I had LASIK on both eyes about 5 months ago.
My right eye (dominant one) was before +4.5 / 1.0 / 90, my left eye was +5.5 / 1.25 / 85. Optical zone was 6.0 / 6.0 on both eyes.
Ablation depth was 73 microns on right and 90 microns on left eye (laser Meditec MEL 70 G-Scan).

I have now almost good vision on right eye (dominant one) but a lot of ghost images on left eye.
I see on topographs taken at one week, one month, three months and five months that the healing process is not
finished yet, but the left eye is far from spherical surface of a perfect eye (I have two decentrated islands, one above the other).

On last visit I have discussed the possibility to have an enhancement for the left eye with the new technology (TOSCA or WASCA).
But the MD was afraid to raise the flap because he said "my K is too thin and it might happen that we do something wrong".
We both decided to wait for another three months to see if the healing process will reduce the islands.

My three months topograph figures (Tomey system) are :

OD : SimK:47.95 @ 94s / 47.53 @ 4s MinK:47.48 @ 41s SRI:0.43 SAI:0.67 PVA:20/20-20/25
OS : SimK:50.17 @ 131s / 47.28 @ 41s MinK:45.83 @ 17s SRI:1.13 SAI:0.83 PVA:20/30-20/40

Please translate above figures for me and tell me if there is any chance to see better with my left eye.
Because my right eye is the dominant one, I can see quite well without closing the left eye, so I am not sure if I should try to
make a new intervention on my left eye (I know a word saying that better is the enemy of good).

Thank you and best regards,

I can not translate your topographies, because the visual information is most important. You should perhaps get a second opinion - as what you are asking requires a complete eye exam and a careful evaluation of the topographies and refractions.

I wish I could help more

Best of luck

Bill Trattler, MD
Miami, FL

I'm starting at about +5D in each eye with no astigmatism. I'm also scheduled for surgery on January 12.

I understand by reading some of your posts that you don't perform Lasik on patients over +4D. After my research, I think I understand why.

However, I have worn glasses since I was 2. I am now 30. I can't really see even with my glasses today and am at least hoping for enough of an improvement to make my vision (even with glasses) better.

What other technologies, would be options for me? Could Lasik help to improve my situation?

I know the FDA has approved the procedure, and that my surgeon will only do up to +5D (he does have his limitations). I know others are very unhappy with their H-Lasik results, but I'm willing to gamble if the potential results are promising.

A twist on an old saying... I'd love to reach the stars, but I'll be happy just to land on the moon.

Any advice would be appreciated.

You may want to speak to Dr. Chu. I recently read an article where he mentioned that he is reducing the amount of hyperopia that he will treat to a maximum of 3 diopters. My current level is 4.
There are other options besides LASIK - which include
1.clear lens extraction: basically the same as cataract surgery, where your lens is removed and a new lens is placed. There are a variety fo risks with this surgery, which you would need to discuss with your surgeon
2. an implantable contact lens: not FDA approved yet. This technology is exciting, but there are also risks.

I hope this helps

Bill Trattler, MD
Miami, FL

Mike,
Please contact me at

patti brankov

I had a similar prescription to you prior to lasik 3 mos ago +4.75 Right and +5.25 Left and have the same problem Right eye is almost 20/20 and left is now 20/50 with severe ghosting at the 6 o'clock position and like you my Right eye is also dominant so I don't notice unless I close my Right eye. I see my surgeon tomorrow and so far he hasn't mentioned any island but I will ask and post back.

Good luck to you I know *EXACTLY* what you're going through.

Don

I spoke to my surgeon today on questioned a small spot on the topography at the bottom of my visual axis and he acknowledged it may be a small island and said it may get better with time as I am only 3mos post Lasik.

Back to the waiting game.

It is interesting that so many of us hyperopic lasik patients have irregular astigmatisms after lasik. I am 4 months post lasik. Before I was about +2.75 in both eyes. I now have severe ghosting in my left eye. My surgeon is considering an enhancement in my rt. eye. I had 3-month follow-up last month. The snelling chart tests indicated my left vision is ok. I would gladly trade the “good” vision with ghosts for my right imperfect vision. My left eye is dominant and if I use my rt. eye very long my left eye crosses. To clarify what I just said – Although the vision test indicates the opposite, I can see much better with my right eye than with the left.

During the surgery they did my right eye then the left immediately after. During the ablation of the left eye, someone put their hand on by head as if to brace it but they seemed to be moving my head during the ablation. It was as if they had their left hand on my head to brace it and were waving a flag or something with their right arm causing the pressure on their left hand on my head to fluctuate. QUESTION: Could this have caused decentralization? They used the Autonomous Ladarvision laser. It almost seemed like they were trying to modify the results with their hand as one would when playing a pin ball machine except this was much more subtle. Would they try to test the limits of the laser's tracking system this way?

