfACE)
Does anyone have details on the functional difference of the schwind 1050 versus the 500 and 750 with the software upgrades?
This is helping me to make my decision between PLEC and LASERVue for SmartSurfACE.
I am really torn between them. LaserVue has lower price and offers "warranty" on a 500 w/ 750rs software. PLEC has later equipment that seems to be better.

  • What are the tracking speeds after upgrades?, I assume the pulse speeds for ablation are not changed by software. Tracking speeds seem to be upgraded to 1050hz.
  • Do the eximer LASERs have the same "resolution"/precision on their zaps of the stroma layer for all 3 models?
    • they say 0.54mm laser for the 750 and the 1050, and the 750 has 2 strengths.. 200mJ and 400mJ. I don't know if the 500 is worse or the 1050 is better.
  • Do all 3 have same ablation zone size?
  • Re. the 6th and 7th "Dimensions" of tracking, does the software add those tracking features to the 750 and 500?
  • Does the 500 upgrade include this "online pacheametry" which is supposed to be a safety thing? this is found on the 750 and the 1050.

===things I know already from research (so you don't have to tell me again :) )===
  • "clinical results are the same" across all 3 models.
  • Time in chair staring the the blinky green light is shorter for higher frequency.
  • Healing time and discomfort may be lower if ablation time is lower.
  • a warranty is only as good as the company.
  • PLEC is not known for their friendly up-front engagement or pre-op support, but people love them.
  • The 7th D is predictive movement and the 6th D is Z axis, and this all may be marketing puffery.
  • Price difference for me is ~USD1500/eye at LASERVue vs ~USD1900/eye at PLEC.

Thanks in advance for anyone who answers.
I'm in the same predicament. I just came back from my consultation at LaserVue. I have high myopia -11 and high astigmatism around -3.25.
The doctor suggested that I can do ICL but since the only reason I am doing this is to be able to join the reserve force (they don't accept ICL)
I asked him whether I could be partially corrected with Trans PRK.
They ran multiple exams and simulation and told me they can reliably lower my prescription to -4 and -5 (no astigmatism) with Trans PRK
which is within an acceptable range for a V4 in the armed forces. Now, I am wondering whether I should go through with this in the first place?
I still have to wear contacts for the rest of my life but the prescription would be much cheaper and easier to get.
Is there a chance that I can get better, lower risk results at PLEC with the newer technology?
Newbie
Jan 6, 2020
6 posts
4 upvotes
I've only been "shopping" between the 2 clinics and have not visited either. Given that:

You seem to be asking the "right" questions and ensuring that you will have given well-informed consent.
PLEC is known to take "difficult" cases, but I would think that their acceptance parameters are not much more liberal than LaserVue for an elective situation.
You're dealing with one of the top 10 clinics in Canada, the response probably won't be much different at one of the other top 10 clinics.

The hardware difference seems to not matter much on the capabilities of the 2 laser systems. The fundamental difference between PLEC's 1040 Laser and LaserVue's 500 (w/ custom software) is 2 things:
  1. speed of ablation on the 1040 is about 2x as fast.
  2. the addition of "7th D" on the 1040. That is "zero-latency" tracking due to prediction. The 1040 model "leads" the aim of the laser when your eye is moving. The systems work in the world of 3ms or less, and studies show that 5ms is very sufficient for time between a tracking sample and ablation. So the value of this "leading" is likely pretty minimal.
Asking pre-op questions is generally free; PLEC will take essentially the same pre-op form and data as LaserVue. I know that the 2 clinics are "friendly". It won't hurt anything to ask LaserVue to send your info on to PLEC for their analysis.

If I were you, I'd probably step back and rethink things from the start. Including motivations, desired outcome, risks, etc.
My personal motivation is... remove the inconvenience of contacts (which has gotten worse lately for me) and avoid glasses for day-to-day distant vision, expecting at least 10 yrs of improvement.
You appear to want surgically improved vision for purposes of meeting an external (though important-to-you) specification. While I wouldn't quite be willing to undergo a significant surgery on my critical eyes for that, your motivations are valid and reasonable. So _I_ wouldn't do it in the situation that you have outlined because the outcomes do not match what is important to me.

Just my thoughts. Given your research already, I think you alone will make a good decision and be happy with it. Just remember, no train has left the station until you are in the chair/bed of the laser.
Deal Addict
Oct 6, 2015
2463 posts
1361 upvotes
jaychee wrote: PLEC is known to take "difficult" cases, but I would think that their acceptance parameters are not much more liberal than LaserVue for an elective situation.
Seems to me that PLEC does anything up to -15 if they can make the math/physics work, and they even have CXL potentially on the table if needed. And they can do combined procedures (ie: ICL + transPRK) entirely with one doctor as Dr. Holland maintains surgical ophthalmological practice at a local private clinic, as well as the public hospital. No reports of LaserVue doing CXL on a transPRK case that I've seen reports of. So there legitimately is a wider treatment range at PLEC compared to Laservue with myopia. OTOH, PLEC apparently doesn't like doing cases of hyperopia (see: Google Reviews), but obviously that's not relevant to someone with high myopia.

Not sure about Canada DND, but I know the US DoD has requirements of pre-treatment refraction which would be unfortunately violated even if treatment was successful for someone -11. The substantially elevated risk of retinal detachment in high myopia does not go away merely because of corneal refractive surgery.
Newbie
Jan 6, 2020
6 posts
4 upvotes
Thanks. Gracefully admitting that my presumptions were wrong!
Jr. Member
Aug 12, 2008
129 posts
14 upvotes
Just wanted to add my experience to this thread.

Read through almost 100 pages of the thread in the past few days before getting surgery.

Ended up going with LASIK MD all laser advanced wavefront (custom Lasik) for $4580 for both eyes at the LasikMD Mississauga location with Dr. Vincent Lam.

Surgery went OK with no complications.

The first 3-4 hours after surgery were the worst. Crazy burning feeling on the eyes (like onions being rubbed on your eyes). Went home, and pretty much napped through the whole day. Pain subsided about 4 hours in.

24 hours in, vision has improved to 20/15. No pain, just a bit of a haze.

I would highly recommend getting this to anyone on the fence.

Decided to go all laser and custom LASIK to preserve as much of my cornea as I could. Also, it's the latest tech for LASIK and id only do the best for my eyes.
Deal Addict
Jul 21, 2006
1065 posts
179 upvotes
Can you claim your 2 year check up under insurance??

Lasik md
Jr. Member
Aug 12, 2008
129 posts
14 upvotes
stratux wrote: Can you claim your 2 year check up under insurance??

Lasik md
The LasikMD staff advised me that this is the case. It would count as your eye checkup every two years.
Deal Addict
User avatar
Apr 3, 2006
2597 posts
629 upvotes
Surgery is set for February 21 at TLC! I began posting to this thread way back in 2011 and after a few attempts seems like its actually going to happen.

Started taking theratears nutriot. 3 pills a day as per the directions on the bottle. Any one take anything else to prep for surgery?
Newbie
Dec 12, 2018
33 posts
55 upvotes
Just came back from my consultation from LasikMD. I have a very high prescription of -10.5 in my right eye and -9.00 with astigmatism in my left. They recommended two routes:
1) Advanced Custom Wavefront All-Laser LASIK ($4,830)
2) Phakic Intraocular Lens Surgery ($6,180)

They offered a lifetime vision enhancement plan as part of the package for either option. Was wondering if anyone has done PIOL before, and if so, how was your experience?

This was my first consultation and was planning on visiting TLC, Herzig and Bochner in the coming days. Does anyone know if Bochner offers 0% financing?

Thanks!

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