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Old 11-17-2012, 03:33 AM   #1
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david590 HB User
Question Overcorrected, Enhancement?

Hi Everyone,

I had Lasik surgery done about 2 1/2 weeks ago and things are gradually improving but it's starting to look like I was overcorrected +.75 in each eye.

So, if this sticks, I'm thinking about enhancement surgery to bring that back to normal. Farsightedness is worse than the nearsightedness I had since nothing is in focus and I need strong readers to read. I'm 55.

My questions are:

1. Has anyone had a similar situation: nearsightedness over-corrected and then done an enhancement to correct it back?

2. What are the risks involved? Is this riskier than the first operation? I'm thinking of the cornea flap being re-opened.

3. I really miss my near-sighted eye. Can one "over-correct" the over-correction to get one eye near-sighted again (mono-vision)?

4. What is the success rate of Enhancements.

Thanks!

Dave

 
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Old 12-14-2012, 02:18 PM   #2
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waterpony HB User
Re: Overcorrected, Enhancement?

I am in the same situation - overcorrected at +0.75, my surgery was 16 days ago. Being nearsighted all my life it is really hard to adjust to not being able to see clearly up close (and at my age I am presbyopic as well).
My doctor gave me contacts in attempt to force cornea into being more steep. I was wearing them for a week but there are no changes in the vision. I am to continue with the contacts and come back for a check up in two weeks.
Does anyone has any knowledge about this approach? I read about CLAPIKS but this is not the same since I do not use any special eye drops. Since the contact have +0.75 prescription it helps me to see better, but I am not sure if this will work.
The option is to have an enhancement if the contacts do not work, so I would also love to hear from people with enhancements due to overcorrection after lasik for myopia.

 
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Old 12-15-2012, 12:45 AM   #3
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Re: Overcorrected, Enhancement?

I'm going to have mine corrected sometime this spring (probably April). I will post here about the correction. I did have a chance to talk to a laser surgeon who seemed to be pretty confident about the procedure and the risks (he was not the doctor who did the original surgery).

My worry is that the enhancement starts the healing process all over again.

I was glad to hear about the contact to steepen the cornea. I'd heard about that but had no further information. Keep me posted if it works or if you have the enhancement done.

Thanks!

 
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Old 12-15-2012, 09:57 AM   #4
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Re: Overcorrected, Enhancement?

Hi David.
Thank you for your reply. According yo my doctor, the contacts work in about 50% of the cases. After my check up yesterday I verified they are just regular contacts with +0.75 prescription (luckily they are rather comfortable and I can wear them overnight).
Honestly, I do not have a lot of confidence in this approach, but we'll see.
As for the enhancement surgery, I have been told that it is usually successful. There is a different region of the cornea being reshaped so the part that was reshaped already should not be affected. But, there is definitely healing involved.

Good luck with your enhancement - please let us know how it went and I'll let you know if contacts made any difference.

Happy holidays!

 
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Old 02-05-2013, 09:08 PM   #5
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Mig0932 HB User
Re: Overcorrected, Enhancement?

Hi,
I may be in the same boat. I had my surgery on January 23rd

My manifest refraction pre-surgery was:
Right Eye: -3.50 SPH -1.25 Cyl 90 Axis (myopic astigmatism)
Left Eye: -3.50 SPH -1.00 Cyl 90 Axis (myopic astigmatism)

The reading of the topolizer pre-surgery was:
Right Eye: -3.25 SPH -1.50 Cyl 94 Axis (myopic astigmatism)
Left Eye: -3.25 SPH -1.50 Cyl 73 Axis (myopic astigmatism)

Surprisingly, at my first exam post-op I had 20/20 vision in the right eye and could see some of the letters on the same line with my left.
Then, at the first week post-op exam, the results were:
Right Eye: +.75 SPH .75 Cyl 180 Axis (mixed astigmatism)
Left Eye: +.5 SPH .75 Cyl 180 axis (mixed astigmatism)

I am 55 and was already presbyotic, so this is discomforting, but I think the astigmatism is the worse. The optometrist who examined me said we have to give it time to settle, but a week later (today) nothing has changed.

If things do not improve significantly, I will definitely consider going through with an enhancement after the three months wait.

 
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Old 02-06-2013, 02:47 PM   #6
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Re: Overcorrected, Enhancement?

Hi Mig,

Sorry to hear that your correction was not perfect. I do understand the discomfort - it is so much easier to deal with presbyopia when one is nearsighted...

