Ryan Carter52 said:Hey Billy the Kid, thanks so much for the detailed breakdown and those links!
Unfortunately, those guys aren't even an option!
Back in 1995, I actually gave hard contact lenses a shot—my eye doctor insisted they were a healthier choice than the soft ones—but man, I just couldn't stand them. They were so uncomfortable! Then, when I went in to get a new prescription about a year ago, things got even weirder. The technicians couldn't even get an accurate reading because apparently, after having laser surgery, the surface of your pupil changes shape. They told me there’s a real chance I might never be able to wear contacts at all. To top it all off, my glasses prescription is -3.5, but when they measured me for contacts, they came back at a 5.0?? It's such a headache.
So, I was just digging through some old records from my laser clinic the other day—you know how it is, always finding little nuggets of info when you least expect it—and I found this:
Pre-op checkup:
I'm looking at some Tonus Apl 19mm—for both eyes.
I just got my Schirmer test results back—looks like I'm sitting at 5mm for both eyes.
I just got my latest eye exam results back from Medtronic—it’s always a little nerve-wracking waiting for those numbers to pop up! So, here is the breakdown: my spherical correction is sitting at 0.00, my cylinder is at 0.60, and the axis is at -14.0. Honestly, it’s nothing too crazy, but I guess I'll be seeing my optometrist again sooner than I thought!
It’s been 8 days since my surgery—and honestly, I'm hanging in there!
Just got my latest eye exam results back from Medtronic—sc is sitting at 0.30, cc is up to 0.70, and my correction is -0.25. Not exactly perfect vision, but hey, we're getting there!
So, looking at the numbers—the projected post-op prescription is sitting right at -1.50.
Optical zone: 5.50mm
So, I was looking back at my old glasses prescription from way back in 2008, and it says this:
So, I just checked my prescription and I'm sitting at a -3.50—not too bad, but definitely enough to make life a bit blurry without my glasses! It’s funny how you don't realize how much you rely on them until everything starts looking like an impressionist painting. Anyone else in a similar boat?
My vision is looking a little bit off lately—I’m sitting at 0.5 in my left eye and 0.8 in my right.
So, I was just looking at my latest measurements—my pupil diameter is sitting right at 6.5mm! It’s funny how much you start noticing these little details once you get into the swing of things, isn't it?
I’ve been doing a bit of digging through some American forums lately, and I'm seeing a lot of people talking about going back in for follow-up procedures—some opting for LASIK and others for PRK. It seems like everyone is having a pretty great experience; most folks are reporting that everything went smoothly and, best of all, those annoying halos they were dealing with have finally cleared up!
Of course, it all really comes down to how much healthy tissue they have left over from that first surgery—that’s the deciding factor in whether a second procedure is even an option at all.
At my first consultation, they told me I could easily go down to -18 without any issues—totally safe for the eyes, considering how much thickness we have to work with!
So, I guess I’ll probably need to head over to Medtronic just for that initial consultation—you know, to get a clear picture of where things actually stand. Once I have the full rundown, then I can make a real call on whether I should go through with the surgery or just leave things exactly as they are.
To be honest, I don't think most ophthalmologists are really equipped to handle the tricky post-LASIK issues—at least not based on what I’ve seen. It feels like a lot of eye doctors actually know surprisingly little about laser correction procedures. My hunch? If you have an irregular cornea, those automated computer tests might just get totally tripped up because the curvature isn't uniform. It's a bit of a headache, really!
You know, there are actually specialists overseas who focus specifically on crafting custom semi-rigid lenses—they basically design them from scratch to fit each patient's unique eye shape. You just send over an eye scan, and they mail the finished lenses right to your door! There’s actually a whole deep dive on this in that massive thread about laser eye surgery started by Disney, who deals with some pretty similar issues himself. Here's the link:
I read about this a while back—I can't quite remember which page it was on, though—but I think the post is probably around a year old now.
