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 Post subject: -1.75 OVERCORRECTION AFTER LASEK
PostPosted: Tue Jan 16, 2007 1:55 am 
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I had LASEK on right eye ONLY Nov 2, 2006. I was -5.75 1.25. (Decided to do LASEK to reduce chance of of more floaters in the eye as I have battled with floaters and had two YAG laser proceedures by Dr Karakov in VA several years ago in an attempt to reduce their impact to my vision--another story altogeather!.)

My vision has been 6 out of 10 since proceedure except when I am outside in bright light condition where it is great (can read license plates hundreds of feet away). Indoors or at night have ghosting and poor focus. Can not read with right eye either.

Today at follow was re examined and found to be overcorrected + 1.75 with -1 astigmitisum.

Dr put in a standard contact (vision improved dramatically) and am going in for follow up in one week. He spoke about performing an enhancment to correct the +1.75 AFTER he understands what is going on with my vision.

Any feedback is appreciated on next step or questions to ask the surgen

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Pete L
Sherman Oaks CA


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 Post subject: Re: -1.75 OVERCORRECTION AFTER LASEK
PostPosted: Tue Jan 16, 2007 1:43 pm 
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Pete L wrote:
I had LASEK on right eye ONLY Nov 2, 2006. I was -5.75 1.25. (Decided to do LASEK to reduce chance of of more floaters in the eye as I have battled with floaters and had two YAG laser proceedures by Dr Karakov in VA several years ago in an attempt to reduce their impact to my vision--another story altogeather!.)

My vision has been 6 out of 10 since proceedure except when I am outside in bright light condition where it is great (can read license plates hundreds of feet away). Indoors or at night have ghosting and poor focus. Can not read with right eye either.

Today at follow was re examined and found to be overcorrected + 1.75 with -1 astigmitisum.

Dr put in a standard contact (vision improved dramatically) and am going in for follow up in one week. He spoke about performing an enhancment to correct the +1.75 AFTER he understands what is going on with my vision.

Any feedback is appreciated on next step or questions to ask the surgen


What was your refractive error 2 months ago after the surgery? Is it changing or is it stable?

Did your surgeon tell you that LASEK is not an FDA approved procedure? It is a relatively new procedure. I wonder how many of these surgeries your surgeon has performed. Maybe he is still fine tuning his nomogram. :roll:

I'd ask the surgeon to do a new topography and a wavefront scan (we can help you understand them). Also, get copies of your records.

Since you mentioned night vision ghosting and poor vision in dim light, what is the size of your pupils in the dark? This measurement should have been done at your pre-op exam.

Whatever you do, don't rush into another surgery. Give it a little more time and consider a 2nd opinion by a surgeon not affiliated or friendly with your surgeon. Also consider contact lenses instead of more surgery.

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Broken Eyes

"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato


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 Post subject:
PostPosted: Wed Jan 17, 2007 1:38 am 
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Thanks for the reply! I belive I am using a very good surgen who is affliated and in Cedars Sinai Hospital. But, with the amount of over correction -- that he seemed really surprised about yesterday, I can not help but wonder did they make a mistake inputting my infomation in the laser or something.

1. Do not know what the error was at +4 or +8 weeks and will ask for thier assessment from the multiple follow ups. Does the machine (do not know its name) that automatically focuses a small scene and approximates a persons perscription (usually the test just before or after glacuma test) suffice?

2. Yes I was told and was well aware LASEK is not FDA approved. I will inquire on the number of LASEKS he has performed; but, I made the choice to avoid adding to my floater problem. What is a nonomagram?

3. He has done the topography (not sure about the wavefront, two seperate tests correct?) and seen a colored topography map.

4. My vison with the newly received +1.75 contact lens has no ghosting and I would describe my vison as good even in dim light (only had lens for one day now). Without the contact lens vison is as previously described

5. Pupils were measured twice and I belive around 6 mm but will ask again. I do not have big pupils

6. Agreed, not going to rush into another surgery (Surgen would suggest PRK vs LASEK too since there were some issues with the epithilium healing properly). I am conservitive and thus the reason I chose to (and as insisted by surgen) did one eye only.

