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Author Wavelight Allegretto laser
drrouter@yahoo.com

2005-05-30, 10:55 pm

Hello

I went through lasik surgery about 2 years ago. I have now been left
with a little blurry eye in the left side. I've been told it may be
due to higher order aberrations. I am now a +1.25. Can the Allegretto
machine correct HOA's? I don't want to make things worse. Each doctor
is different, I can't decide which one makes sense.

Glenn - USAEyes.org

2005-05-31, 8:54 am

What would be best for you will depend on many things, including where
you are located, your exact refractive error, how well you see with
glasses correcting that refractive error, the type of unusually
elevated higher order aberrations (if any) and much more.

Outside of the United States, the Allegretto can provide custom
wavefront-guided ablations. Inside the United States the Allegretto
is wavefront "optimized". That means that they used wavefront data to
create a static ablation profile.

In the United States, only the newest version of the Visx Star S4 is
able to provide wavefront-guided hyperopic correction.

The fact that two years after surgery you are now +1.25 may be an
indication of more serious trouble. If you were hyperopic
(farsighted, longsighted) before surgery, then this may be normal
regression. If you were myopic (nearsighted, shortsighted) before
surgery, this could be indicative of keratoectasia. Ectasia is when
the cornea becomes weak and bulges outward.

Helpful information would be your age, sex, prescription before
surgery, prescription now, and what your doctors have said regarding
why you are now +1.25.

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.
drrouter@yahoo.com

2005-05-31, 8:54 am

I was orginally farsighted. I'm 30, and male. The doctor said I
regressed, and this was normal for farsighted patients. My problem eye
has some elevated trefoil and coma, and is a bit drier.

I see that the Visx machine is available, but is there any data on how
well it works with retreatments? Original doc only uses Ladarvision
machines, so if I want to get redone on the Visx, I'll have to go
elsewhere. Is there a doctor you would recommend in the
Nevada/California area?

My corneas are still 520 microns. No problem with flap. I think it
boils down to a slightly decentralized ablation, from what I can gather.

Glenn - USAEyes.org

2005-05-31, 11:52 am

Hyperopic correction is more difficult to achieve predictably,
irregularities are too often introduced, and regression is common.

Outcome information from the hyperopic Visx clinical trail is at
http://www.fda.gov/cdrh/pdf/p930016s017.html

Dry eyes will exacerbate aberrations by causing an irregular corneal
surface. I recommend that you first resolve your dry eye problem
before any additional surgery. You don't want to have surgery attempt
to correct a problem that is temporarily caused by dry eyes.

You may want to see http://www.usaeyes.org/faq/subjects/hyperopia.htm
and http://www.complicatedeyes.org/dry_eye_treatment.htm


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.
drrouter@yahoo.com

2005-06-02, 10:58 pm

Last question, what is the differenct between Wavefront Guided (such as
the Allegretto) and true Wavefront? Is it worth investigating, or
would you recommend waiting for the technology to further improve? I
know you're not a doc, but I've seen 3 since my surgery, and each has a
different answer.

Glenn - USAEyes.org

2005-06-03, 9:01 am

Details are at
http://www.usaeyes.org/faq/subjects...ustom_lasik.htm but the
simple answer is that in the US the Allegretto uses a static ablation
profile based upon wavefront analysis "in the lab". The others use an
individual patient's wavefront analysis to provide a customized
ablation. Outside the US, Allegretto also is custom.

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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