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Old 02-05-2013, 01:02 PM   #1
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My lasik experience and worries

Hi,
I got Lasik surgery on both eyes on January 23rd and right now I am a little anxious about the long term results. I would very much like if someone on this board could comment on my experience and vision progress or lack thereof.

First I would like to tell you that I am a 55 year old man and I had presbyiopia as well as moderate myopia and astigmatism since I was ten. I wanted to undergo lasik surgery to correct my distance vision and knew right away that this would not help the prebyopia. I thus knew that I would still need glasses to work at the computer and to read.

Now, here is some information on my visual condition at the time I went to the lasik clinic in early January 2013 for an evaluation exam. Normal ocular pressure, normal peripheral vision, no sign of cataract, no dry eye, no sign of any corneal disease or other eye disease. Just a small scar on the right cornea, well below and to the right of my dilated pupil. The scar, given its size and location, was considered unimportant by the optometrist.

Here are my pre-surgery data:

Prescription for my 3 year old progressive glasses:
Right Eye: -3.75 SPH -1.50 Cyl 95 Axis (myopic astigmatism) add +2.25 (for presbyopia)
Left Eye: -3.75 SPH -1.25 Cyl 90 Axis (myopic astigmatism) add +2.25 (for presbyopia)

I could see most of the line below the 20/15 line with my glasses at my first evaluation exam at the lasik clinic

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)

The topolizer images showed a regular corneal surface for both eyes.

I had a 6mm dilated pupil for each eye and corneal thickness was 615 microns for the right eye and 619 microns for the left eye.

I met the surgeon the day of the operation. I had Intralase SBK for the flap and Wavefront Optimized correction with the Allegretto Wave EYE-Q 400. The surgeon told me that he was going for a 6.5mm true optical zone plus a transition zone of few more millimeters, such as is normal for a wavefront optimized treatment. He also told me that he was using the manifest refration data to program the laser, plus a slight over correction of .25 diopters to account for expected regression. He said that there was an 80% to 85% probability that I would end up seeing as well as with my glasses after my vision had stabilized, given my age, my health condition and my actual refraction errors.

The sugery itself went very well. The immediate postop exam under the slit lamp confirmed that everything was looking good. I saw the world through a haze, which was normal. My wife drove me home. I kept the provided sunglasses all day, kept my eyes closed all day, except for putting on all the drops of course. The discomfort in my eyes was berable and had almost completely disappeared by the time I went to bed.

At my first post-op exam the day after, I saw 20/20 with my right eye and could see two letters of the 20/20 line with my left eye, that was a bit blurry. The corneal exam under the slit lamp showed everything was good. In fact, I was thrilled. That night I watched TV and everything was cristal clear with the right eye and still a bit hazy with the left. I went out and saw some haloes and starbusts from bright lights, but nothing troublesome. I could have driven without any problem.

Over the next few days, I noticed a few things. In broad daylight, outside (with the provided sunglasses on mind you) I tested my distance vision at around 20/15 using an eye chart. I was also able to accomodate clearly objects farther than 5 feet away. I took the sunglasses off for a few minutes and experience no light sensitivity whatsoever at noon on a sunny day in a very bright sunny landscape. I put the sunglasses back on according to post-op instructions. At night outside (without sunglasses), the halos and starbusts had diminished to almost the level experienced.I did not feel dry eyes but I knew they were dry because putting in artificial tears made me feel more comfortable and improved my vision for a moment. Inside during the day but especially in the evening under normal (not too bright lighting), I could not see anything clearly at 20 feet or less. I could not accomodate well at shorter distances than 20 feet and of course the closer the object the blurrier the image. Under those conditions, I became very aware that I now had astigmatism at 180 degrees: a luminous point at six feet, such as the power led on the tv, would appear blurred and also doubled horizontally with each eye and also with binocular vision.

I hypothesized that the much better day light vision resulted from a smaller pupil under such lighting, which increases depth of field as well as hides corneal aberrations outside the pupil diameter zone.

At my first week post-up exam, on January 30th, things were not as good, around 20/40 for each eye. Testing the refraction, here are the results:

Right Eye: +.75 SPH .75 Cyl 180 Axis (mixed astigmatism)
Left Eye: +.5 SPH .75 Cyl 180 axis (mixed astigmatism)

I told the optometrist pretty much everything I have written here so far on my post surgery experienced. He told me that the overcorrection he just observed was likely there on day one, but I could see 20/20 in his exam room on day one because of the remaining liquid between the flap and the cornea and possibly some inflammation, both factors influencing the refraction. Plus, my eyes were watery the day after and they were not a week after.

He told me to give it time, and that it would be up to three months for my vision to stabilize. He also said that each patient may heal differently and that is why the surgeon indicated an 80% probability of seeing as well without glasses after surgery as I was seeing with glasses prior to surgery. He also added that at three months deadline, an enhancement would be possible if needed.

I felt somewhat reassured.

Now, from my reading I know that the bulk of changes in vision post lasik occur within the first week. So, I think it is unlikely that I will not need an enhancement.

There is something else that I just considered today, in light of the fact that my glasses were at -3.75, my manifest refraction at -3.50, and my topographic corneal data at -3.25. This means that my eyes were always accomodating with my glasses and therefore would it be possible that my manifest refraction was erroneous because my eyes were so used to accomodate at all times that I did not have a relaxed lens?