7. Yes, I am considering a second openion. Any recomendations of a LA based doctor?

8. Yes I may just stick with a contact lens, but if I do not get other eye done (its -5.25 and LASEK eye is +1.75) I suspect glasses may be tough to fit. Currently wearing contact lens in -5.75 eye too and vison is fine

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Pete L
Sherman Oaks CA


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 Post subject:
PostPosted: Wed Jan 17, 2007 1:45 am 
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I am sorry to go off topic but I wanted to know how your procedure with treating your floaters went.

I read about two doctors who address floaters with a laser treament - one in Florida and then other, your doctor, from VA.

I was going to go to VA in a few months to see if that Dr. was able to help my situation out.

Feel free to PM if you like.

Thanks alot - any information on your experiences with the Dr. in VA would be great.


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 Post subject:
PostPosted: Wed Jan 17, 2007 2:03 am 
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Pete L wrote:
Thanks for the reply! I belive I am using a very good surgen who is affliated and in Cedars Sinai Hospital. But, with the amount of over correction -- that he seemed really surprised about yesterday, I can not help but wonder did they make a mistake inputting my infomation in the laser or something.


It wouldn't be the first time. However over-correction happens even without an input error. Other factors can cause under or over correction. Get your records.

Pete L wrote:
1. Do not know what the error was at +4 or +8 weeks and will ask for thier assessment from the multiple follow ups. Does the machine (do not know its name)


Autorefractor

Pete L wrote:
that automatically focuses a small scene and approximates a persons perscription (usually the test just before or after glacuma test) suffice?


It would be close. But I would imagine they've been refracting you at each visit. Get your records.

Pete L wrote:
2. Yes I was told and was well aware LASEK is not FDA approved. I will inquire on the number of LASEKS he has performed; but, I made the choice to avoid adding to my floater problem. What is a nonomagram?


It's a fine-tuning to the laser ablation that the doctor can make based on the results he's getting. If all his -5D patients are coming out undercorrected about a half diopter, he can adjust for that on future patients. That's what a nomogram is.

Pete L wrote:
3. He has done the topography (not sure about the wavefront, two seperate tests correct?)


Yes, topography reads the corneal surface. Wavefront reads the way light focuses on the retina. The corneal surface has a direct impact on the retinal image but it's two different tests -- however I think some machines now can do both tests. But typically it's two different machines.

Pete L wrote:
and seen a colored topography map.

4. My vison with the newly received +1.75 contact lens has no ghosting and I would describe my vison as good even in dim light (only had lens for one day now). Without the contact lens vison is as previously described


Well that's good news! (It's a soft lens, right?) It means your vision problem is mainly simple hyperopia which can be corrected easily with glasses or contacts.

Pete L wrote:
5. Pupils were measured twice and I belive around 6 mm but will ask again. I do not have big pupils


Good for you! :)

Pete L wrote:
6. Agreed, not going to rush into another surgery (Surgen would suggest PRK vs LASEK too since there were some issues with the epithilium healing properly). I am conservitive and thus the reason I chose to (and as insisted by surgen) did one eye only.

7. Yes, I am considering a second openion. Any recomendations of a LA based doctor?


James Salz is in LA.

Pete L wrote:
8. Yes I may just stick with a contact lens, but if I do not get other eye done (its -5.25 and LASEK eye is +1.75) I suspect glasses may be tough to fit. Currently wearing contact lens in -5.75 eye too and vison is fine

_________________
Broken Eyes

"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato


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 Post subject: Stick with those contacts
PostPosted: Fri Jan 19, 2007 12:22 am 
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For the best possible vision and to avoid any future corneal disasters your best bet is to stay with contacts in both eyes!


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 Post subject: Impossible to correct vision precisely with a laser
PostPosted: Sun Feb 25, 2007 3:35 am 
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It is impossible to guarantee you will hit any particular refractive outcome because living tissue is involved in the surgery and the biomechanical and healing responses are unpredictable and vary among individuals.

Corneal refractive surgery is a crap-shoot and doctors should be honest about this with their patients - most people wouldn't knowingly gamble with their vision. Most patients also wouldn't appreciate receiving a fragile flap that is vulnerable to trauma for life ... A FLAP THAT NEVER HEALS.

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We can easily forgive a child who is afraid of the dark. The real tragedy of life is when men are afraid of the light. -Plato


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