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What's the best for my son?
|
|
| J Poy 2005-11-15, 10:59 am |
| Greetings,
My son is 28 years old with -9 D & -9.5D (stable) at his eye examination
during the consultation the with doctor, he recommended LASIK for -9D and
PRK for -9.5. The doctor recommended this because of his concerned for his
corneal thickness. He mention he would use the laser to create a very thin
flap for the LASIK surgery.
I asked the doctor if PRK could be done on both eye's he said yes, but this
would result in a longer recovery time. I asked him if he could have PRK
for both eyes because I thought it would be the safest for him. He also
agreed and said that according his calculations, that were very
conservative, either way would be good and that it would be his choice.
After reading the brochure I got at the doctor office I noticed that they
also offer other options epi-LASIK and LASEK
are better then PRK?
Another question would be do they use the same type of laser for all the
procedures and what type of laser is best for the surgery?
Since I have limited knowledge of the different types of refractor surgery,
what do you think is the safest procedure and will give the overall best
results?
The only knowledge I have is what I have read on the internet and this news
group. I would appreciate any comments and real life experiences.
A Concerned Parent,
Thank You!
BTW. I will call the doctors office to ask these questions too but it would
be nice to hear the comments from the group.
| |
|
| talk to the doctors what they think about IOLs for severe myopia like
his. He probably would be out of range for wavefront and the risks of
haze is there with high pescriptions. I would want IOLs in my own eyes
if I didnt qualify for wavefront.
| |
| Glenn - USAEyes.org 2005-11-15, 12:55 pm |
| I suggest your son proceed with extreme caution. There are many issues
being raised that indicate your son is not anywhere near an ideal
candidate for refractive surgery.
9.00 diopters of myopia (nearsighted, shortsighted) vision is rather
high. The probability of an excellent outcome is less for a high myope
than a low or moderate myope. You know all those "20-Minute Miracle"
LASIK patients you hear about? They were not high myopes.
It is common for patients with high refractive error to regress after
surgery (http://www.usaeyes.org/faq/subjects/regression.htm).
Regression is when the cornea moves back toward the original
refractive error while healing.
It would be reasonable to assume that a -9.00 patient would regress
anywhere from 0.50 diopters to 2.00 diopters. This means that either
your son would need to be initially overcorrected into hyperopia
(farsighted, longsighted) vision with expected regression bringing him
back to plano (no refractive error), or your son will require
enhancement surgery to resolve whatever regression takes place.
Because of your son's high myopia and the probability of regression,
the total amount of tissue that would need to be removed would be
significant. You are really looking at as much as an -11.00 diopter
correction (9.00 stable myopia plus up to 2.00 diopters regression).
At a minimum that would be 132 microns of tissue removal and if your
son has naturally dilated pupils larger than about 5.5mm, the amount
of tissue would be significantly more. See
http://www.usaeyes.org/faq/subjects..._pupil_size.htm
Another issue is whether or not your son would be able to have a
wavefront-guided laser ablation rather than a conventional ablation. I
believe you are in Canada and I am not familiar with the limitations
on Canadian lasers. The enhancement would undoubtedly be able to be
wavefront-guided. Your son would have a higher probability of a good
outcome with wavefront-guided rather than conventional ablation. A
problem with wavefront-guided is that it tends to remove more tissue.
See http://www.usaeyes.org/faq/subjects...ustom_lasik.htm
The surface ablation techniques PRK, LASEK, and Epi-LASIK are
virtually identical except in how they handle the outermost layer of
the cornea called the epithelium. PRK simply removes the epithelium,
which grows back rather quickly. LASEK disrupts the epithelium with an
alcohol solution, moves it aside, and then returns it over the treated
area. Epi-LASIK uses a special device to shave up the epithelium,
which is moved aside and repositioned over the treated area.
The advantage of saving the epithelium is that there should be less
discomfort and a quicker vision recovery, however even if the fragile
epithelium is lost during surgery, it will reproduce quickly.
A major disadvantage of the surface ablation techniques is that there
is a significantly higher probability of wound response that can
result in corneal haze. This can be treated after surgery with
Mitomycin C applied to the cornea, but you want to avoid haze if at
all possible. In my opinion a -9.00 surface ablation would absolutely
have some corneal haze, requiring either preventative treatment or
treatment after surgery.
