Wednesday, June 29, 2011

LASIK Over Correction-What is It-Can It be Fixed?

Question: What exactly is LASIK "over correction"? Is it possible to perform another procedure to correct it? Or, is it too late once it is already done?

Answer: An over correction from Laser Eye Surgery such as LASIK is as the name implies, a situation where the end result of the treatment has created "too much" correction rather than the exact attempted or intended amount of correction. This can happen from time to time for many reasons that may include but not be limited to instability of the prescription when it was measured during the initial examination perhaps due to previous contact lens wear, swelling and deswelling of the cornea due to hormonal changes-this can easily happen during pregnancy or when Laser Eye Surgery has been performed too early in the post partum period or too close to the cessation of nursing or simply just not getting a precise refraction at the examination. More common though is the fact that each eye just heals slightly different and sometimes it can result in an over correction. If the over correction is considerable and it disturbs vision, after waiting approximately 90 days after the surgery it is usually possible to adjust the prescription with and enhancement procedure.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, June 27, 2011

LASIK after Rigid Contact Lens Wear

Question: I have been wearing gas permeable contacts lenses for over 30 years and have been told that I will need to wear glasses for the next two months in order to be able to get an accurate exam of my eyes prior to potential laser eye surgery. Would you concur with this suggestion if you were to do my eye surgery? I would appreciate your candidness.


Answer: Top Laser Eye Surgeons strive to get the best possible results for their patients. Because contact lenses have been overly commercialized, patients often forget that they are medical devices and do impact the shape, structure and surface of the cornea. Long term rigid gas permeable lens wear-30 years for sure-is highly likely to cause some degree of corneal shape change or "molding' as well as some change in corneal thickness as well as alteration of the tear film stability. ALL of these are critical factors in determining your ultimate suitability for as well as treatment parameters and protocol for LASIK Surgery or any type of Laser Eye Surgery and in fact even Cataract Surgery. Discontinuation of Rigid Gas Permeable Contact Lens wear prior to Laser Eye Surgery such as LASIK is based on clinical research and experience that indicates that in order for the cornea to return to it's "normal' state and be stable, it requires a "lens free" period of 6-12 weeks on average. Sometimes it can take a little less time-sometimes a little more. Follow the advice of a top eye surgeon is the best course of action.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

LASIK Surgery after RK?

Question: In April of 1995 I received Radial Keratotomy. My uncorrected vision improved from 20/600 to 20/25-20/30. I've noticed over the years that my left eye vision has decreased a little, plus there may be a little astigmatism. Does having that surgery preclude me from LASIK because of the cuts on my cornea?

Answer: In order to get the best results from LASIK Surgery careful patient selection and the skill of the LASIK Surgeon are probably the two most important factors. Having had previous corneal surgery does add a degree of complexity to the decision but does not necessarily exclude you from being a good candidate for Laser Eye Surgery or Laser Vision Correction. Careful evaluation of the position and depth of the previous incisions as well as the current shape, thickness and health of your cornea will play a role in whether any type of Laser Eye Surgery might be appropriate. In addition, the stability of the prescription and the regularity of the cornea may alos be factors. Last, it might very well be possible that you might be a better candidate for other types of Laser Eye Surgery, such as PRK, rather than LASIK. All of these considerations can be evaluated by a top LASIK Surgeon who can then advise you on the options that might be available to you. Your next step is to schedule an examination and consultation with a LASIK Surgeon in your area to explore your individual situation. You can also check our blog posts from: Lasik After RK on May 16, Lasik After RK on May 6 and Lasik After RK on March 15, 2011.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on www.seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of www.seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, June 17, 2011

LASIK Enhancement-Bladeless or Traditional?

Question: I had LASIK 8 months ago. I had a free flap and now I have debris under the flap and some under correction. Now I want to go for a LASIK enhancement. Is it safe to have an enhancement with traditional LASIK or should I have Femtosecond laser LASIK with i LASIK or Z-LASIK?


Answer: Having a LASIK enhancement is a second surgery and should only be done if it is absolutely medically and optically necessary. First, you must have enough corneal thickness remaining to safely have an enhancement. Second, you are assuming that you will need to have another flap created in order to have the excimer laser enhancement of the LASIK surgery. This may or not be the case as it is often possible to lift the previously prepared flap-although 8 months after the primary LASIK procedure is a bit far out-but not impossible. Of you do need a new flap prepared there is really equivocal data to support whether traditional LASIK or Femtosecond laser LASIK is actually safer. The key to a safe and effective LASIK procedure is the hands of the LASIK Surgeon and not really which method is used to make the flap. Just as you had a complication of a free flap with traditional LASIK, it is also entirely possible to have other flap complications with Femtosecond Bladeless LASIK as well. Your next step should be to find the best LASIK Surgeon in your area and schedule a consultation-and they will help you decide on whether the flap can be lifted or whether a new flap should be created and the best way to do it for you.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Sunday, June 12, 2011

Laser Surgery after Cornea Transplant

Question: I am very active (play soccer and tennis), and am 62 years old. have keratoconus and I had a cornea transplant 20 years ago. A few stitches remain. I had cataract surgery 10 years ago. With corrective lenses my vision improves somewhat, but not fully, and even with a contact lens, my vision is not fully correctable. Would this surgery make my vision as good as or better than contact or corrective lenses.