When it comes to those 6.5mm pupil measurements, I have to say—I’m a little skeptical about the conditions they were taken under. Some of these machines aren't exactly cutting edge; they can give you a reading even if the lighting isn't totally dark or if the focus is slightly off. In my experience, if you really want an accurate number, you've got to use an infrared pupilometer. It just makes a world of difference!
I was just looking back at that thread I linked earlier regarding how some of our local clinics handle their measurements—and honestly, it’s a bit of a mess. To put it bluntly, the methods they're using are completely unreliable. It’s like they aren't even trying to get it right! Take the staff over at Mayo Clinic, for example—it wouldn't have been any harm to actually check the pupils without all that light interference. In fact, there's a good chance they still haven't bothered to do it properly.
Looking at those results you shared—specifically that comparison of best-corrected vision before and after the procedure—it does show an improvement from 0.6 to 0.7. But here’s the thing about high myopia: when you're looking through glasses, everything looks a bit smaller, which can make your measured visual acuity seem lower than it actually is. If we were talking about contact lenses, the numbers would look totally different! So, it's very likely that the surgery didn't actually change your vision compared to what you could achieve with lenses. Also, let's be real—visual acuity changes depending on how much light you have, but these clinics usually ignore that part of the equation when they're trying to show off how successful their surgeries were.
When they mentioned that the cornea is safe for LASIK up to -18 diopters, they weren't actually talking about avoiding GASH—they were referring to keratoconus. That’s the condition where the cornea becomes too thin under the LASIK flap. Honestly, it might be theoretically impossible for someone with a -18 prescription to undergo an older laser treatment without facing GASH symptoms; you'd need unlit pupil sizes to stay under 4mm, which—if you ask me—is highly unlikely to happen at all.
And even with keratoconus, there's no absolute guarantee it won't develop, even if the corneal thickness under the flap stays above 250 micrometers.
So, why would some surgeons still push ahead with these procedures? Well, it’s pretty obvious they figure a patient's signed consent regarding GASH risks covers their tracks—basically treating the risk as "not that big of a deal" since they're tackling high myopia, and many patients could just settle for hard contact lenses anyway. If clinics were too strict about the wide-pupil criteria, they’d lose too many customers, which means less revenue and potentially putting the whole practice in the red.
Here are some forum links related to this topic:
http://en.allexperts.com/q/Laser-Eye...tarburst-1.htm
http://www.lasik-flap.com/forum/view...a04686b8e9e4b6
http://www.lasermyeye.org/forums/sho...?t=2553&page=4
The issue with clinics here in the States is that they often lack the top-tier tech needed to handle these specific complications. Plus, some surgeons act more like irresponsible businessmen than medical professionals (especially when they don't bother measuring unlit pupils). It's also hard to say how effective the Ivis Suite mentioned in that last link really is; until some actual peer-reviewed research comes out, we're mostly just relying on anecdotal stories from forum users, which can be hit or miss.
Undergoing surgery always carries extra risk. It wouldn't hurt to have a chat with Dr. Smith over at Medtronic just to gather more info, but please—take everything with a grain of salt. Surgeons can sometimes be a bit too "persuasive" when they want to close a deal and secure that procedure fee.
Getting LASIK again could lead to some really tough consequences for you, because the flap would have to be lifted a second time, which usually leads to subpar results. On top of that, if -18 is the limit, using a new LASIK correction to fix your standard prescription would likely bring the corneal thickness under the flap down to
right at the bare minimum threshold that surgeons consider acceptable.
PRK can offer better results, but if you've had LASIK before, you'd always have to use MMC, and we still don't truly know what the long-term risks of that are.
Still, I wonder if PRK would even work for correcting your prescription, since you'd have to go quite deep into a flap that's already questionable in thickness. If the goal is just to reduce higher-order aberrations (rather than fixing the actual prescription), then maybe it's doable. But is current laser technology truly mature enough to solve these issues with total certainty? That's a huge question mark for me. I haven't found any research that proves it works reliably; most studies just seem to debunk the fears. People on forums claim the Ivis Suite is the most powerful tool for these issues, but until the data is published, it’s really just a matter of faith.