I am two months out and my vision has not improved. Actually, my distance vision has been sharper in the first weeks but now everything has settled at around +1.5 - according to the doctor, same prescription in both eyes even though I feel I see better with my right eye...I guess this is subjective.

The contacts approach did not make any difference (and honestly, I did not expect much), so I have scheduled the enhancement for mid-April. In the meantime, it's reading glasses or contacts from close and mid-range vision (reading, computer) and nothing for driving etc...Still better than before but I certainly hope the enhancement will fix the farsighted problem.

Best regards.

 
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Old 02-18-2013, 08:14 AM   #7
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Re: Overcorrected, Enhancement?

Hi,
My one month post-op exam is scheduled for Wednesday, February 20th. My own assesment is that overcorrection may have gone down by .25D at most and astigmatisme has not changed in magnitude but has shifted a bit in angle (differently in each eye too). I will see on Wednesday.

Waterpony, thank you for your kind words.
David590, hang in there.

I have read a ton of material on refractive surgery in the last weeks.
One thing I would like to add. Despite my somewhat disappointing results so far, I must say that I received excellent services from my surgeon and all the staff at the clinic, both pre-op, at surgery time and post-op.

 
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Old 02-21-2013, 07:50 AM   #8
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Re: Overcorrected, Enhancement?

Hi,
I had my one month post-op exam yesterday as scheduled.
From the slit-lamp examination, there are no issues i.e no flap microstriae to speak of, no epithelial ingrowth, etc...
Standard acuity measurement indicate that asigmatism is gone in the right eye and has regressed in the left eye. The optemetrist also said that the initial overcorrection has decreased.
I disagreed with her assessment of my visual acuity, stating that the double vision for objects closer than two meters persisted, although it had improved. I said that I was still farsighted and no only prebiopic, but that the distance at which I could focus perfectly had slightly diminished, hence my ability to watch tv at two meters much more comfortably than at week one. She answered that I could have a cycloplegic refraction exam and a corneal topography done at my next exam two months from now if I wanted.
Note: cycloplegic refraction measurement is the refraction measured when the eye focuses at infinity with no accomodation effort (cilliary muscles are totally relaxed). A farsighted person has to accomodate even to see distant objects, but this will not be revealed by a standard test at 20 feet, because the slighlty farsighted individual will often easily accomodate to get best focus at that distance. the cycloplegic refraction measurement is obtained after the administration of eye drops that paralyzes the cilliary muscles. It is important to do that measurement to get a true prescription value. A presbiopic person with otherwise normal vision simply does not have the accomodating power to focus on nearby objects (typically reading distance to computer work distance for most presbiopics). If on top of that the presbiopic person has been corrected into hypermetropia, the distance at which that person can come to best focus is increased. The difference between the slighly farsighted and presbiopic person and a person simply presbiopic is that the former will be able to focus let us say on objects beyond three meters while the latter can focus nearer (let us say a meter and a half).
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I am not a doctor or health professionnal.
Anything I post on a subject is based on my personal understanding of it.

 
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Old 04-22-2013, 11:42 AM   #9
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waterpony HB User
Re: Overcorrected, Enhancement?

Hi guys,

How are you doing? I just wanted to give you an update - my enhancement surgery was scheduled for my left eye last wednesday. I am very pleased with the result. My close-up vision has returned! Even with only one eye corrected, I can see the computer with no glasses. The feeling is somewhat bizarre, I will admit, because my other eye is still overcorrected, but overall my vision is so much better now. The reading is still challenging, so I took out one lens from the reading glasses I've been using. I know it sounds weird but it works
Now, I will admit that the distance vision on my corrected eye is not as sharp as it was - I am not sure if that is because I got so used to a great distance vision or am I slightly nearsighted now. But, it is too early to tell, I know. My next check-up is in a week, so I guess I'll find out.
Good luck to you guys!

 
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Old 09-25-2013, 12:51 AM   #10
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david590 HB User
Re: Overcorrected, Enhancement?

Well I had my correction done and the vision almost perfect for distance now. This was three months ago and I still have dry eye but otherwise things seem good. The optometrist says that I am -.25 in the left eye and 0.0 in the right eye. That works for me. There's some prism though but otherwise the vision is great.

The doctor was great in Istanbul and the Clinic was really top-notch again. They really were caring and concerned and understood how I was feeling. The procedure was relatively quick but seeing someone come at you with a scaple to re-open the flap was a little nerve racking!

