I had a few questions concerning candidacy for lasik.
I will be using the autonomous ladarvision laser. my current prescript is as follows:
-3.00 x -3.75 x 180
-4.0 x -3.75 x 180
I also had my cycloplegic exam done today and was at:
-3.0 x -4.5 x 180 and -3.5 x -4.0 x 180

I realize I have a high degree of astigmatism and my pupils have been measured at both 6 mm and 7 mm.
My questions
1. Am I a good candidate
2. is this the laser for me
3. what is the estimated enhancement rate for my prescription
4. what would or should be realistic expectations for me? everyone talks about having realistic expectations, but I don't know what would be considered realistic to know if I am OK with that.
5. should the 2 different measurements on my pupils concern me?
6. Should the regular eye script reading and the cycloplegic ones be different? this seems like a big difference to me.
7. what are the standards around corneal thickness? I don't have my numbers with me, but my Dr made extra sure and redid calculations to ensure I would have enough cornea after the surgery. He did comment that I might possibly not have enough left for an enhancement. I did see somewhere on this site about wanting at least 250 microns left undisturbed.

Thank you for your responses and I have found a wealth of knowledge on this site and more questions to ask my Dr's. than I ever thought. This is a great resource!

jennifer

Jennifer,
The first comment I can make - do not even consider LASIK is your doctor says that there will not be plenty of room for an enhancement. Your risk of enhancement is very high - every center is different, but it may range from 10-30% per eye. As well, patients with high astigmatism are at higher risk of ending up with some irregular astigmatism or monocular double vision, so you should proceed cautiously.
Another concern is your large pupils. The autonomous laser is probably the best laser for large pupils, as it can increase the optical zones. But larger optical zones result in deeper tissue removals (and corneal thickness is an issue).
An alternative option is PRK or LASEK. PRK is surface laser. LASEK is a modification of PRK, where an epithelial flap is made, and then replaced after the laser. PRK and LASEK appear to have similar visual results as LASIK. The advantages of PRK and LASEK is that you do not need to worry about flap wrinkles or flap problems, nor a condition called DLK. As well, since no flap is made with PRK, you have more cornea to work with (corneal thickness is less of an issue).
Obviously every procedure has risks -so please talk with your doctor about all of the risks of PRK and/or LASEK to help you understand what is best for you.

Best of luck

Bill Trattler, MD
Miami, FL

Dr. Trattler,

Thank you for your response - can you tell me what corneal thickness range I should be looking at total, for an enhancement and the original procedure and a little more on LASEK, including where I might find info. Never heard of it and tried to look briefly for info. is it new or what? THANKS AGAIN!