8 weeks post lasik for hyperopia question

It's now 8 weeks since I had lasik for hyperopia.
I realised that I would need reading glasses but was unsure about
middle distance vision.
I have regressed since the op and am at 2 diopters for reading and 1
diopter for middle distance.
Long distance is pretty perfect.

I have an appointment in approx 4 weeks and was wondering if I could
ask for an enhancement and what I should ask for. Ideally I would like
middle distance without glasses, even if it was at the expense of
loosing a little long distance.

I am also considering buying some glasses (bifocal or varifocals) to
cover the middle and short distance problems, at 8 weeks is my
prescription likely to change or will it have settled?

Thanks in advance.

Unfortunately hyperopic LASIK commonly regresses, and may continue,
which means you might need stronger glasses in another month or two. If
you have an enhancement, have them shoot for about 1.50 overcorrection,
and hope for no more than another .5 of regression after that one.

w.stacy, o.d.

(E-Mail Removed) wrote:

>It's now 8 weeks since I had lasik for hyperopia.
>I realised that I would need reading glasses but was unsure about
>middle distance vision.
>I have regressed since the op and am at 2 diopters for reading and 1
>diopter for middle distance.
>Long distance is pretty perfect.
>
>I have an appointment in approx 4 weeks and was wondering if I could
>ask for an enhancement and what I should ask for. Ideally I would like
>middle distance without glasses, even if it was at the expense of
>loosing a little long distance.
>
>I am also considering buying some glasses (bifocal or varifocals) to
>cover the middle and short distance problems, at 8 weeks is my
>prescription likely to change or will it have settled?
>
>Thanks in advance.
>
>
>

In article <wKeQg.6569$(E-Mail Removed)>,
William Stacy <(E-Mail Removed)> wrote:

> Unfortunately hyperopic LASIK commonly regresses, and may continue,
> which means you might need stronger glasses in another month or two. If
> you have an enhancement, have them shoot for about 1.50 overcorrection,
> and hope for no more than another .5 of regression after that one.
>
> w.stacy, o.d.

Dear Bill,

Please don't play into the LASIK marketing strategy using the
terminology of "enhancement". It's a make-nice, sugar coated term for
*retreatment* or *repeat surgery* and as you know, has similar risks as
the first surgery.

LB, O.D.

Play into? That's what they've been called since the first one. I have
a problem calling it a retreatment since it is another surgery, not just
a treatment, and repeat surgery would suggest recutting the flap, which
it almost NEVER entails. The patient knows what is meant by lifting the
flap and relasering. I see it as having much less risk, since no
cutting, no pressure/suction ring trauma, although the flollowup
care/cautions are obviously the same as the original procedure.

BTW I wouldn't recommend hyperopic lasik to anyone, esp. a presbyope,
but since she already had it done, not much ADDITIONAL risk in having a,
what shall I call it, a flap lift?

w.stacy, o.d.

LarryDoc wrote:

>In article <wKeQg.6569$(E-Mail Removed)>,
> William Stacy <(E-Mail Removed)> wrote:
>
>
>
>>Unfortunately hyperopic LASIK commonly regresses, and may continue,
>>which means you might need stronger glasses in another month or two. If
>>you have an enhancement, have them shoot for about 1.50 overcorrection,
>>and hope for no more than another .5 of regression after that one.
>>
>>w.stacy, o.d.
>>
>>
>
>Dear Bill,
>
>Please don't play into the LASIK marketing strategy using the
>terminology of "enhancement". It's a make-nice, sugar coated term for
>*retreatment* or *repeat surgery* and as you know, has similar risks as
>the first surgery.
>
>LB, O.D.
>
>

I use "enhancement surgery" to remind folks that is surgery.

The idea of Lasik overcorrection from hyperopia (farsighted,
longsighted) into myopia (nearsighted, shortsighted) vision is
theoretically appropriate for select patients, but there is nothing
that screws up a perfectly good theory faster than reality. Try the
reality in contacts first.

If you think that 1.50 diopters myopic would be a good final result,
get fitted with contacts that provide -1.50 vision. Wear them
religiously for at least a month and see how you actually like the
world of myopia. You may find that you want to be more myopic, less
myopic, or not myopic at all. You can try different refractive error
until you determine what is best for your individual needs. Then, and
really only then, should you consider having that correction attempted
with Lasik or Lasik enhancement surgery.

Two months after Lasik is commonly enough time to know where your
vision will settle, but not with hyperopic correction. Hyperopic
correction often regresses. It is probably best that you do not
consider having enhancement surgery until at least six months postop,
and possibly even longer.

Glenn Hagele
Executive Director
USAEyes.org
Patient Advocacy Surgeon Certification

"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.

Copyright 2006
All Rights Reserved

LarryDoc wrote:
>
> Dear Bill,
>
> Please don't play into the LASIK marketing strategy using the
> terminology of "enhancement". It's a make-nice, sugar coated term for
> *retreatment* or *repeat surgery* and as you know, has similar risks as
> the first surgery.
>
> LB, O.D.


Here goes another one seeing monsters under his bed. No one is
"playing into any lasik marketing strategy" here. Just giving advise,
that's all, no secret agendas.

Glenn wrote:
> I use "enhancement surgery" to remind folks that is surgery.

Good! As long as "surgery" is included, I don't have the slightest
problem. Just honesty. I know you agree!

What I DO have an issue with is the practices that call it simply
"enhancement", which conveys the impression that all is well and all you
need is a little extra something to make it better. And THAT is
disingenuous.

Bill wrote:

>Play into? That's what they've been called since the first one.
That doesn't make it right. Just like "through away your glasses and
contacts!" and "now with all-laser LASIK and CustomCornea you can have
20/20, even 20/15 vision!" Come on, you've heard the ads! Come on down!

>I have a problem calling it a retreatment since it is another surgery,
>not just a treatment,
Ah, but you you just said it's another surgery. So call it what it is!

> and repeat surgery would suggest recutting the
>flap, which it almost NEVER entails.

But hitting it with the laser and altering the cornea tissue is most
certainly SURGERY.

>The patient knows what is meant
>by lifting the flap and relasering.

Patient for the most part know only what we tell them, so why not tell
them the truth?

> I see it as having much less risk,
>since no cutting, no pressure/suction ring trauma, although the
>flollowup care/cautions are obviously the same as the original
procedure.

It might be less risky, but it is not without risk and the outcome of
the additional surgery is far from certain.

My ONLY contention is simply to be honest with our disclosures and
presentation. So stop using disingenuous and misleading terminology.

LB, O.D.

LarryDoc wrote:
>
> That doesn't make it right. Just like "through away your glasses and
> contacts!" and "now with all-laser LASIK and CustomCornea you can have
> 20/20, even 20/15 vision!" Come on, you've heard the ads! Come on down!
>

Actually, as you probably know, many LASIK and wave front patients can
indeed throw away their glasses and contacts. Millions have. What IS
your problem?


> Patient for the most part know only what we tell them, so why not tell
> them the truth?
>

Who's lying about what? I would never tell a patient to go back and
have a "touch up" without informing them that it entails more surgery!

> It might be less risky, but it is not without risk and the outcome of
> the additional surgery is far from certain.

I presume you have some documentation where the enhancements (flap
lifts, re-surgery, whatever you want to call it) has less than positive
benefits? I've never seen one go wrong yet.
>
> My ONLY contention is simply to be honest with our disclosures and
> presentation. So stop using disingenuous and misleading terminology.

Those are strong words. I have made some people happy with
retreatments. The terminology is secondary and, I think, a bit picaune.

As someone once told me, Chill...