Sorry for the long post, but any comments or opinions would be very much appreciated.

 
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Old 02-13-2013, 05:25 PM   #2
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Re: My lasik experience and worries

Update February 13th

About a week ago, I started using drops a lot more, at least every hour, after realizing that my eyes were very dry even if they did not feel dry.

My vision is still progressing, but progress is very slow. I can now watch TV comfortably, which I could not do the first time I wrote. Astigmatism in my right eye is decreasing faster than in my left eye, but it has gone down in both.

I believe that the initial overcorrection is slowly regressing.

Glare and starbusts, which were not a big issue, are getting dimmer.

I have my first month post-up next week.

Progess is slow as I said, but it is moving in the right direction.

Vision outside during daytime is still great. I would assess it at 20/19 in my left eye and 20/16 in my right eye.

 
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Old 02-27-2013, 08:20 PM   #3
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Re: My lasik experience and worries

Update February 27th, six weeks after lasik

Had my one month post-op last week. Both corneas were healing well, no flap complication of any kind. I still was slighlty overcorrected, but it has regressed since my one week post-op exam.

Today, a week later, things have progressed some more. Haloes and starbust have diminished again. Astigmatism, which is more noticeable in dim lighting, has also decreased.

I am writing this at the computer without glasses. Mind you, it is fuzzy, but readable. Could not have done that two weeks ago.

I put drop in my eyes five times a day (Refresh Endura in one use vials, without presrvative, and it seems to be enough.

Daylight distance vision is now at 20/16 in each eye.

I practice archery and pistol shooting. I tried bow shooting two weeks ago indoors at night and could not see my sight, despite fairly good lighting at the practice range. . For pistol, the front sight was so fuzzy that I did not even try. I went to archery practice last night and when I concentrated on my sight I could see it well enough too shoot well. Will try the pistol again next weekend.

Things are improving. For people who do not see well after a few weeks, I will say: be patient.

I am much less anxious now than I was when I first wrote, even if everything is not perfect yet
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Old 03-20-2013, 01:00 PM   #4
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Re: My lasik experience and worries

It has been eight weeks today that I had lasik surgery.
My vision is still changing but at a very slow pace. My left eye is not as good as my right eye at intermediate (6-7 feet) and close distances, as it still has noticeable astigmatism. Distance vision during the day is still very good and night vision, which was not so bad at first, has improved.
I can work at a computer most of the time without glasses even though there is some fuzziness.
My eyes are not so dry anymore. I put eye drops 3 times a day now.
My next exam at my lasik clinic is scheduled for May 3, but I am seeing my regular optometrist tomorrow.

To all people who have had lasik surgery in the last few weeks or days and are uncertain and even anxious about their results (like I was), I can only recommend patience. The healing process can indeed be slow
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Old 03-23-2013, 10:14 PM   #5
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Re: My lasik experience and worries

I went to my regular optometrist on March 21.
My eyes are still drier than normal, but not terribly so.
My numbers:
Right eye: +.25 with .5 astigmatism at 180 (mixed astigmatism)
left eye: +.25 with .25 astigmatism at 180 (mixed astigmatism)
So my vision is still progressing slowly after eight weeks. My chart measurement is 20/15 for each eye.
At this stage, I consider my lasik surgery to be a success even if things stabilized right where they are now
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Old 03-25-2013, 09:22 AM   #6
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Re: My lasik experience and worries

I am glad to hear that your vision has continued to improve. It is a slower healing process than most people realize. I had mine a little over a year ago, to correct fairly significant myopia (-5.50, -6.00). In the first month afterwards, I was somewhat frustrated by the remaining asigmatism in my left eye and the fact that it was somewhat undercorrected. I had 20/20 in my right eye immediately, but a fuzzy 20/30 in the left. It slowly continued to improve and at my one year follow up a couple weeks ago, I now have 20/25 in both eyes and although there is a little astigmatism yet in the left eye, my brain has adjusted so that I do not even notice it. I am confident that in a few months you will be even happier with your results.

Kally

 
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Old 05-03-2013, 09:45 AM   #7
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Re: My lasik experience and worries

I had a another post-op exam today, slightly more than three onths after surgery.
Prescription:
Right eye: 0 spherical and 0 cylinder
Left eye : +0.25 spherical and 0 cylinder.
I can read the 20/15 line with each eye.
I can stop using eye drops, my tear production and eye lubrication have returned to pre-op level.
Haloes and starbusts have diminished yet again, to the level I was experiencing with my glasses prior to lasik surgery and, according to my surgeon, they may diminish slightly more over the next three months.

I could not be happier with the results. Of course, at the age of 56, I need reading glasses. However, the cheap drugstore reading glasses at +2.00 do the job just fine.

As you can see if you read my earlier posts, the road was bumpy at times. The healing process does take time, even for people like me who have not experienced long term complications.
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Old 06-18-2013, 12:35 PM   #8
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Re: My lasik experience and worries

Wow Mig0932. That sounds fantastic! It looks like your doctor had it planned perfectly, so that when you were done healing, your eyes would be golden!

20/15, with no more astigmatism! I'm glad it went so well for you!

Last edited by PlayLoud; 06-18-2013 at 01:55 PM.

 
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