Laser adjustment after cataract surgery

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The surgeon who did my cataract operation has agreed to a laser adjustment, for the astigmatism (cylinder = -0.5 or -0.75) and for the slight over correction (Sphere = +0.5 or +0.75).

But I am not sure what target strength to request, particularly as both the cylinder and sphere will be adjusted). I would be happy to be slightly undercorrected (as I was previously very short-sighted, and the mid distance vision would be easier) providing the distance vision is sufficient for say daytime driving (I wouldn't mind wearing glasses to drive at night). My prescription before the catarct op was -15 sphere. 

  

The other eye is scheduled to be done next year, following an unsuccessful contact lens trial (strength -11 go -14 diopters) - that unfortunately produced fluctuating double vision and prescription strength.

 

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10 Replies

  • Posted

    Just aim for -0.25 to 0. That is what I asked for during my LASIK enhancement and have been pleased with the result.
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  • Posted

    Thank you.  That will cure the over-correction, without the risk of coming out too low to have a clear enough focus eg when walking and driving.

    I don't know what the degree of tolerance is with a laser adjustment, but if he is aiming to reduce by 0.5 of a diopter I guess the tolerance must be not more than 0.25 ?

    I am slightly confused about the effect of correcting the minus astigmatism on the overall strenght- but perhaps he uses a formula to deal with that, so the aimed for overall strength is still achieved ?

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  • Posted

    The two main questions about a laser adjustment (only about +0.75 diopter sphere and -0.5 diopter cylinder:

    1) What is the degree of risk, given I was very myopic (-15), and

    2) What is the degree of tolerance in the prescription correction - ie. is there a risk of overshooting, then needing a second laser adjustment ?

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    • Posted

      The answers to your questions depend to some extent on how good the LASIK equipment is (some are more modern than the others) and of course, the skill of the surgeon. So, it is best to talk with your LASIK surgeon to get his / her response to your questions.

      Based on my experience with LASIK for my eyes:

      1. Considering that your needed correction is quite small, the cornea thickness (or your degree of myopia before cataract surgery) should not be an issue.

      2. If you aim for the -0.25D to 0 prescription range after LASIK, but end up in the -0.5 D to -0.25D range, that will still provide you a lot better vision over a wider distance range than what you have right now.

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  • Posted

    I will ask the surgeon (who did my left eye cataract operation).

    If the result was - 0.5, would that still provide good enough distance vision for eg driving, especially at night?

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    • Posted

      If your correction did overshoot to -0.50, your far distance vision or the night vision for driving should be as good as you have right now. More importantly, your vision will be much better (than now) at intermediate distances (should be about 20/25 or so at 40 inches)
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    • Posted

      This definitely sounds advantageous, and worth the cost of private treatment.  However, my optomotrist, who is very experienced and used to work at the same hospital eye department,  is not in favour - she thinks there is the risk of damage leading to a fuzzy area of vision, that the result might not be accurate, and that the prescription can be corrected with progressive glasses with no risk involved.

      I feel that the slight reduction would improve both distance and mid distance, and is worth trying providing the result will be accurate and that there isn't an appreciable risk.

      I am sure the surgeon would give a risk assessment and also describe the tolerance of the outcome.  He may not do the laser treatment himself, but I guess he would refer or recommend.    I think his advice is the best way to decide if it is wise to go ahead.

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    • Posted

      I think that it will also be good to talk with one or more LASIK surgeons in your area. Most of them in Seattle area provide a consultation free of charge.
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    • Posted

      We are in the UK, but the surgeon at the NHS hospital who did the operation is very experienced.

      I am certain he would be very careful and conservative, and will advise about the degree of risk, of the margin in the prescription outcome and whether he recommends laser overall. (He is also a vitreo-retinal specialist).    

      With the left eye, text on television is not sufficiently clear (upright lines appear slightly double), viewing at about 8' - 8'6" feet away. *I also notice distortion on reflections on eg metal candlesticks at a similar distance The optometrist said not everyone would notice this, given the small degree of over correction and astigmatism, and thinks it might be due to the left eye being the non-dominant one.   She said viewing will be much better when I am using both eyes together after the op, and advised to have the right eye op done before considering laser correction to the left, which she thought had a degree of risk of which might cause a fuzzy / cloudy area of vision - probably not worth risking given that progressive glasses will deal with the slight over-correction and the astigmatism, and could perhaps incorporate micro-monovision to give a little more range of focus.

      So the main advantage of a laser touch-up is not needing to wear specs for distance and middle vision, and using weaker reading glasses.

       

      The optometrist says it will be easier after the right eye is operated on (rather than using the left eye with the other completely out of focus due to -15 myopia) but I am not sure she is right?

      *noticeably improved by wearing +0.5 or +0.75 over the counter glasses.

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    • Posted

      You can take your time making the decision with the various information which you have.
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