Hi doctors,
I'm short sighted (-2, -1.75) with astigmatism
(-4.5, -3.5) and considering LASIK. I've heard 2 different oppinions from 2 different doctors. One uses Visx Star, said that most likely because of the astigmatism, I'll need enhancement in 3 months after the procedure. The second uses the newest Nidek, said that most likely I WILL NOT need enhancement because the Nidek can correct both of them better than any other laser.
both are highly qualified doctors.
I'm so confused. Please advise.

Thanks in advance,
Mike.

I don't think either doctor is probably right. There is really no way to determine ahead of time who will or will not need an enhancement. I've had patients with very small amounts of nearsightedness require enhancement and others with very large amounts of myopia and astigmatism not require any. Be sure that communication between you and your doctor is good. I tell all my patients that they may need enhancement and then we're all happy when we don't need to (which is most of the time). Good luck.
Steven Ofner, M.D.
Eugene, Oregon
http://www.eugeneeyecare.com

There is always a chance that someone will need an enhancement with LASIK, so I would be careful of the person who claims that you would not need an enhancement. The published studies of LASIK show that in general, 90 to 98% (depending on the study) of patients will have 20/40 or better vision. With higher levels of myopia, the chance of having 20/40 or better vision will decrease. I am not aware of any published studies that have shown the Nidek to have a 100% success rate. I have also found 3 studies that used the Nidek laser for patients with similar levels of refractive error. (summaries published in eyeWorld August 1999). One study had 85% of patients reach 20/40 or better, while the other 2 studies had 98.9% and 95.6% of patients reach 20/40. Thus, these studies had results similar to the VISX laser - with a small percentage of patients needing enhancements.
It worries me when surgeons make claims as you have mentioned (no chance of enhancement). Plese let me know what your thoughts are.

Bill Trattler, MD
Miami, FL

Thank you Dr.Ofner.
Thanks Dr.Trattler. As far as my thoughts go, I feel more comfortable with the one who said that there is a good chance I'll need an enhancement. (Althoug he's a lot more expensive). I'm afraid the other doctor just doesn't want to bother achieving the best possible results by doing enhancement if needed (his fee is relatevely low). I won't know whether I can do better or not after the procedure because I suppose I'll be better that what I'm now any way, which would be great to me. I think the one who predicts enhancement is the way to go.
Thanks again,
Mike.

>There is always a chance that someone
>will need an enhancement with LASIK,
>so I would be careful of
>the person who claims that you
>would not need an enhancement.
>The published studies of LASIK show
>that in general, 90 to 98%
>(depending on the study) of patients
>will have 20/40 or better vision.
> With higher levels of myopia,
>the chance of having 20/40 or
>better vision will decrease. I am
>not aware of any published studies
>that have shown the Nidek to
>have a 100% success rate.
>I have also found 3 studies
>that used the Nidek laser for
>patients with similar levels of refractive
>error. (summaries published in eyeWorld
>August 1999). One study
>had 85% of patients reach 20/40
>or better, while the other 2
>studies had 98.9% and 95.6%
>of patients reach 20/40. Thus,
>these studies had results similar to
>the VISX laser - with
>a small percentage of patients needing
>enhancements. It worries
>me when surgeons make claims as
>you have mentioned (no chance of
>enhancement). Plese let me know
>what your thoughts are.

>Bill Trattler, MDMiami, FL