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Avatar universal

Why Flaps pre-surgery?

At my initial consultation, I was told that in some cases when they  are not sure if the IOL will completely fill the RX, they recommend that the patient come in for laser surgery before the lens replacement procedure to "get the flaps ready."  Then, about a month after the second eye, I can come back in for laser enhancements. I would like to avoid additional surgery if I can but wonder if there is a medical reason to do "the flaps" first. If I needed enhancement, could I go back after the implants and have laser correction to fine tune?  As a point of reference, I am about -11.00 in both eyes, with mild astigmatism in one eye. Thank you all for an informative and helpful site.
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Avatar universal
Just make sure with your amblyopia that you don't have any need for "prisms" in your glasses. If so, you will still need them after surgery even with ReZoom or whatever IOL you have.
Good Luck
Helpful - 0
Avatar universal
I hope to have the ReZoom IOL.  I am intrigued by mixing lenses and getting the ReZoom for my dominant eye and ReStor in no-dominant, but I have some ambylopia in non-dom eye and am concerned it may throw me off too much.  So probably ReZoom in both.  I am getting the A-scan this week and meeting with my surgeon next week.
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Avatar universal
There are variables here that your surgeon will have to answer and you need to quiz him or her. It depends on your corneal thickness and the projected outcome a lasik could give you. Both are common procedures. What IOL are you thinking about having implanted?
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Avatar universal
Eyecu, thank you for responding.  At my last appointment, the doctor explained that it is due to concern about the amount of suction pressure put on the eye when they make the flaps.  If the flaps are created ahead of time, it is safe to do the lasik about 1 month after the implant.  If not, we'd have to wait about 3 months after the surgery to make sure the eye has healed enough to sustain the pressure.

Another question:  The OD said the surgeon may want to "piggyback" my lenses to get me to full correction.   I don't understand the RX process for IOLs, it seems pretty complicated.  As beween piggybacked lenses versus lasik to get me to full distance, does anyone have any recommendations or can address the risks or benefits?  thank you.
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Avatar universal
I really do not know as well but will find out for you. I do know that most surgeons do cut the flap first, go in and implant the lens and then do the proper laser correction post op IOL implant. It could be do the pressure on the eye fromm suction to hold it in place during the cutting of the flap is safer with the crystalline lens in place within the capsular bag versus after IOL implantation. But it is a common practice.
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Avatar universal
IOL's generally run from a 6 diopter to 30 diopter in common powers. They are also made down to -10 in low power up to 5 diopters. When you operate on previous RK and Lasik patients it is harder to predict the outcome due to the change in the cornea. If they shoot for a plano correction and end up 2 diopters off then they will "piggy back" or place a low power IOL into the sulcus in front of the IOL that is placed in the bag to achieve the right correction. It is a common practice and for someone with thin corneas and a high myope like yourself, it is another alternative.
Helpful - 0
Avatar universal
If I need to choose between piggyback IOLs or lasik after implants, would you recommendone one as against the other?   I know I am a complicated case but I would like to minimize my risks.   Any thoughts or opinions on risks, benefits etc would be appreciated.
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Avatar universal
hmm.  dont know.  i think its more common to do the IOL 1st and the lasik later.
Helpful - 0

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