LASIK and IntraLASIK (with a laser created flap) cause a very
different wound response and the probability of haze is almost nil,
but that flap will be from 110 to 160 microns thick. Considering the
amount of tissue that would need to be removed to correct your son's
vision, plus the extra for wavefront-guided ablation, plus the
thickness of the LASIK or IntraLASIK flap, your son would need to have
an unusually thick cornea. It appears your son's doctor has already
determined this is not the case.
Intraocular lenses (IOL) are artificial lenses within the eye. An
aphakic IOL is designed to replace the natural crystalline lens of the
eye. Replacing the natural lens with an artificial lens is exactly
what is done in most cataract surgery. Your son could have the natural
lens replaced with an artificial lens that is of a power to correct
his refractive error, however he would lose the ability to change
focus from distant objects to objects near. He would immediately need
to use reading glasses and not too many 28 year olds want to look like
their parents and grandparents who need reading glasses.
Another kind of IOL is the phakic IOL (P-IOL). This is a "helper" lens
that is placed in front of the natural crystalline lens. Because the
natural lens is not disturbed, your son would still be able to change
focus from distance to near. P-IOLs seem to be more ideal for high
refractive error where corneal tissue loss is a concern.
There are two major P-IOLs. One is placed just behind the iris
(colored portion inside eye) and the other is placed in front of the
iris and actually clipped onto the iris. These P-IOLs may be the most
appropriate method for surgical correction for your son, however they
have their own set of limitations and concerns.
Because P-IOLs require surgery inside the eye, many LASIK surgeons do
not do them. LASIK, PRK, IntraLASIK, LASEK, and Epi-LASIK are all
performed on the surface of the cornea, not inside the eye. You may
find that you need to seek the advice of an accomplished cataract
surgeon, rather than the average LASIK doctor. Ideally, you would be
able to find a surgeon who is proficient in both cornea-based
refractive surgery and lens-based refractive surgery.
You and your son have good reason to be concerned, but there are
hundreds of thousands of high myopes who had refractive surgery and
are delighted. Golfer Tiger Woods was reportedly -11.00 before having
refractive surgery some years ago, and it obviously has worked out for
him. Of course, your son is not Tiger and every individual patient has
a unique set of circumstances that need to be evaluated in detail to
come to the best possible recommendation.
I highly recommend that you and your son spend some time continuing
your research.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
|
| "Another kind of IOL is the phakic IOL (P-IOL). This is a "helper" lens
that is placed in front of the natural crystalline lens. Because the
natural lens is not disturbed, your son would still be able to change
focus from distance to near. P-IOLs seem to be more ideal for high
refractive error where corneal tissue loss is a concern."
this sounds like a good option. If he still wants to go with lasik, he
may not have enough cornea for an enhancement. Another thing, does he
demand perfect vision? What are his expectations?
| |
| Ragnar 2005-11-15, 5:59 pm |
| That is a very high prescription. But.. Tiger Woods was -11D... so
you are still in the ballpark.
Hopefully he doesn't have large pupils nor a lot of astigmatism. It
sounds as if your surgeon is giving appropriate advice.
On Tue, 15 Nov 2005 08:23:51 -0500, "J Poy" <jpoy@sympatico.ca> wrote:
>Greetings,
>
>My son is 28 years old with -9 D & -9.5D (stable) at his eye examination
>during the consultation the with doctor, he recommended LASIK for -9D and
>PRK for -9.5. The doctor recommended this because of his concerned for his
>corneal thickness. He mention he would use the laser to create a very thin
>flap for the LASIK surgery.
>
>I asked the doctor if PRK could be done on both eye's he said yes, but this
>would result in a longer recovery time. I asked him if he could have PRK
>for both eyes because I thought it would be the safest for him. He also
>agreed and said that according his calculations, that were very
>conservative, either way would be good and that it would be his choice.
>
>After reading the brochure I got at the doctor office I noticed that they
>also offer other options epi-LASIK and LASEK
>are better then PRK?
>
>Another question would be do they use the same type of laser for all the
>procedures and what type of laser is best for the surgery?
>
>Since I have limited knowledge of the different types of refractor surgery,
>what do you think is the safest procedure and will give the overall best
>results?
>
>The only knowledge I have is what I have read on the internet and this news
>group. I would appreciate any comments and real life experiences.
