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Home > Archive > Lasik Eyes Surgery > February 2006 > Contact lenses after treatment?
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Contact lenses after treatment?
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| I know that some people are advised that after treatment and if left with a
residual prescription, that they won't simply be able to wear contact lenses
to correct it.
I was told at my consultation by an optometrist that, for me at least, if
this should occur, then I will still be able to wear contact lenses, albeit
custom made rather than 'off-the-shelf' disposables.
Can anyone explain why for some people this is not possible? Is it purely
down to the cornea curvature? Am not sure if it's relevant, but I have a
high prescription and have been recommended for wavefront LASEK.
TIA
Gary
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| CatmanX 2006-02-25, 9:54 pm |
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Dry eye can be a complication in refractive surgery. Reports show up to
30% of people experience dry eye post RS due to damage to nerves in the
anterior cornea from the laser. The degree will vary and some are much
worse than others. In most cases this resolves within 6 months of
treatment as some of the nerves regenerate.
Most people are either able to wear CL's or are corrected sufficiently
to not need them.
dr grant
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| Glenn - USAEyes.org 2006-02-25, 9:54 pm |
| Dr. Grant is correct that a high percentage of Lasik patients have
temporary dry eye after surgery, but the surface ablation techniques
Epi-LASIK, PRK, and LASEK tend to induce dry eye symptoms less often,
and with less severity.
If you have a dry eye condition before surgery, you will want to treat
and manage that problem before making any decision about elective
refractive surgery.
If refractive surgery will not be able to provide full correction, is
it really wise to subject yourself to the cost and risk (albeit
relatively small) of elective surgery to get what you don't want?
Any elective, arguably cosmetic, surgery is a balance of potential
risk against potential benefit. Your potential risk will be the same
even if your potential benefit is limited because you will not be able
to achieve full correction. That kind of situation tends to tilt away
from refractive surgery.
If your desire is to wear thinner glasses or be able to function some
of the time without glasses, then maybe (emphasis on maybe) refractive
surgery is appropriate.
It seems like a lot of trouble to go through just to wear thinner
glasses.
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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| Ragnar 2006-02-25, 9:54 pm |
| I know you meant to put an S on the end of "Dry eye"
We must not confuse dryness or dry eyes as being the condition known
as "dry eye" which has a completely different etiology and is much
more serious.
On 23 Feb 2006 09:33:35 -0800, "CatmanX" <drgrant@ozemail.com.au>
wrote:
>
>Dry eye can be a complication in refractive surgery. Reports show up to
>30% of people experience dry eye post RS due to damage to nerves in the
>anterior cornea from the laser. The degree will vary and some are much
>worse than others. In most cases this resolves within 6 months of
>treatment as some of the nerves regenerate.
>
>Most people are either able to wear CL's or are corrected sufficiently
>to not need them.
>
>dr grant
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| Ragnar 2006-02-25, 9:54 pm |
| dry eyes please.. not dry eye...
and I'm not even going to pick on that Dr. thing since he is acting
rational lately. There is a time to stomp on people and he seems to
have figured out who needs to be stomped and when.
On Thu, 23 Feb 2006 18:20:34 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>Dr. Grant is correct that a high percentage of Lasik patients have
>temporary dry eye after surgery, but the surface ablation techniques
>Epi-LASIK, PRK, and LASEK tend to induce dry eye symptoms less often,
>and with less severity.
>
>If you have a dry eye condition before surgery, you will want to treat
>and manage that problem before making any decision about elective
>refractive surgery.
>
>If refractive surgery will not be able to provide full correction, is
>it really wise to subject yourself to the cost and risk (albeit
>relatively small) of elective surgery to get what you don't want?
>
>Any elective, arguably cosmetic, surgery is a balance of potential
>risk against potential benefit. Your potential risk will be the same
>even if your potential benefit is limited because you will not be able
>to achieve full correction. That kind of situation tends to tilt away
>from refractive surgery.
>
>If your desire is to wear thinner glasses or be able to function some
>of the time without glasses, then maybe (emphasis on maybe) refractive
>surgery is appropriate.
>
>It seems like a lot of trouble to go through just to wear thinner
>glasses.
>
>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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Thanks both for the replies.
> If you have a dry eye condition before surgery, you will want to treat
> and manage that problem before making any decision about elective
> refractive surgery.
That's not a condition I suffer from.
> Any elective, arguably cosmetic, surgery is a balance of potential
> risk against potential benefit. Your potential risk will be the same
> even if your potential benefit is limited because you will not be able
> to achieve full correction. That kind of situation tends to tilt away
> from refractive surgery.
It's unclear if full correction will be achieved, but it's a 'maybe' that
I'm prepared to accept.
Regards
Gary
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| Glenn - USAEyes.org 2006-02-25, 9:54 pm |
| On Thu, 23 Feb 2006 22:09:40 -0000, "Gary"
<gary@franklin49deletethisbit.freeserve.co.uk> wrote:
>
>It's unclear if full correction will be achieved, but it's a 'maybe' that
>I'm prepared to accept.
And that is exactly the point. If it is an outcome that you are
willing to accept, then surgery may be appropriate. The key is to have
considered the probable outcome before electing for surgery.
