I went to two different doctors to see if I was a candidate for LASIK.

The first doctor said that he could perform Custom LASIK, but that it was possible there wouldn't be sufficient tissue remaining to do an enhancement afterwards if necessary. Alternately he could do a conventional LASIK treatment, which would require less tissue, but would have an increased probability of needing an enhancement and possibly having night vision issues.

The second doctor said that due to my corneal thickenss and prescription level that he would perform the procedure in two steps. First a conventional LASIK treatment to correct the majority of my prescription. Then about 3 months later he would retreat with Custom LASIK. Since the Custom procedure removes more tissue per diopter than conventional, he explained operating in this manner would result in less tissue loss (since the Custom would only be used for the small diopter correction).

Both doctors would be using VISX CustomVue with Intralase. Experience and reputation for both doctors were very similar (very high). Price was also essentially identical.

My question is: What will be the end difference in two eyes, one that under went a full Custom treatment and the second that had this two step Custom treatment? It doesn't seem possible to me that the two step process can end up with the same results as the one step without removing the same amount of tissue.

how thin are your corneas and how high is your pescription? PRK or even IOLs may be an option

>how thin are your corneas and how
>high is your pescription? PRK or
>even IOLs may be an option
>

Hopefully, I'm writing this correctly:
-7.00 -1.50 x 160
-7.50 -2.00 x 015
thickness about 535

Yes, in the research that I've done since meeting with both doctors, it's starting to look to me that PRK may be a much better option. I'm surprised that neither doctor suggested it. I guess that brings up an additional question: Is there any expected difference in the results for a Custom PRK treatment versus a Custom LASIK treatment?

I'm still curious about the answer to my original question though (even if I'm not a good candidate for LASIK).

-Tim

Your surgeon may be right. With that much myopia and astigmastim, youd get one shot with lasik. Pretty risky if something goes wrong, you wont have enough for enhancement. PRK is definately the better option but theres a risk of haze. If you can tolerate contacts or dont mind glasses, its best to wait for something better to come out :)