>
>A Concerned Parent,
>
>Thank You!
>
>BTW. I will call the doctors office to ask these questions too but it would
>be nice to hear the comments from the group.
>
| |
| Ragnar 2005-11-15, 5:59 pm |
| The problem with IOLs is that they eliminate all of the accomodation
of the natural flexible crystalline lens that is removed. Unless
someone is at least 50 years old, they should not go jumping to have
IOLs.
There are at least two available types of accomodating IOLs, but they
are not covered by any insurance and they cost about $4500 EACH or
$9000 for the pair.
On 15 Nov 2005 06:24:00 -0800, "Ace" <acemanvx@yahoo.com> wrote:
>talk to the doctors what they think about IOLs for severe myopia like
>his. He probably would be out of range for wavefront and the risks of
>haze is there with high pescriptions. I would want IOLs in my own eyes
>if I didnt qualify for wavefront.
| |
| Ragnar 2005-11-15, 5:59 pm |
| It's true that he's not the ideal candidate... but then one could say
that sick people don't make the best patients. In his case, he is
very likely to have a tremendous benefit by having the procedure done.
He is also going to be a difficult case to treat.
An analogy... someone with a 20 pound tumor in their chest is not the
best candidate for cancer treatments... but that person is also one
that would benefit greatly from the treatments.
On Tue, 15 Nov 2005 17:51:10 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>I suggest your son proceed with extreme caution. There are many issues
>being raised that indicate your son is not anywhere near an ideal
>candidate for refractive surgery.
>
>9.00 diopters of myopia (nearsighted, shortsighted) vision is rather
>high. The probability of an excellent outcome is less for a high myope
>than a low or moderate myope. You know all those "20-Minute Miracle"
>LASIK patients you hear about? They were not high myopes.
>
>It is common for patients with high refractive error to regress after
>surgery (http://www.usaeyes.org/faq/subjects/regression.htm).
>Regression is when the cornea moves back toward the original
>refractive error while healing.
>
>It would be reasonable to assume that a -9.00 patient would regress
>anywhere from 0.50 diopters to 2.00 diopters. This means that either
>your son would need to be initially overcorrected into hyperopia
>(farsighted, longsighted) vision with expected regression bringing him
>back to plano (no refractive error), or your son will require
>enhancement surgery to resolve whatever regression takes place.
>
>Because of your son's high myopia and the probability of regression,
>the total amount of tissue that would need to be removed would be
>significant. You are really looking at as much as an -11.00 diopter
>correction (9.00 stable myopia plus up to 2.00 diopters regression).
>At a minimum that would be 132 microns of tissue removal and if your
>son has naturally dilated pupils larger than about 5.5mm, the amount
>of tissue would be significantly more. See
>http://www.usaeyes.org/faq/subjects..._pupil_size.htm
>
>Another issue is whether or not your son would be able to have a
>wavefront-guided laser ablation rather than a conventional ablation. I
>believe you are in Canada and I am not familiar with the limitations
>on Canadian lasers. The enhancement would undoubtedly be able to be
>wavefront-guided. Your son would have a higher probability of a good
>outcome with wavefront-guided rather than conventional ablation. A
>problem with wavefront-guided is that it tends to remove more tissue.
>See http://www.usaeyes.org/faq/subjects...ustom_lasik.htm
>
>The surface ablation techniques PRK, LASEK, and Epi-LASIK are
>virtually identical except in how they handle the outermost layer of
>the cornea called the epithelium. PRK simply removes the epithelium,
>which grows back rather quickly. LASEK disrupts the epithelium with an
>alcohol solution, moves it aside, and then returns it over the treated
>area. Epi-LASIK uses a special device to shave up the epithelium,
>which is moved aside and repositioned over the treated area.
>
>The advantage of saving the epithelium is that there should be less
>discomfort and a quicker vision recovery, however even if the fragile
>epithelium is lost during surgery, it will reproduce quickly.
>
>A major disadvantage of the surface ablation techniques is that there
>is a significantly higher probability of wound response that can
>result in corneal haze. This can be treated after surgery with
>Mitomycin C applied to the cornea, but you want to avoid haze if at
>all possible. In my opinion a -9.00 surface ablation would absolutely
>have some corneal haze, requiring either preventative treatment or
>treatment after surgery.