Answer: It is impossible to tell whether LASIK or Laser Eye Surgery of the cornea for vision correction would offer you any benefit as it is unclear as to why you have reduced vision. If the decrease in vision is due to any sort of retinal problem, such as Age Related Macular Degeneration (AMD), the answer is there will not be any improvement. If the vision is due to posterior capsular opacification as a late complication of the cataract surgery, then no, Laser Eye Surgery of the cornea for vision correction will not help, but perhaps this could be treated by other means. If the decreased vision is due to an irregular shape or irregular astigmatism of the cornea, then one would expect a rigid contact lens to offer considerably improved vision-and perhaps it is possible the PRK Laser Eye Surgery of the cornea might afford close or equivalent vision for you. Your best next step is to schedule a consultation with a top Laser Eye Surgeon who is also a Corneal Specialist and have them evaluate your situation and determine what is possible.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, June 7, 2011

LASIK after Retinal Detachment

Question: I had cataract surgery over two years ago.Then I had a retinal detachment and they put in a gas bag in it and it leaked out too soon so they put a silicon bag in it and it had to stay in for three months.When they took it out my vision went to 20/50. They're saying I have chronic dry eyes and I was wondering if LASIK could fix my problem.

Answer: Laser Eye Surgery such as LASIK is used to correct nearsightedness, farsightedness and astigmatism to help patients see more clearly at distance. It is not apparent from your description whether the decrease in your vision is due to a simple refractive error such as those mentioned, or due to the condition of the retina after your retinal detachment, or even some other issues from the multiple surgeries you have had. That said, if in fact you have chronic dry eyes that are not treatable, you would not be a suitable candidate for LASIK as it requires a normal quality and quantity of tears for a successful surgery.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Sunday, June 5, 2011

LASIK Surgery for High Farsightedness

Question: I am very farsighted and would like to know if I am eligible for LASIK? My contact lens prescription is +4.50 D in my left eye and +5.25 D in my right eye.

Answer: Being eligible to have LASIK Surgery really depends on more than just your prescription. Technically there are excimer lasers that can be programmed to provide up to +6.00 D of refractive correction. However, other considerations that come into play include the shape of your cornea, you age, the health and integrity of your cornea, the quality and quantity of your tear film and the stability of your prescription, to name just a few. There are a number of other considerations as well. LASIK for high hyperopia may be appropriate however probably would not be the procedure of choice due to a high incidence of regression and instability of the prescription. PRK is often a better alternative and depending on your age it is possible that Lens Replacement Surgery might be the best option with the highest levels of patient satisfaction. Your next step is to find the best LASIK Surgeon in your area who is a comprehensive Refractive Surgeon and also can provide consultation for Lens Implants.
Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on seewithlasik.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, June 2, 2011

Contact Lens Problem Risk Factors

Researchers publishing in the eye care journal Investigative Ophthalmology and Visual Science reported results from the Contact Lens Assessment in Youth (CLAY) Study

Regarding the risk factors for corneal infiltrative and inflammatory events in young soft contact lens wearers. Charts from 3549 contact lens patients were examined for the period January 2006 to September 2009 and found to produce 187 corneal infiltrative and inflammatory events (CIEs) in 159 wearers. Age was a significant factor with the most significant risk to those between 15 and 25 years of age. Having a contact lens wearing history of less than one year of soft contact lens (SCL) use was less risky than for longer periods of use. Patients who used multi-purpose care products had 2.86 times more risk of CIE, those wearing silicone hydrogels had 1.85 times more risk of CIE and those wearing their contact lenses on an extended wear basis had 2.37 times greater risk of infiltrates and inflammation from the contacts. The authors concluded “Patient age, years of lens wear, use of multi-purpose care products, silicone hydrogels and extended wear were all significantly associated with CIEs with SCL wear. Use of SCLs in young patients aged 8 to 15 years was associated with lower risk of infiltrative events compared to teens and young adults.”

Wednesday, June 1, 2011

Additional Cell Type Causes Dry Eye

According to the National Eye Institute of U.S. National Institutes of Health, Dry Eye disease occurs when the eyes do not produce an adequate quantity of tears and/or when tears natural evaporate too quickly. As many as five million Americans, 50 years of age and older, are estimated to suffer from Dry Eyes, with the majority affected being women. Tens of millions more are believed to have similar, but less severe Dry Eye symptoms. Current help for Dry Eye can consist of prescribing artificial tear eye drops to increase the amount of tear in the eyes, insertion of tiny tear duct plugs to help retain tears and prescription medication such as Restasis® eye drops to combat the inflammation in the Lacrimal Gland that often prevents you from producing enough of your own tears.

Now, there is even additional good news on the horizon for the millions of people around the world who struggle with dry eye disease. Researchers reporting in the Journal of Leukocyte Biology have identified that the presence of Natural Killer (NK) cells that normally offer immunity to the eye may actually promote inflammation and play a critical role in causing Dry Eye. The identification of these cells as one of the causes of Dry Eyes will hopefully all for the treatment the cellular cause of the disease rather than its symptoms through the development of new medications.