Lasik Eyes Surgery - 3 week checkup

Author

3 week checkup - lots to tell!

Tom Lucas

2006-10-20, 8:27 am

I went for my three week checkup yesterday evening and enjoyed a good
lengthy chat with the optometrist too.

Firstly, we decided to have a three week appointment instead of four
because I had a microstriae (is one a microstrium?) in the left eye he
wanted to monitor. It is still there but causing no problems and he also
spotted one in the right but it is well outside the visual area and not
causing problems either. I'm not too worried about the striae and
neither is he so my next trip back will be in two months.

My left eye was measured plano by the autorefractor and I could easily
read the 20/15 line with it - 20/10 was a bridge too far though. My
right eye came out at -0.25 and I could read the 20/20 line fine but
20/15 was not really readable. I also had a good long look at the room
and if the chart was not at 20 feet then it was damn close in case Ace
starts shouting about conspiracies ;-)

I also had a good long chat with the optometrist about visual
corrections in general but, for balance, it should be remembered that he
works for a Lasik clinic although he is fairly fresh from university so
he is up to date on current thinking. He believed that OrthoK was a bad
idea and could cause damage to the cornea with long term use. Apparently
this was also the opinion of the Professor in charge of his school who
is supposedly a world authority on contact lenses. He said that the
repeated compression would eventually damage the elasticity and leave a
permanently mishapen cornea. He was saddened when he heard about the
soft contact OrthoK scam but understood why people would fall for it and
recognised that it probably wasn't eye-threateningly dangerous for a
short-term trial but over a long period would be highly risky.

He also mentioned that a major laser manufacturer has found a solution
for presbyopia which is undergoing trials at the moment and they will be
applying for FDA approval some time next year. He doubts that we'll see
it in the UK for 3 or more years and we both agreed it was better to
test it on Americans first ;-) However, when it does arrive then I'm
going to want shares in that place because there are going to be floods
of people wanting it done.

He also stated that recent studies have shown that Lasik is actually
safer than contact lenses which is reassuring (or worrying about
contacts depending on how you look at it!). I would also note that I
didn't see those studies and he that he works for a Lasik clinic but we
were informally chatting and have already had Lasik so he has no reason
to say it unless he meant it.

I was also irritated to find that they started offering intralase a
couple of weeks ago which I've missed out by only four months. Oh well,
I'm not having any more flaps cut so I guess it doesn't matter!

Bassslapper

2006-10-20, 4:30 pm

I heard from my doctor that there are 2 procedures going for FDA
approval soon for presbyopia so we shall see what will coem of that. If
something successful comes about, I guarantee the market will be
flooded with baby boomers getting their eyes lased to eliminate the
need for readers.

Ragnar

2006-10-20, 9:30 pm

Presbyopia is probably the biggest area of eye care research at the
moment. It is not the best timing though... Currently, cataract
surgery is covered by medicare. The surgery to preserve/restore
accomodation/pseudo accmodation is extremely expensive and not too
likely to be covered by medicare because Medicare is already running
out of money. It is troubling that the operation to treat presbyopia
is roughly 10 to 40 times the cost of an abortion. Strange world.

On 20 Oct 2006 11:58:37 -0700, "Bassslapper" <dr_george@prodigy.net>
wrote:

>I heard from my doctor that there are 2 procedures going for FDA
>approval soon for presbyopia so we shall see what will coem of that. If
>something successful comes about, I guarantee the market will be
>flooded with baby boomers getting their eyes lased to eliminate the
>need for readers.

Ace

2006-10-21, 2:30 am

Tom Lucas said:
> I went for my three week checkup yesterday evening and enjoyed a good
> lengthy chat with the optometrist too.
>
> Firstly, we decided to have a three week appointment instead of four
> because I had a microstriae (is one a microstrium?) in the left eye he
> wanted to monitor. It is still there but causing no problems and he also
> spotted one in the right but it is well outside the visual area and not
> causing problems either. I'm not too worried about the striae and
> neither is he so my next trip back will be in two months.

sounds good.