>
>LASIK and IntraLASIK (with a laser created flap) cause a very
>different wound response and the probability of haze is almost nil,
>but that flap will be from 110 to 160 microns thick. Considering the
>amount of tissue that would need to be removed to correct your son's
>vision, plus the extra for wavefront-guided ablation, plus the
>thickness of the LASIK or IntraLASIK flap, your son would need to have
>an unusually thick cornea. It appears your son's doctor has already
>determined this is not the case.
>
>Intraocular lenses (IOL) are artificial lenses within the eye. An
>aphakic IOL is designed to replace the natural crystalline lens of the
>eye. Replacing the natural lens with an artificial lens is exactly
>what is done in most cataract surgery. Your son could have the natural
>lens replaced with an artificial lens that is of a power to correct
>his refractive error, however he would lose the ability to change
>focus from distant objects to objects near. He would immediately need
>to use reading glasses and not too many 28 year olds want to look like
>their parents and grandparents who need reading glasses.
>
>Another kind of IOL is the phakic IOL (P-IOL). This is a "helper" lens
>that is placed in front of the natural crystalline lens. Because the
>natural lens is not disturbed, your son would still be able to change
>focus from distance to near. P-IOLs seem to be more ideal for high
>refractive error where corneal tissue loss is a concern.
>
>There are two major P-IOLs. One is placed just behind the iris
>(colored portion inside eye) and the other is placed in front of the
>iris and actually clipped onto the iris. These P-IOLs may be the most
>appropriate method for surgical correction for your son, however they
>have their own set of limitations and concerns.
>
>Because P-IOLs require surgery inside the eye, many LASIK surgeons do
>not do them. LASIK, PRK, IntraLASIK, LASEK, and Epi-LASIK are all
>performed on the surface of the cornea, not inside the eye. You may
>find that you need to seek the advice of an accomplished cataract
>surgeon, rather than the average LASIK doctor. Ideally, you would be
>able to find a surgeon who is proficient in both cornea-based
>refractive surgery and lens-based refractive surgery.
>
>You and your son have good reason to be concerned, but there are
>hundreds of thousands of high myopes who had refractive surgery and
>are delighted. Golfer Tiger Woods was reportedly -11.00 before having
>refractive surgery some years ago, and it obviously has worked out for
>him. Of course, your son is not Tiger and every individual patient has
>a unique set of circumstances that need to be evaluated in detail to
>come to the best possible recommendation.
>
>I highly recommend that you and your son spend some time continuing
>your research.
>
>Glenn Hagele
>Executive Director
>USAEyes.org
>
>"Consider and Choose With Confidence"
>
>Email to glenn dot hagele at usaeyes dot org
>
>http://www.USAEyes.org
>http://www.ComplicatedEyes.org
>
>I am not a doctor.
| |
|
| There is a new phakic IOL that keeps your natural lense. Yes they can
cost twice or more per eye than lasik but for very high myopes, its the
better option than lasik. Lasik may not even be an option past -8 to
-10 without increased risks and regression. I talked to one lady who
was a -9 and her surgeon said shes gonna need a thin pair of glasses.
She has too much myopia to be fully corrected and wont have enough
cornea for an enhancement. He did say her dependancy on glasses will be
reduced. She told me her expectations were high, she wanted perfect
vision after lasik and never need glasses. I told her this isnt
relistic and she said I know thats why ill stick to glasses even though
im sometimes unhappy. I dont blame her.
if someone has a tumor, it HAS to be removed no matter how large. Lasik
is elective so there is no NEED to get it if your not a good candidate!
bad analogy!
"Bad analogy Ragnar."
im in agreement. a tumor can kill and has to come out whether you like
it or not.
"I think this young man should enjoy his crisp
correctable vision with glasses."
I agree although the lasik decision is up to him, he will be facing
increased risks because of his near double digit severe myopia. He
probably wont qualify for wavefront because of too thin cornea and too
high a pescription. Hes at risk of haze from surface ablation as well
as more HOAs because of no wavefront. If hes gonna get surgury, IOLs
are his safest bet. If he cant or wont get IOLs then id stick with
glasses. Hes probably still gonna need thinner glasses anyway after prk
or lasek anyway due to too much myopia and regression and not enough
cornea.
