I have been pre-screened and was told I was a good candidate for Lasik. I now need to determine if I should have Lasik in one eye or both eyes. I am 31 years old and have troubles wearing contacts (toric) and my prescription is as follows:

OD: Pl, -1.00, 145
OS: +2.75, -1.50, 005

As you can tell, I have very little prescription in my OD (right eye). Yes, I do see better with glasses in that eye, but I don't know if the surgery risk is worth it for that eye since my vision isn't that bad. I do however want to have Lasik performed in my OS (left) eye to bring the eyes closer together.

Any opinions on whether or not you would recommend Lasik for the eye with very little prescription.

Mike

It seems to me that the best route would be to have surgery only on the worse eye, wait until the end of the healing process, and then decide from experiencing your "new" vision if surgery on the eye that only has astigmatism is desired. There is no reason to make this decision now, and you may find that surgery on the one eye is enough to provide what you seek.

Glenn Hagele
http://USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

Thanks for the follow up.

In your opinion, would you risk having the Lasik procedure done on the eye that only has astigmatism? I know it is a personal choice, but I'm just looking for an unbiased opinion. My whole purpose for wanting the Lasik is cosmetic.........with eyeglasses my left eye is magnified due to the hyperopia while my right eye looks normal. I want both eyes to look similar if I have to wear eyeglasses.

If I only get the left eye corrected, I will more than likely still need to wear glasses to correct the astigmatism in the right eye. Would a non-prescription plastic lens be used for the corrected eye or how would that be handled.

Thanks
Mike

You would have lenses in both sides of the glasses and they would provide any needed correction. If you do not need correction, the lens would be “clear”.

You have asked for my personal opinion on astigmatism-only surgery. I do not perceive the potential benefit to be worth the potential risk, HOWEVER this opinion only applies to me, my values, and my experiences. You are a different person and your opinion may be that the potential benefit is very much worth the risk. Only you can decide what is best for you.

Glenn Hagele
http://USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

After looking at my prescription from the Lasik doctor, it looks different from my optometrist’s prescription.

Prescription from my optometrist:
OD: Pl, -1.00, 145
OS: +2.75, -1.50, 005

Prescription from Lasik Dr.
OD: -1.00, +1.00, 145
OS: +1.25, +1.50, 005

Why the difference in prescriptions when I see fine out of my eyeglass prescription from the optometrist? Based on the Lasik Dr’s prescription, it looks like I now have 1.00 diopter of myopia in the right eye in comparison to Plano from my optometrist.

In your professional opinion, you did not recommend having Lasik done on the right eye and I’m kind of leaning toward your advice. If I do, however, elect to have it done on my right eye, I’ve read that hyperopia can be induced by correcting only the astigmatism. Is this true? I do not want to end up hyperopic in my right eye.

Thanks and I really appreciate your advice.

Mike

One prescription is in minus cylinder, and the other is in plus cylinder. A detailed explanation is at http://www.usaeyes.org/lasik/faq/read-eyeglasses-contacts-prescription.htm

Double check the last number from script to script. They should be different.

The physics of laser assisted refractive surgery causes a coupling effect that automatically creates a myopic (nearsighted, shortsighted) correction whenever astigmatic correction is performed - even if you don't want it. The ratio is about 0.25 – 0.35 diopter of myopic correction for every 1.00 diopter of astigmatism correction. Each system is a little different. There is some ability to offset this, but it is limited. It would be reasonable to expect the need of enhancement surgery to “fine tune” the correction if you go for astigmatism-only correction. I don’t want to sound overly pessimistic and it may not be necessary, but be prepared just in case.

Glenn Hagele
http://www.USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

Thank you for all of your advice. I think I’ve decided against having Lasik for the eye with only astigmatism, but am still interested in having Lasik for the hyperopic eye with astigmatism. I do not like the magnification in my left eye when I wear glasses.

I’ve been doing some research since your last response and I’m finding mixed opinions on hyperopic lasik. Given my prescription from an earlier post (+2.75, -1.50, 005), do you feel there is a good percentage of achieving plano for that eye. I’ve read regression with hyperopic lasik is a lot greater than with myopic lasik. Is this true?

Also, as I get older, will my eye with only astigmatism (pl, -1.00, 145) more than likely become hyperopic? I am 31 years old right now. I’d hate to correct one for hyperopia now and then have hyperopia in the other in 5 or 10 years.

I guess in the end, if I have to wear glasses, I’d like my eyes to look similar to each other and not magnify as my left eye does now due to the hyperopia.

Thanks
Mike