What are the specifics that may keep you from attaining full
correction? I'm assuming a thin cornea is one, as you are considering
surface ablation and yet may not achieve full correction.
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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| Why not look into IOLs this is the much better choice for high myopes.
If you can tolerate contacts fine, theres NO reason to get lasik,
especially since youll probably still be wearing contacts(and less
successfully) afterwards. If you must have 20/20, dont even bother,
youll just set yourself for disapointed if lasik is "all or nothing"
for you. If you dont mind wearing a thin pair of glasses occasionally
after lasik then your chances of being happy is much higher.
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| Ragnar 2006-02-25, 9:54 pm |
| What is your problem with LASIK? you mention every other possible
alternative to LASIK.
You obviously know absolutely nothing about the natural crystalline
lens in the eye that bends to accomodate and provide the best possible
vision for near and far objects and everything in between. When IOL's
are put in, the natural lens is removed, and your accomodation is then
eliminated permanently. Recommending IOL's is kind of like
recommending that a child have dentures put in so they won't have to
be bothered with braces on their teeth.
On 23 Feb 2006 15:37:44 -0800, "Ace" <acemanvx@yahoo.com> wrote:
>Why not look into IOLs this is the much better choice for high myopes.
>If you can tolerate contacts fine, theres NO reason to get lasik,
>especially since youll probably still be wearing contacts(and less
>successfully) afterwards. If you must have 20/20, dont even bother,
>youll just set yourself for disapointed if lasik is "all or nothing"
>for you. If you dont mind wearing a thin pair of glasses occasionally
>after lasik then your chances of being happy is much higher.
| |
|
| > What are the specifics that may keep you from attaining full
> correction? I'm assuming a thin cornea is one, as you are considering
> surface ablation and yet may not achieve full correction.
Yes, that's correct.
If I was able to wear contact lenses for longer periods then I probably
wouldn't go down this route. I presently wear toric lenses, which, being
thicker, tend to get slightly uncomfortable after about 8 hours or so,
presumably through lack of oxygen to the cornea, rather than eyes being dry
(drops make no difference).
If I'm left with a residual prescription, I'm prepared to accept this,
decreasing my dependence on glasses. If contact lenses are still required
(and wearable), then hopefully I will not have to wear the toric type, so
should be able to wear them for longer periods without discomfort.
Regards
Gary
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| Gary,
A high prescription is a risk factor for a bad outcome for refractive
surgery.
Why? Because you have more lasering which is by nature irregular and induces
distortions called higher order aberrations in your cornea. You have more
tissue removed,
and the ablation must be deeper for a high prescription. More, deeper, nerve
damage also results.
Even wavefront treatments induce distortions in your cornea. Dare your
doctor
to deny it.
If you have LASIK for a high prescription the flap must settle down in the
valley created
where they removed tissue. The bigger the valley, the more likely you are to
have flap wrinkles.
Everyone with a LASIK flap has some wrinkles, it just varies from person to
person as to how
much loss of visual quality results.
The front of your cornea is actually flattened for correction for myopia.
You have a flat front, then
a hump where the edges of your flap overlap, then another zone which is the
uncorrected portion of
your eye. A very unusual shape, and not what nature intended. It takes an
expert to fit contacts on the irregular
corneas of people who have had corneal refractive surgery, and they can't
always restore the vision you had before. Sometimes
they just can't get a fit. Besides, with surgically-induced corneal nerve
damage your eyes may just be too dry to tolerate contacts like
they used to. Off the shelf soft lenses are made for normal round eyes, not
surgically flattened eyes. You are likely
closing the door to easy, comfortalbe and inexpensive contact lens wear for
good by having laser eye surgery. Those post-LASIK contact lens fitting
experts can be expensive and you usually have to travel to find one.
Corneal refractive surgery damages corneal nerves, induces distortions in
your cornea that'
cannot be fixed with glasses, and thins/structurally compromises your
cornea. Why would
you want to do this to your eyes?
Plain and simple, corneal refractive surgery harms every eye.
Contact lens technology is getting better and better...
Gary, you need to go read for a while on
http://lasikflap.com/forum
You'll get an education there about the surgery you're considering.
"Gary" <gary@franklin49deletethisbit.freeserve.co.uk> wrote in message
news:dtklnj$7c2$1@emma.aioe.org...
>I know that some people are advised that after treatment and if left with a
> residual prescription, that they won't simply be able to wear contact
> lenses
> to correct it.
>
> I was told at my consultation by an optometrist that, for me at least, if
> this should occur, then I will still be able to wear contact lenses,
> albeit
> custom made rather than 'off-the-shelf' disposables.
>
> Can anyone explain why for some people this is not possible? Is it purely
> down to the cornea curvature? Am not sure if it's relevant, but I have a
> high prescription and have been recommended for wavefront LASEK.
>
> TIA
> Gary
>
>
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| |
| Ragnar 2006-02-25, 9:54 pm |
| Of course a high prescription is going to be more difficult to treat.