"By the way, Kashmira, Tiger's ex who
was visually handicapped and is disabled after surgery by Tiger Wood's
LASIK surgeon Dr. Mark Whitten, claims that Tiger's night vision is
absolute garbage."
Do you have any links? I dont doubt you but would be interested to read
more about this. I havent been able to find anything except positive
results and the praises of his risky lasik for -11! I could only find
one negetive result about tiger and it said his vision isnt as sharp on
cloudy or overcast days.
"Tiger also had multiple surgeries in each eye. That can NOT have been
pleasant."
I heard he had two or three enhancements but this is not a supprise for
a -11 guy.
"High myopes are at increased risk for a poor visual outcome. A
permanent poor visual outcome, not the kind of life sentence you'd wish
on a young person. "
very true. Many of the lasik disasters were done on high myopes. I read
the diary of a -16 lady who got lasik. Shes legally blind at night and
even her daytime vision is decreased. -16 is waaaaaaaay too high to
have lasik. Lucky for her she only got one eye done. She wore contacts
before but they werent comfortable. She wears a contact in the virgin
eye. Many surgeons now dont even consider you a candidate past -8 to
-10, just too risky. I personally think IOLs are the better choice if
your more than a -8, especially if your corneas are thin.
"Can't argue with this. But that's a personal decision between this
person and his doc."
thats correct and no one can stop him, but we can inform him of the
increased risks. He needs to think long and hard if reduced vision is
worth reduced dependancy on glasses.
Eye, you never told your full story on your bad lasik experience. What
was your pescription before lasik and how well were you seeing with
glasses? How well do you see now? 20/30?
| |
| serebel 2005-11-16, 12:59 am |
| I doubt that there would be any "links" to Woods ex's claims.
It's just rumor.
I believe he had one "enhancement" only. He swears by his lasik in his
own words in the ads.
He is still a top pro on the tour, and no, no one plays golf at night.
SErebel
| |
|
| Thats good to hear he had a good experience. I hope his vision
countinues to be good and not regress eventurally like some do,
especially high myopes. You are right, no one golfs at night but this
doesnt mean his night vision may be lacking some.
| |
| ycdbsoya 2005-11-16, 10:59 am |
| Check his scores and how he does late in the day or on cloudy days. I
think you'll see some differences in his game that affect him more than
other players under the same conditions.
| |
| Ragnar 2005-11-16, 1:16 pm |
| Ace, you are so wrong about so many things.
Those P-IOLs are a very expensive alternative and not really her best
option.
Most turmors are benign, not cancerous. And the cancerous ones are
often not removed, they are treated with radioactive chemicals
(chemotherapy).
On 15 Nov 2005 19:32:11 -0800, "Ace" <acemanvx@yahoo.com> wrote:
>There is a new phakic IOL that keeps your natural lense. Yes they can
>cost twice or more per eye than lasik but for very high myopes, its the
>better option than lasik. Lasik may not even be an option past -8 to
>-10 without increased risks and regression. I talked to one lady who
>was a -9 and her surgeon said shes gonna need a thin pair of glasses.
>She has too much myopia to be fully corrected and wont have enough
>cornea for an enhancement. He did say her dependancy on glasses will be
>reduced. She told me her expectations were high, she wanted perfect
>vision after lasik and never need glasses. I told her this isnt
>relistic and she said I know thats why ill stick to glasses even though
>im sometimes unhappy. I dont blame her.
>
>if someone has a tumor, it HAS to be removed no matter how large. Lasik
>is elective so there is no NEED to get it if your not a good candidate!
>bad analogy!
>
>
>
>"Bad analogy Ragnar."
>
>im in agreement. a tumor can kill and has to come out whether you like
>it or not.
>
>
>"I think this young man should enjoy his crisp
>correctable vision with glasses."
>
>
>I agree although the lasik decision is up to him, he will be facing
>increased risks because of his near double digit severe myopia. He
>probably wont qualify for wavefront because of too thin cornea and too
>high a pescription. Hes at risk of haze from surface ablation as well
>as more HOAs because of no wavefront. If hes gonna get surgury, IOLs
>are his safest bet. If he cant or wont get IOLs then id stick with
>glasses. Hes probably still gonna need thinner glasses anyway after prk
>or lasek anyway due to too much myopia and regression and not enough
>cornea.