> My left eye was measured plano by the autorefractor and I could easily
> read the 20/15 line with it - 20/10 was a bridge too far though. My
> right eye came out at -0.25 and I could read the 20/20 line fine but
> 20/15 was not really readable. I also had a good long look at the room
> and if the chart was not at 20 feet then it was damn close in case Ace
> starts shouting about conspiracies ;-)

Were trial lenses used? Ya know "which is better one or two" Hmmm 20/15
is very good
what was the catch this time? You didnt see 20/15 with glasses. Perhaps
you never got the exact right glasses prescription? I remember when you
were 20/50 after your first lasik and got temp glasses they were too
weak and I thought so too. If you had a 20/15 BCVA then 20/50 would
correspond with -1.5 so you were more undercorrected than you thought!
Funny you dont even know for sure your own prescription.

> I also had a good long chat with the optometrist about visual
> corrections in general but, for balance, it should be remembered that he
> works for a Lasik clinic although he is fairly fresh from university so
> he is up to date on current thinking. He believed that OrthoK was a bad
> idea and could cause damage to the cornea with long term use. Apparently
> this was also the opinion of the Professor in charge of his school who
> is supposedly a world authority on contact lenses. He said that the
> repeated compression would eventually damage the elasticity and leave a
> permanently mishapen cornea. He was saddened when he heard about the
> soft contact OrthoK scam but understood why people would fall for it and
> recognised that it probably wasn't eye-threateningly dangerous for a
> short-term trial but over a long period would be highly risky.

How long can one safely wear orthoK? I plan to wear orthoK till
something better comes out. Should probably be about 5 years, maybe up
to 10. I did hear that long term orthoK isnt exactly good for the
cornea but most people dont wear orthoK all their lives, just a number
of years and for various reasons quit before problems occur. Maybe I
could email him with questions on orthoK? I know its much safer than
lasik and if its not, why isnt anyone speaking up? Even the lasik
malcontents say orthoK "probably" wont do harm and that its safe enough
to go ahead. I have done much reserch on orthoK and unless facts are
shown that orthoK is riskier than I thought, im considering it. I am
not much of a risktaker.

> He also mentioned that a major laser manufacturer has found a solution
> for presbyopia which is undergoing trials at the moment and they will be
> applying for FDA approval some time next year. He doubts that we'll see
> it in the UK for 3 or more years and we both agreed it was better to
> test it on Americans first ;-) However, when it does arrive then I'm
> going to want shares in that place because there are going to be floods
> of people wanting it done.

By any chance is it multifocal lasik? That wont work well and in
clinical trials, many werent happy with it. I think this type of
surgury however has the best chance but it sounds risky:

http://www.emedicine.com/oph/topic7...toperative_data

> He also stated that recent studies have shown that Lasik is actually
> safer than contact lenses which is reassuring (or worrying about
> contacts depending on how you look at it!). I would also note that I
> didn't see those studies and he that he works for a Lasik clinic but we
> were informally chatting and have already had Lasik so he has no reason
> to say it unless he meant it.

Glenn posted this article but it does not properly explain that it only
applies to extreme circumstances. For example, wearing contacts 30 days
strait is very bad for your eyes. I have a few friends who do that and
they will ruin their eyes soon and no longer be able to wear contacts.
The risk of 24/7 contacts is 10-20x riskier than daily wear contacts
that get removed every night to give your eyes a rest. Daily wear
contacts have a good safety that even minors wear them. Even some
failed lasik victims wear them for improved vision.
I have seen a few have problems with contacts(most who didnt properly
care for them) but far, far more problems with lasik.

> I was also irritated to find that they started offering intralase a
> couple of weeks ago which I've missed out by only four months. Oh well,
> I'm not having any more flaps cut so I guess it doesn't matter!

I had suggested PRK. Intralase has its own problems and theres debates
if intralase is any better than microkeratome.

Ace

2006-10-21, 2:30 am

Bassslapper wrote:
> I heard from my doctor that there are 2 procedures going for FDA
> approval soon for presbyopia so we shall see what will coem of that. If
> something successful comes about, I guarantee the market will be
> flooded with baby boomers getting their eyes lased to eliminate the
> need for readers.

Please tell me more about those. Are they the ones I talked about?
Right now monovision, undercorrection and multifocal are the options.
Presbyopia surgury may appeal to those with a plano prescription. Those
already wearing glasses have bifocals or progressives. They would need
two or more surguries to correct their refractive error *and* their
presbyopia. Myopes wont be a good candidate for presbyopia surgury
because they can just take their glasses off to see clear from near!