Five months ago I had Lasik. The right eye was -1.25 -1.00 110 and turned out 20/20 at -.25 but the left is a big problem.
Original: -.75 -2.00 88
Current: -.75 +1.50 175

The examining doctor at the lasik clinic, not the one who did the surgery, seemed somewhat concerned and bit bewildered when I asked about the results. He said it cannot be corrected with a visx laser and is not optimistic about it getting much better. He wants to look at it again in 6 more weeks.

Questions:
1) What went wrong here? It looks like the laser put a pit in my eye. This is not a case of simple over-correction, is it? The myopia wasn't touched.

2) Could a contact lens be fitted for this strange RX - I mean is it realistically possible to fit it?

3) What other options have I got?

Fortunately, I'm Right eye dominant but this is causing problems in low light situations and for reading and night driving. I'm 48 years old. I could use some advice.

You need to convert the numbers, because you are working with negative and positive cylinders. The conversion is such

Old-.75 -2.00 X 88 -

Convert to positive cylinder format

-2.75 + 2.00 X 178

After laser: -.75 +1.50 X 175

So you can see that the laser corrected your myopia, but for some reason your astigmatism was not improved.
The VISX laser should be able to treat your eye later this summer once the new software gets approved. It is a little complicated to explan why you can not be corrected currently in the U.S., but once the new software gets approved - you can be treated.

I hope this helps explain your situation

Bill Trattler, MD
Miami, FL

If your current prescription truly is -.75 + 1.50 x 175, and if yourastigmatism is regular on the topo map, then this is mixed astigmatism and can usually be corrected by astigmatic keratotomy or AK. In AK, one or usually two tiny arc-shaped slits are placed in the PERIPHERAL cornea to reduce the astigmatism. This will also, in this case, reduce your myopia.
I would recommend AK over a laser enhancement in this particular case

Vincent deLuise MD

Dear Tom,

Instead of trying to solve what went wrong, it seems more important to solve what can be done. If the astigmatism is real, then I would try to lift the flap and place one or two small AK incisions along the axis with the astigmatism. That might eliminate the entire problem. Ask your doctor if he
agrees.

Joel H. Goffman, M.D.

Dr. Trattler, I know how opposed you are to my traveling to Canada for LASIK, but when you mention new software being approved for the VISX, is that just in the US? Would this perhaps already be in use in Canada? Does it have a particular name or version number I can ask about? If you would prefer to take this to email please feel free to write .

Thank you!

I am more than happy to provide information if I know the answer. Can you tell me which type of software you are interested in. VISX is currently planning to perform wave-front guided treatments, but I do not know whether they have begun these studies yet. Their web site is at VISX.com
If you have irregular astigmatism or a central island, this type of treatment may be helpful (we do not know yet, as it is still experimental). If you are interested in being involved in the studies, you should contact VISX and ask them to send you this information.
I am happy to help

Bill Trattler, MD
Miami, FL

I forgot what forum I was in. I don't have an irregular astigmatism, but the idea that there is a software upgrade coming to the US this summer made me wonder if it is one that is available and in use in Canada. I wanted to find out what it was so I could ask my doctor if he's using and is familiar with the latest upgrade.

I have read all the white papers at the VISX website. I didn't find anything about it, perhaps because their focus is on the United States.

Dear Dr. Trattler:
What will the new VISX software do? Is it approved yet?