>
>
>"By the way, Kashmira, Tiger's ex who
>was visually handicapped and is disabled after surgery by Tiger Wood's
>LASIK surgeon Dr. Mark Whitten, claims that Tiger's night vision is
>absolute garbage."
>
>
>Do you have any links? I dont doubt you but would be interested to read
>more about this. I havent been able to find anything except positive
>results and the praises of his risky lasik for -11! I could only find
>one negetive result about tiger and it said his vision isnt as sharp on
>cloudy or overcast days.
>
>
>"Tiger also had multiple surgeries in each eye. That can NOT have been
>pleasant."
>
>
>I heard he had two or three enhancements but this is not a supprise for
>a -11 guy.
>
>
>"High myopes are at increased risk for a poor visual outcome. A
>permanent poor visual outcome, not the kind of life sentence you'd wish
>
>on a young person. "
>
>
>very true. Many of the lasik disasters were done on high myopes. I read
>the diary of a -16 lady who got lasik. Shes legally blind at night and
>even her daytime vision is decreased. -16 is waaaaaaaay too high to
>have lasik. Lucky for her she only got one eye done. She wore contacts
>before but they werent comfortable. She wears a contact in the virgin
>eye. Many surgeons now dont even consider you a candidate past -8 to
>-10, just too risky. I personally think IOLs are the better choice if
>your more than a -8, especially if your corneas are thin.
>
>
>"Can't argue with this. But that's a personal decision between this
>person and his doc."
>
>
>thats correct and no one can stop him, but we can inform him of the
>increased risks. He needs to think long and hard if reduced vision is
>worth reduced dependancy on glasses.
>
>
>Eye, you never told your full story on your bad lasik experience. What
>was your pescription before lasik and how well were you seeing with
>glasses? How well do you see now? 20/30?
| |
| Ragnar 2005-11-16, 1:16 pm |
| Late in the day...
No golf game is ever played in anything but full daylight. Eyes do
not dilate much on cloudy days. They do in darkness.
On 16 Nov 2005 08:55:20 -0800, "ycdbsoya" <the_boydstons@hotmail.com>
wrote:
>Check his scores and how he does late in the day or on cloudy days. I
>think you'll see some differences in his game that affect him more than
>other players under the same conditions.
| |
| ycdbsoya 2005-11-17, 12:59 am |
|
Ragnar wrote:
> Late in the day...
> No golf game is ever played in anything but full daylight. Eyes do
> not dilate much on cloudy days. They do in darkness.
>
Err...wrong on both accounts. Besides, the pupils dilate, not the eyes.
Anyway, back to the original posting... the kid's scrip is way too high
and he's way too young to get it done. Wait.
| |
| Ragnar 2005-11-17, 12:59 am |
| The last time I checked.. the pupils were part of the eye...more
specifically, the pupils don't even exist.. the pupil is an
opening/hole which allows light into the eye. The size of that hole
is determined by the how much the muscles within the cornea are
dilated. Those muscles are the strongest muscle tissue in the body
and are actually the colored iris.
As for the "kid" being way too young. That "kid" is 28 years old! I
am 100% certain that his eyes are stable by now.
This idea of "wait" reminds me of my grandmother's husband. Ever
since I could remember, he was gray haired, with lousy crooked stained
teeth, just about blind, and was covered with very large protruding
moles.
At 88 years of age, due to chain smoking his entire life, he was
diagnosed with terminal cancer. In the last 5 months of his life, he
dyed his hair brown, got a fancy set of dentures, had the moles
removed, gave up smoking entirely, had cataract surgery and bought a
new car (that he couldn't drive). Other than the cancer, he had not
been in such good condition for over 40 years! So much for waiting!
On 16 Nov 2005 20:12:25 -0800, "ycdbsoya" <the_boydstons@hotmail.com>
wrote:
>
>Ragnar wrote:
>
>Err...wrong on both accounts. Besides, the pupils dilate, not the eyes.
>
>Anyway, back to the original posting... the kid's scrip is way too high
>and he's way too young to get it done. Wait.
| |
|
| In article <hf8on19vq4onm88v97dse7op0g4q3ukh4b@4ax.com>,
Ragnar <ragnarsuomi@yahoo.com> wrote:
> As for the "kid" being way too young. That "kid" is 28 years old! I
> am 100% certain that his eyes are stable by now.