I'm enjoying the benefits but I wouldn't do it again. There's just too much risk. Perhaps LASEK (PRK) but not LASIK. Had I known that the cornea never heals I would have never done it. If someone is considering it look at LASEK which does not cut a flap. There are risks, too, of course, and I am not a doctor, but it seems to me to be a more conservative approach.

Dave

Quote:
Originally Posted by waterpony View Post
Hi David.
Thank you for your reply. According yo my doctor, the contacts work in about 50% of the cases. After my check up yesterday I verified they are just regular contacts with +0.75 prescription (luckily they are rather comfortable and I can wear them overnight).
Honestly, I do not have a lot of confidence in this approach, but we'll see.
As for the enhancement surgery, I have been told that it is usually successful. There is a different region of the cornea being reshaped so the part that was reshaped already should not be affected. But, there is definitely healing involved.

Good luck with your enhancement - please let us know how it went and I'll let you know if contacts made any difference.

Happy holidays!

 
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Old 09-25-2013, 02:24 AM   #11
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david590 HB User
Re: Overcorrected, Enhancement?

Just a note on the contacts... Yes, they worked well actually and interestingly I didn't have any dry eye with them in because they were moisturized. I had one eye for near and one eye for distance (monovision) which worked perfectly. I'm planing on wearing one for near distance in my non-dominant eye as soon as the doctor gives his okay.

I hope you are all doing well!

Dave

Quote:
Originally Posted by david590 View Post
Well I had my correction done and the vision almost perfect for distance now. This was three months ago and I still have dry eye but otherwise things seem good. The optometrist says that I am -.25 in the left eye and 0.0 in the right eye. That works for me. There's some prism though but otherwise the vision is great.

The doctor was great in Istanbul and the Clinic was really top-notch again. They really were caring and concerned and understood how I was feeling. The procedure was relatively quick but seeing someone come at you with a scaple to re-open the flap was a little nerve racking!

I'm enjoying the benefits but I wouldn't do it again. There's just too much risk. Perhaps LASEK (PRK) but not LASIK. Had I known that the cornea never heals I would have never done it. If someone is considering it look at LASEK which does not cut a flap. There are risks, too, of course, and I am not a doctor, but it seems to me to be a more conservative approach.

Dave

 
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Old 01-06-2014, 01:10 PM   #12
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danielmm HB User
Re: Overcorrected, Enhancement?

Hi everyone,

Many thanks for sharing your experiences! Here is mine:

I had LASIK done 3 days ago and I have just seen the optician, as they have clearly overcorrected it.

Pre-surgery: -4.50 -4.25 (and a good amount of astigmatism which I cannot recall right now)
Post-surgery: +0.50 +0.75 (I think little to no astigmatism, will check)

Too early to tell whether it's permanent, he said, what with inflammation and all, so for now I just have to wear reading glasses and wait. Funnily enough, I'm using +2 glasses to look at the screen and they're adequate so I'm not sure how much I should trust that measurement.

If this doesn't completely fix itself in the next 2 months, all else being well I am definitely going for an "enhancement" procedure, which they have been very reassuring about.

I will keep this updated with further developments.

Cheers,
Daniel

 
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Old 01-06-2014, 01:36 PM   #13
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david590 HB User
Re: Overcorrected, Enhancement?

Hi Daniel,

As far as I know, "normal" screen correction should be 1.0 and for reading 2.0.

Your values sound very similar to mine which are now excellent after the correction. The dry-eye is taking longer to heal this time though. After 6 months I still have to use drops from time to time.

Best of Luck,

Dave

 
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Old 01-12-2014, 10:07 AM   #14
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Re: Overcorrected, Enhancement?

Hi Dave,

Many thanks! Had I read your posts here and other people's I may have not gone straight for LASIK either, but considered other options. I did kind of jump into it headfirst. I've always had dry-ish eyes so this makes it much worse.

Also, I was hoping that the cornea will heal (i.e. close the flap) at some point, and that if it doesn't do it naturally there is some procedure to do it (e.g. what they do for LASEK). I will check with doctors and such.

Best,
Daniel

Quote:
Originally Posted by david590 View Post
Hi Daniel,

As far as I know, "normal" screen correction should be 1.0 and for reading 2.0.

Your values sound very similar to mine which are now excellent after the correction. The dry-eye is taking longer to heal this time though. After 6 months I still have to use drops from time to time.

Best of Luck,

Dave

 
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