What alternative does one have? Contact lenses can't handle high
prescriptions - especially since high prescriptions are usually
accompanied by high astigmatism. Glasses aren't going to work well
since the lenses will have to be quite thick and therefore look like
hell and create minification which is the opposite of looking through
a magnifying glass.
Your post below is complete garbage.
What is your purpose in posting?
On Fri, 24 Feb 2006 19:09:44 -0500, "Wendy" <Wendy@nospam_ aol.com>
wrote:
>Gary,
>
>A high prescription is a risk factor for a bad outcome for refractive
>surgery.
>Why? Because you have more lasering which is by nature irregular and induces
>distortions called higher order aberrations in your cornea. You have more
>tissue removed,
>and the ablation must be deeper for a high prescription. More, deeper, nerve
>damage also results.
>Even wavefront treatments induce distortions in your cornea. Dare your
>doctor
>to deny it.
>
>If you have LASIK for a high prescription the flap must settle down in the
>valley created
>where they removed tissue. The bigger the valley, the more likely you are to
>have flap wrinkles.
>Everyone with a LASIK flap has some wrinkles, it just varies from person to
>person as to how
>much loss of visual quality results.
>
>The front of your cornea is actually flattened for correction for myopia.
>You have a flat front, then
>a hump where the edges of your flap overlap, then another zone which is the
>uncorrected portion of
>your eye. A very unusual shape, and not what nature intended. It takes an
>expert to fit contacts on the irregular
>corneas of people who have had corneal refractive surgery, and they can't
>always restore the vision you had before. Sometimes
>they just can't get a fit. Besides, with surgically-induced corneal nerve
>damage your eyes may just be too dry to tolerate contacts like
>they used to. Off the shelf soft lenses are made for normal round eyes, not
>surgically flattened eyes. You are likely
>closing the door to easy, comfortalbe and inexpensive contact lens wear for
>good by having laser eye surgery. Those post-LASIK contact lens fitting
>experts can be expensive and you usually have to travel to find one.
>
>Corneal refractive surgery damages corneal nerves, induces distortions in
>your cornea that'
>cannot be fixed with glasses, and thins/structurally compromises your
>cornea. Why would
>you want to do this to your eyes?
>
>Plain and simple, corneal refractive surgery harms every eye.
>
>Contact lens technology is getting better and better...
>
>Gary, you need to go read for a while on
>
>http://lasikflap.com/forum
>
>You'll get an education there about the surgery you're considering.
>
>
>
>"Gary" <gary@franklin49deletethisbit.freeserve.co.uk> wrote in message
>news:dtklnj$7c2$1@emma.aioe.org...
>
>
>*** Free account sponsored by SecureIX.com ***
>*** Encrypt your Internet usage with a free VPN account from http://www.SecureIX.com ***
| |
|
| In article <6g8vv196soi515sbprrod4mnqgsktodbm9@4ax.com>,
Ragnar <ragnarsuomi@yahoo.com> wrote:
> Your post below is complete garbage.
No actually there are some good points to the post, but the combative
language, like "dare your doctor to deny it" makes it all seem like
"agenda" rather than constructive advice. "Wendy" is arguing against the
LASIK industry--a huge nameless combatant--rather than giving Gary
advice directly.
"Wendy," it may help Gary understand where you're coming from if you
explain what your post LASIK issues are and why you are so adamant
against the procedure without the rhetorical challenges.
--
~RT
| |
| Glenn - USAEyes.org 2006-02-25, 9:54 pm |
| Nicely said, RT. Let's pull out some of those good points surrounded
by rhetoric.
High prescriptions (over about 8.00 diopters) are more difficult to
correct and less likely to provide an excellent outcome.
High prescriptions require more tissue removal, therefore thinning the
cornea to the point of instability must be carefully evaluated.
Although on occasion a wavefront-guided ablation will reduce higher
order aberrations (HOA), on the whole any ablation will induce HOA,
with wavefront-guided inducing less HOA than conventional ablation.
If the edge of the flap or edge of the treatment zone is within the
visual axis, light passing through these zones of transition can be
irregular and provide inferior vision.
Flap striae (wrinkles) tend to be more prevalent after large
corrections, but interfere with vision quality relatively rarely
Contact lenses are commonly more difficult to fit after refractive
surgery, depending upon the exact nature of the correction.
Custom fitted contact lenses, if required after surgery, are commonly
more expensive than off-the-shelf contacts.
I do not include the "nerve damage" statements because the vast
majority of refractive surgery patients have nerve sensitivity return
to functional levels and studies have that nerve density returns to
preoperative levels in about three years for surface ablation (PRK,
LASEK, Epi-LASIK) and five years for Lasik.
Nerve damage is a possibility, but rather than dwell on one potential
complication like nerve damage, it seems more valuable to point out
that about 3% of refractive surgery patients have some sort of
unresolved surgery induced complication at six months postop, with
about 0.5% having a serious complication that requires extensive
maintenance, intrusive intervention, or both.
Nature may have intended for Gary to be nearsighted, but there are
many options that can correct his vision. One of those options is
refractive surgery. Refractive surgery, like all surgery, carries
risk. Now we are back to my original point about how every individual
must weigh the potential benefit against the potential risk, based
upon their own individual circumstances.
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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