100% certain? As you know, I'm a bit of a gambler, having had LASIK, so
I see your 100% and raise you to 50%.
I had a diopter change over the course of my 30s. ie. I went from -4.50
to -3.50 in my left eye.
--
~RT
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| Ragnar 2005-11-17, 5:58 pm |
| The only relevant fact is that at 28, the "kid" is plenty old enough
to have the surgery. Waiting because of his age is ridiculous.
On Thu, 17 Nov 2005 12:33:41 GMT, RT <RTMD24@NOSPAMyahoo.com> wrote:
>In article <hf8on19vq4onm88v97dse7op0g4q3ukh4b@4ax.com>,
> Ragnar <ragnarsuomi@yahoo.com> wrote:
>
>
>100% certain? As you know, I'm a bit of a gambler, having had LASIK, so
>I see your 100% and raise you to 50%.
>
>I had a diopter change over the course of my 30s. ie. I went from -4.50
>to -3.50 in my left eye.
| |
|
| makes sense. that he doesnt see as well in cloudy/dark days.
P IOLs are expensive but who cares you have one set of eyes and you
cant put a price on them. Theres a reason IOLs were made, look into
those!
as for pescription changes, most people remain stable once they are in
their early 20s. Even if his changes so what he can wear a thin pair of
glasses instead of his thick ones
| |
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| Glen,
I would also like to thank you for detailed response to our questions they
were very much appreciated.
My son decided to have Epi/LASIK (PRK) on Wednesday and he is now slowly
recovering, his doctor also used Mitomycin C during the surgery. He is also
taking 500mg of vitamin C twice a day along with his antibiotics. Hopefully
he will have the contacts removed on Saturday if all goes well.
The first day after surgery I notice his eyes were blood shot due to the
surgery, he told me could see the best on that day (blurry with no haze) so
far. On the second day he noticed haze as well. My guess it will take at
least a week before things start to improve. His Myopia has improved a great
deal (blurry with haze) he doesn't need his glasses anymore and can read
street signs etc. Only time will tell for sure I hope all goes well for
him.
Thanks Again Glen!
BTW I found this site very informative regarding PRK and more. I thought it
might be useful for others.
http://www.chicagocornea.com/html/lasik.html#prk
"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM@USAEyes.org> wrote in message
news:ss5kn1po56mvv32n09ermh8hu5ldvgcnvr@4ax.com...
>I suggest your son proceed with extreme caution. There are many issues
> being raised that indicate your son is not anywhere near an ideal
> candidate for refractive surgery.
>
> 9.00 diopters of myopia (nearsighted, shortsighted) vision is rather
> high. The probability of an excellent outcome is less for a high myope
> than a low or moderate myope. You know all those "20-Minute Miracle"
> LASIK patients you hear about? They were not high myopes.
>
> It is common for patients with high refractive error to regress after
> surgery (http://www.usaeyes.org/faq/subjects/regression.htm).
> Regression is when the cornea moves back toward the original
> refractive error while healing.
>
> It would be reasonable to assume that a -9.00 patient would regress
> anywhere from 0.50 diopters to 2.00 diopters. This means that either
> your son would need to be initially overcorrected into hyperopia
> (farsighted, longsighted) vision with expected regression bringing him
> back to plano (no refractive error), or your son will require
> enhancement surgery to resolve whatever regression takes place.
>
> Because of your son's high myopia and the probability of regression,
> the total amount of tissue that would need to be removed would be
> significant. You are really looking at as much as an -11.00 diopter
> correction (9.00 stable myopia plus up to 2.00 diopters regression).
> At a minimum that would be 132 microns of tissue removal and if your
> son has naturally dilated pupils larger than about 5.5mm, the amount
> of tissue would be significantly more. See
> http://www.usaeyes.org/faq/subjects..._pupil_size.htm
>
> Another issue is whether or not your son would be able to have a
> wavefront-guided laser ablation rather than a conventional ablation. I
> believe you are in Canada and I am not familiar with the limitations
> on Canadian lasers. The enhancement would undoubtedly be able to be
> wavefront-guided. Your son would have a higher probability of a good
> outcome with wavefront-guided rather than conventional ablation. A
> problem with wavefront-guided is that it tends to remove more tissue.