Has anyone else had an experience that may have caused the laser to get off center?

I am a little confused. Are you saying that someone was purposefully moving your head around during the LASIK procedure? This would be highly irregular and innapropriate (if you are suggesting that they were testing the tracking of the laser). If this were the case, you could have irregular astigmatism, decentration, or other problems.
You may want to consider a second opinion.

Best of luck

Bill Trattler, MD
Miami, FL

I am scheduled for Lasik surgery on January 12. Like you, I am starting at about +5D in both eyes. I do not have any astigmatism.

I know you've had problems, but have you been happy overall with your results?

I have been glued to these bulletin boards for the last six weeks. I have searched the net, spent hours at the library, and have inundated my surgeon with questions. (I think he'll be really glad when he's rid of me!)

Some things I read/hear are terrible about Lasik. Other things are wonderful. I personally know eleven other people (ten have gone to my surgeon) that have had Lasik and all are very happy. At the same time, all of them were myopic. I would love to hear from someone that started out as hyperopic as me that was happy with their results.

Kimberly, yes, I can say I am happy, but not 100% as I was not lucky enough to get as good as right eye result for the left one.
I wish you good luck but please consider also the bad side of the story, it may happen that you will fall into 5% patients with postop problems.

Kimberly,

I have not talked to one hyperope who has not regressed after LASIK who had more than a +2 pre-op Rx. Some of them are back to their original Rx and some of them have become even more farsighted. I would suggest that you talk to Dr. Robert Maloney in Los Angeles about hyperopic LASIK. He is the only surgeon I know of who has been able to utter an honest comment about H-LASIK results.

Mostly for Daniel but others might find this helps.Pre lasik I was
R +3.00 -.50@82 L.+3.50 -.25@90.
I month R -1.50.-1.25@120 L-2.50 -1.50@165
15 months R 0.00 -1.75@130 L-0.75 -1.75@165
Thus regression has only happened on the myopic side and with the astigmatism, I have not gone back to being hyperopic.Unfortunatley I am unable to find any doctor who will treat this astigmatism, which is getting worse in my left eye with severe GASH. So technically you can achieve hyperopic lasik without regression back to the hyperopia but at the expense of other problems.

I am going to translate your prescriptions into plus cylinder, which is more commonly used:

Your final refraction would be:

-1.75 + 1.75 X 40 (right)
-2.50 + 1.75 X 75 (left eye)

The main problem that you have at this point with both eyes is the astigmatism, which if you had enhanced, could be eliminated. An enhancement for the astigmatism only would potentially leave you with 0.00 sphere on the right and -0.50 on the left. I do not know why any doctor would not treat that astigmatism - there is nothing to difficult about it.
As for your night time symptoms - are you currently wearing glasses when you drive at night. The reason that you might be having night time symptoms is that without correction (or atleast an accurate correction in your glasses), then the light is not focused well, and you will jhave night time symptoms. So I was wondering whether you were using glasses, and if so how they affect your night time vision.

Best of luck

Bill Trattler, MD
Miami, FL

Many, many thanks for your response.To hear(read) something positive is wonderful. Now you have. translated the prescription into Plus, it actually makes more sense. I couldnt understand why, with so little refraction 0.00.& 0.75 I am still seeing everything in the distance at a blurr. NOW it makes sense!. I go for another consultation on January 4th so will find out exactly why my doctor is reluctant to enhance my eyes. I assumed that it was because of the low figures and he didnt want to make the eyes regress. But this may not be the case... I shall attend in a more positive frame of mind now.
With regard to glasses. I need them for anything that I do which is not within a 6/8 foot radius.
The astigmatism is at all distance in my right eye but left eye only starts at about 6 feet away.
It is impossible to drive at any time without glasses, but during the dark I feel I am a danger to myself and others, so avoid night driving since my treatment. Glasses eliminate four of the ghosts on the left eye and lessen the one complete image above the real object, two ghosts on the right are eliminated with glasses but glasses only make a slight difference to the starbursts.(Left only)Christmas lights are a definate NO NO. it makes me feel sick to look at them!. Maybe you read something here that tells you why he wont treat me?

It is likely that the multiple images that you are seeing are related to the astigmatism you have. If the glasses indeed eliminate all of the multiple images, then an enhancement designed to elimiante the astigmatism should hopefully accomplish the same.
I do not know why your doctor will not treat you further, but you should certainly get a second opinion.

Best of luck

Bill Trattler, MD
miami, FL