I had RK on my left eye only in 1987 (both my eyes were approx -8.00 plus some astigmatism.)RK corrected my left eye only to -4.25, so I did not proceed with RK in the right eye.

12 years later, in 1999, I had Lasik on both eyes. The right eye, which had not had previous RK, turned out perfectly; 20/20, and has stayed that way. The doctor was afraid of overcorrection on the left eye due to the previous RK, so after Lasik, I was still undercorrected in that eye. An enhancement several months later left me still undercorrected; I'm now about -2.00 with some astigmatism. (I presently correct this to 20/20 by wearing glasses.) I believe I have enough cornea left for Lasik to correct this; the doctor was just not as aggressive with this eye due to the previous RK.

I had a good doctor and have had no trouble after any of my surgeries and healed very quickly. I would, however, like to reduce the nearsightedness and astigmatism in my left eye if it is possible. My question is, which surgery do you think is best, if any; 1) epithelial PRK or 2) a second Lasik enhancement. It's been 3 years since the flap has been lifted, and this is a flap with previous RK. Or are there any new surgeries or lasers that you think I should wait for? I'm worried that if I wait too long, I lose any chance of having the flap lifted. Thanks!

Charlotte,
It would be helpful to know your age. If you are
nearing or are older than 40 you need to consider
the advantage of being nearsighted in one eye. If
the astigmatism is not too high you might want to
consider an astigmatic keratotomy which is related
to RK. By remaining nearsighted in one eye you
will be able to read without glasses. As you have
already hinted, lifting a flap late is potentially
difficult. Lifting one which has had RK would be
even riskier. You mentioned that you have had no
problems with your previous surgeries but each
intervention has it's own risks and you can have
no guarantee's you will continue with such good
luck. Let us know your age and complete RX.
Leonard Friedman MD Washington D

Thanks for your reply. In answer to your questions, I am 48 years old. The way my prescription is written, my RX (for glasses) in the left eye for distance vision only is -1.00 spherical, -0.75 cylindrical, axis 110. For near vision correction, both eyes are +1.75. I'd appreciate your opinion on what you think my best option may be at this point. Also, although I've heard that remaining nearsighted in one eye will help me read as I get older, I'm wondering if this is temporary and will not help forever as one ages and develops further presbyopia.

The first thing I would recommend is to correct
the eye with a contact and see what it is like to
lose the near vision you are getting now by being
slightly under corrected. I recomment against PRK
because of the risk of haze. Lifting the flap is
also risky. You can reduce some of the
nearsightedness by doing an AK which will help
with the small amount of astigmatism. However if
you can read well in spite of the small
astigmatism, don't do anything. I hope this
helps. What is the status of your other eye?
Leonard Friedman MD Washington DC