> See http://www.usaeyes.org/faq/subjects...ustom_lasik.htm
>
> The surface ablation techniques PRK, LASEK, and Epi-LASIK are
> virtually identical except in how they handle the outermost layer of
> the cornea called the epithelium. PRK simply removes the epithelium,
> which grows back rather quickly. LASEK disrupts the epithelium with an
> alcohol solution, moves it aside, and then returns it over the treated
> area. Epi-LASIK uses a special device to shave up the epithelium,
> which is moved aside and repositioned over the treated area.
>
> The advantage of saving the epithelium is that there should be less
> discomfort and a quicker vision recovery, however even if the fragile
> epithelium is lost during surgery, it will reproduce quickly.
>
> A major disadvantage of the surface ablation techniques is that there
> is a significantly higher probability of wound response that can
> result in corneal haze. This can be treated after surgery with
> Mitomycin C applied to the cornea, but you want to avoid haze if at
> all possible. In my opinion a -9.00 surface ablation would absolutely
> have some corneal haze, requiring either preventative treatment or
> treatment after surgery.
>
> LASIK and IntraLASIK (with a laser created flap) cause a very
> different wound response and the probability of haze is almost nil,
> but that flap will be from 110 to 160 microns thick. Considering the
> amount of tissue that would need to be removed to correct your son's
> vision, plus the extra for wavefront-guided ablation, plus the
> thickness of the LASIK or IntraLASIK flap, your son would need to have
> an unusually thick cornea. It appears your son's doctor has already
> determined this is not the case.
>
> Intraocular lenses (IOL) are artificial lenses within the eye. An
> aphakic IOL is designed to replace the natural crystalline lens of the
> eye. Replacing the natural lens with an artificial lens is exactly
> what is done in most cataract surgery. Your son could have the natural
> lens replaced with an artificial lens that is of a power to correct
> his refractive error, however he would lose the ability to change
> focus from distant objects to objects near. He would immediately need
> to use reading glasses and not too many 28 year olds want to look like
> their parents and grandparents who need reading glasses.
>
> Another kind of IOL is the phakic IOL (P-IOL). This is a "helper" lens
> that is placed in front of the natural crystalline lens. Because the
> natural lens is not disturbed, your son would still be able to change
> focus from distance to near. P-IOLs seem to be more ideal for high
> refractive error where corneal tissue loss is a concern.
>
> There are two major P-IOLs. One is placed just behind the iris
> (colored portion inside eye) and the other is placed in front of the
> iris and actually clipped onto the iris. These P-IOLs may be the most
> appropriate method for surgical correction for your son, however they
> have their own set of limitations and concerns.
>
> Because P-IOLs require surgery inside the eye, many LASIK surgeons do
> not do them. LASIK, PRK, IntraLASIK, LASEK, and Epi-LASIK are all
> performed on the surface of the cornea, not inside the eye. You may
> find that you need to seek the advice of an accomplished cataract
> surgeon, rather than the average LASIK doctor. Ideally, you would be
> able to find a surgeon who is proficient in both cornea-based
> refractive surgery and lens-based refractive surgery.
>
> You and your son have good reason to be concerned, but there are
> hundreds of thousands of high myopes who had refractive surgery and
> are delighted. Golfer Tiger Woods was reportedly -11.00 before having
> refractive surgery some years ago, and it obviously has worked out for
> him. Of course, your son is not Tiger and every individual patient has
> a unique set of circumstances that need to be evaluated in detail to
> come to the best possible recommendation.
>
> I highly recommend that you and your son spend some time continuing
> your research.
>
> Glenn Hagele
> Executive Director
> USAEyes.org
>
> "Consider and Choose With Confidence"
>
> Email to glenn dot hagele at usaeyes dot org
>
> http://www.USAEyes.org
> http://www.ComplicatedEyes.org
>
> I am not a doctor.
| |
| Glenn - USAEyes.org 2005-11-28, 1:00 am |
| Thank you for all your kind words. I greatly appreciate knowing my
response was helpful.
Refractive surgery is more a process than an event, especially for
someone with your son's previous refractive error. Tell him to expect
changes, continued improvement in vision clarity, to not be too
surprised if he needs enhancement surgery in a few months, and to
listen to his doctor.
Glenn Hagele
Executive Director
USAEyes.org
"Consider and Choose With Confidence"
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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