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Eye Care (Expert Forum)
Re: Best laser for LASIK?
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Re: Best laser for LASIK?
by hfhs-md--ke, Jan 01, 1995 12:00AM
Posted By hfhs md- ke on December 27, 1998 at 21:53:22:
In Reply to: Best laser for LASIK? posted by Fern on December 23, 1998 at 18:46:49:
What is the best type of laser for LASIK refractive surgery? I have large pupils - about 7 mm in a somewhat darkened room, as measured by a pupillometer. I wear a -5.75 and -6.00 in my eyeglasses. I have dry eyes and eye allergies and cannot tolerate contact lenses much, so I am considering LASIK. I have been reading on the Internet that in the U.S., mostly the broad beam lasers are approved (such as VisX, Summit), but the Autonomous Technologies flying spot laser has recently been approved. What about the Chiron Technolas 217, which is their most recent? This is not yet approved here in the U.S., but it is in Canada. How does it compare to the Visx Star 2 smooth scan? Which is best for my prescription and fairly large pupils? I am at a higher risk for night glare problems (starbursts and halos) because of my large pupils. Should I have a larger ablation zone to cover my pupil size in darker situations? But then, the laser would have to go deeper, which poses other risks of distortions, I hear. Would you recommend leaving this country to have the Chiron Technolas laser? Or is the VisX Star 2 fine? (VisX Star 2 claims it gives a smoother transition and that it has 7 beams. But it's still broad beam.) Should I wait for a flying spot or scanning slit laser type? I am now 40 years old, and not yet presbyopic - I can read with my distance glasses okay. Should I be undercorrected with LASIK and have one eye slightly more undercorrected to stave off the need for reading glasses? (I wouldn't like to have to immediately have to get reading glasses after having LASIK.) I appreciate your advice on these matters. Thank you.
dear fern-
happy holidays. typical of many refractive surgery patients you are not only full of questions, but also full of knowledge- and that is good! they are your eyes and they are the only ones you have!!! anyway, in regards to your questions/ concerns: you are correct, only the summit and visx broad beam lasers are approved here in the u.s. the outcomes of these lasers nationally and internationally have been excellent, though. despite the proliferation of other types of lasers, eg the scanning lasers, they, in my opinion, remain the gold standard. ( though because of the lightning fast advances in this field, this fact can change quickly ) with your fairly "straight forward " refractive error ( no astigmatism, moderate myopia ) i feel that a trip outside the counrty is NOT necessary. i feel that you would do well with either the visx or summit laser, though you are correct that the visx laser now has the option of a slightly larger blended optical zone- which would help reduce the chances of halos and starbursts at night due to large dilated pupils. i have to say with a maximum dilation of 7 mm under the darkest of conditions i doubt you would experience many problems from this, though it is certainly possible. i also feel with your history of dry eyes and allergies you should opt for LASIK and not PRK. finally, to undercorrect one eye would make you what we call a "monovision" patient- which means one eye ( the fully corrected eye ) would be for distance and the other ( undercorrected ) eye would be for reading. this is a situation we commonly create in presbyopic contact lens wearers- and many of them fully enjoy it since they need no glasses at all- just the contacts. HOWEVER, this is not tolerated by everyone because it takes a while to adapt to and it does degrade our binocular
( stereo ) vision. to determine if you may be a "monovision" candidate after laser corrective surgery you should first undergo a contact lens trial to see if you can tolerate it. another simple alternative, at your age, is to slightly undercorrect both eyes- this would allow you, probably, to avoid "readers" for a few years, though you may require glasses occasionally for driving and other distance activities. all these issues can be explored with your eye md. i hope this helped, and if you need further info please call 800-653-6568
sincerely,
hfhs md- ke
Disclaimer
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
In Reply to: Best laser for LASIK? posted by Fern on December 23, 1998 at 18:46:49:
What is the best type of laser for LASIK refractive surgery? I have large pupils - about 7 mm in a somewhat darkened room, as measured by a pupillometer. I wear a -5.75 and -6.00 in my eyeglasses. I have dry eyes and eye allergies and cannot tolerate contact lenses much, so I am considering LASIK. I have been reading on the Internet that in the U.S., mostly the broad beam lasers are approved (such as VisX, Summit), but the Autonomous Technologies flying spot laser has recently been approved. What about the Chiron Technolas 217, which is their most recent? This is not yet approved here in the U.S., but it is in Canada. How does it compare to the Visx Star 2 smooth scan? Which is best for my prescription and fairly large pupils? I am at a higher risk for night glare problems (starbursts and halos) because of my large pupils. Should I have a larger ablation zone to cover my pupil size in darker situations? But then, the laser would have to go deeper, which poses other risks of distortions, I hear. Would you recommend leaving this country to have the Chiron Technolas laser? Or is the VisX Star 2 fine? (VisX Star 2 claims it gives a smoother transition and that it has 7 beams. But it's still broad beam.) Should I wait for a flying spot or scanning slit laser type? I am now 40 years old, and not yet presbyopic - I can read with my distance glasses okay. Should I be undercorrected with LASIK and have one eye slightly more undercorrected to stave off the need for reading glasses? (I wouldn't like to have to immediately have to get reading glasses after having LASIK.) I appreciate your advice on these matters. Thank you.
dear fern-
happy holidays. typical of many refractive surgery patients you are not only full of questions, but also full of knowledge- and that is good! they are your eyes and they are the only ones you have!!! anyway, in regards to your questions/ concerns: you are correct, only the summit and visx broad beam lasers are approved here in the u.s. the outcomes of these lasers nationally and internationally have been excellent, though. despite the proliferation of other types of lasers, eg the scanning lasers, they, in my opinion, remain the gold standard. ( though because of the lightning fast advances in this field, this fact can change quickly ) with your fairly "straight forward " refractive error ( no astigmatism, moderate myopia ) i feel that a trip outside the counrty is NOT necessary. i feel that you would do well with either the visx or summit laser, though you are correct that the visx laser now has the option of a slightly larger blended optical zone- which would help reduce the chances of halos and starbursts at night due to large dilated pupils. i have to say with a maximum dilation of 7 mm under the darkest of conditions i doubt you would experience many problems from this, though it is certainly possible. i also feel with your history of dry eyes and allergies you should opt for LASIK and not PRK. finally, to undercorrect one eye would make you what we call a "monovision" patient- which means one eye ( the fully corrected eye ) would be for distance and the other ( undercorrected ) eye would be for reading. this is a situation we commonly create in presbyopic contact lens wearers- and many of them fully enjoy it since they need no glasses at all- just the contacts. HOWEVER, this is not tolerated by everyone because it takes a while to adapt to and it does degrade our binocular
( stereo ) vision. to determine if you may be a "monovision" candidate after laser corrective surgery you should first undergo a contact lens trial to see if you can tolerate it. another simple alternative, at your age, is to slightly undercorrect both eyes- this would allow you, probably, to avoid "readers" for a few years, though you may require glasses occasionally for driving and other distance activities. all these issues can be explored with your eye md. i hope this helped, and if you need further info please call 800-653-6568
sincerely,
hfhs md- ke
Disclaimer
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
