Nobody at the Zurich conference had anything good or bad to say about
your potential doctor.

Glenn Hagele
Executive Director
USAEyes.org

"Consider and Choose With Confidence"

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

It does sound like they are providing a comprehensive evaluation and
telling you the information you need to know. The doctors you mention
are not listed as attending this conference - this is a rather
specialized meeting - so I will ask the doctors who should know if
they have any opinions good or bad.

I am of the opinion that a person with low higher order aberrations
(HOA) has a greater need for wavefront-guided ablation. While the
doctor is correct that the normal induction of HOA with surgery may
raise you only to the level of the average person, your are not
accustomed to the vision of the average person. Driving from zero to
50 klicks seems much greater a change than driving from 50 to 100
clicks. In relative terms, you may find a raise to "normal" vision to
be a let down. I continue to believe it is best to use a
wavefront-guided ablation in a situation like yours, if the ablation
can be large enough to accommodate your pupils.

The subjective vision test (manifest refraction) is probably more
valuable than you realize. This is your "true" vision with all of the
processes of light to nerve signal to brain analysis. The
which-is-better-one-or-two exam is more often than not the basis of
the ablation, with the wavefront derived data as comparative.

Glenn Hagele
Executive Director
USAEyes.org

"Consider and Choose With Confidence"

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

Its up to you if you want one or both eyes done. One eye at a time is
safer but a little less convinent for you and your surgeon. Glasses
should be higher than contacts due to vertex distance. -3.75 contacts
would be comparable to -4.75 glasses and -4.25 contacts comparable to
-5.25 glasses. I am like a -5 but I see just as good with -4 contacts.
Of course the 1.25 time ratio may be a little different depending on
the person. Ive been told those who have pseudomyopia manifast more of
it with glasses than contacts. The optometrist online told me -4
contacts is between -4.25 and -4.5 glasses for many people. I cant
speak for his patients but my friends need 1.25 times higher glasses
pescription than contacts just like me. Did you get a cycoplegic
refraction? This is very important to check for pseudomyopia or you may
end up a hyperope as you get older and be back in bifocals.

I would be worried about your nearly 8mm pupils. You are at increased
risk of decreased night and low light vision loss. In fact youll
probably lose some quality. Hopefully not a whole lot. You have a low
amount of aberrations so this is another worry. You are right in saying
youll have more aberrations after surgury. If you were seeing 100% with
glasses clearly, this means your a solid 20/20 and I wouldnt be
supprised if you could see some or even all of the 20/15 line as well.
Theres no guarantees what youll end up after PRK, only that youll be
closer to plano. What are your expectations? If they are not relistic,
dont bother or youll just be disapointed and back in contacts again.

I am not gonna talk you out of it, I can see youve had your mind set on
it for a while. Its good to hear you are well informed, more than 98%
of patients. You probably know what you are getting into and what to
expect. I just hope youll be happy with your new eyes whatever they end
up with. Lasik nor PRK is for me despite my relistic expectations. I
know ill still need glasses anyway, I may lose some BCVA due to
increased aberrations and I can kiss my night vision bye due to very
large pupils. The tradeoff in vision isnt worth the possibility of a
reduced dependance for me.

Glenn - USAEyes.org wrote:
- quote -

It's at Argus Øyeklinikk in Oslo. The founder is called dr Willy
Pettersen (whom I am not sure really is educated as a surgeon) but I am
scheduled with the second doctor who started working there last year
named dr Jonathan A. Strauch. He has been working as an eye-surgeon in
Sweden, doing cataract surgery, inserting/removing lenses etc (so they
told me) - so I believe he knows eyes well too, although might not have
years of experience with lasik/lasek/prk as I don't know if he did that
in Sweden.

If you hear horrible things about them, please let me know, I haven't
paid yet and can cancel any time. You can email me if you prefer privacy :-)

I got some numbers from the pre-op exam today. A guy (not one of the
surgeons) measured my "subjective" diopters to be around -4.00 and -4.75
(he had some more numbers from different measurments then added a little
and subtracted a little), although my contact lens prescription is -3.75
and -4.25, but he said that is quite normal and that my measurements
were good and they match well with what is expected. I really don't like
these subjective measurements though. "What looks better? This?... or
this?" "Ummmm not sure!" Especially picking the better crowd of dots
was difficult. The rest of world skewed when he changed those lenses,
but I was only supposed to judge the actual dots. Afraid I say something
wrong and that it might matter. I hope they rely more on the real
measurements than on my unreliable eyes, brain and mouth.

