Aged 61 and myopic since childhood, I had EPI-LASEK in Oct 2004 from an experienced UK ophthalmologist. [I chose this method as it is less invasive, vitamin C treatment avoids haze, and my surgeon is highly experienced in this alternative. This is not the main issue in my post.]
My pre-op scrip was R –5.0/-0.75/90 and L –2.0/-2.5/85; R eye dominant. BCVA 20/20 [slightly better in the R eye]. Several clinics decided that I am not a candidate for wavefront.
The agreed target was R 0/0 L –1/0 i.e. a monovision/blended vision solution with the aspiration that I will not need reading glasses after treatment. LASEK involved pulling back the epithelium, lasering with a Technolas 217, and repositioning of the epithelium.
The outcome after 3 months is R +1.0/-1.25/90 L +0.5/-1.0/70 and appears stable. Astigmatism on the R eye was –2.0 after 1 month so has reduced but there have been no other changes. No side effects like haze or night driving problems. My myopia has obviously gone and my visual acuity is approx 18/20. I need glasses to read most print except in bright light.

Clearly the monovision solution has not been achieved. The surgeon has suggested two enhancement steps. Firstly, a LASEK enhancement of the R eye to attempt to remove the astigmatism that was induced. Secondly, if I wish it, later LASEK enhancement on the L eye to try to achieve the –1/0 profile that will give greater reading ability.

I would really appreciate any comments or evidence anyone can offer regarding the probability/likelihood of a worthwhile improvement in either case. I have confidence in the surgeon’s skills but it seems difficult to determine the inherent variability of the process including healing.

Is it possible to be more accurate when the correction to be attempted is smaller as now or is there a real risk of making things worse e.g. by induced astigmatism?