There was one thing that I noted though. I could read the bottom line of
the text he showed just fine (which was the "100%-line"), so I told him
I could probably read smaller text too, at least with my right eye, but
he wouldn't go any smaller. Maybe it would be easier to see "what looks
better, this or this?" if he had went smaller, but who am I to argue.

On the journal I got (I asked for it), it says
* Subjective OD: Sph -4.00, OS: Sph -4.75, then Syl:0.00 Axis: 0 Add:
0.00 for both. About no astigmatism at all the guy said.
* Size of dilated pupil: 7.87 / 7.98, so kind of large, but the surgeon
said that's not a problem with this laser as it smoothes the edge of
ablation or something, so shouldn't be any problems in the dark.
* Orbscan pachymetri: 562 / 564 - that's on the thinnest part I think. I
saw the charts and other parts of my cornea were more than 600. They
said mine are thicker than average. They wouldn't give me the charts
(the pictures), but they will save them so I can come there and see them
if I need to.
* WTW: 12.5 / 12.4
* Orbscan keratometri: od 40.7 / 41.1 * 106gr, os 40.1/40.7 * 90gr
* Eye pressure: 19 m.m. on both eyes - they said it's good.

The surgeon said I have very little HOA, but that refractive surgery is
expected to raise them somewhat. Since mine are so low, there shouldn't
be a problem. I am scheduled to have LASEK with Zyoptix (mostly for its
tissue saving capability) and mitomycin - because of the somewhat big
ablation zone (probably 7.5, but not sure, it's up to them).

The surgeon liked my reasoning for choosing LASEK over LASIK and said
that I obviously know more than 98% of the patients coming in there
(based on my questions/comments). He also added that LASEK has shown to
give *at least* as good results as LASIK. A lot (about 50%) of LASEK
surgeries end up as PRK as the epithel-layer does not hold, he said, but
that is not a problem at all because the laser makes the surface so
smooth and nice (with its 1 mm laser that smoothens it out), and that
LASEK actually might be obsolete cos PRK is just as good. A bandage lens
will be provided and removed probably at the next follow-up session 3
days later. Vision will probably be worse when it is removed, but will
be better as the epithel-layer heals and smoothens out. Any enhancement
later is included in the price, with no time limit.

All in all, I am pretty confident in them. A little less confident in
myself and my judgement of "what looks better, this or this". My right
eye is my dominant eye (by far) so I am a little afraid that I might see
better with my right after the surgery too so it will be even more
dominant, so in a way I hope my left eye will get a little better
results than my right

I don't know if they now have the data they need for the laser or if
they will do more measurements on the day of the surgery.

---
André Aubert
andraub[at]online.no

Andre, who is the surgeon you selected? I am at a conference in Zurich
where there are a couple of surgeons from Oslo. You can email me if
you prefer privacy.

Glenn Hagele
Executive Director
USAEyes.org

"Consider and Choose With Confidence"

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

I can certainly understand the desire to not have glasses hanging
around your neck. I can also understand the desire to not wear
glasses for distance vision any more.

For a person who is presbyopic (need reading glasses or bifocals)
refractive surgery offers only a compromise. There is not "cure" for
presbyopia, but there are ways to work around it.

A person can have surgery with the intent to have fully corrected
distance vision. This is most ideal for someone who is limited in the
use of "inside" vision or near vision. A person who plays golf,
tennis, drives often or long distances, etc. will probably find this
correction to be best, and then use inexpensive reading glasses for
near vision needs.

It is also possible to elect to have surgery to provide near vision
correction. This would normally be between 1.00 and 2.00 diopters of
myopia (nearsighted, shortsighted) vision. Someone who spends the
majority of his or her time reading, at a computer, or in similar
activities, may prefer this correction, and then use prescription
glasses for corrected distance vision.

A technique known as monovision is a combination of one eye corrected
for distance and one eye corrected for near vision. After several
weeks the brain figures out what is happening and will "look" through
the eye corrected for distance when looking at objects distant and
will "look" through the eye corrected for near when looking at objects
near. Monovision is not for everybody. About one-third of people who
try monovision cannot stand it. Often a loss of depth perception
occurs, which requires a pair of fully corrected glasses for superior
distance vision and depth perception. In the best of circumstances,
monovision can provide acceptable vision about 85% of the time. For
more on monovision, visit
http://www.usaeyes.org/faq/subjects/monovision.htm

I point out these options for those who are considering refractive
surgery, are age 40 and above, and are reading about the difficulties
you report about your husband. Also, if your husband requires
enhancement surgery to resolve any under or over correction issues, he
may want to consider monovision.

Glenn Hagele
Executive Director
USAEyes.org

"Consider and Choose With Confidence"

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.

"Glenn - USAEyes.org" <glenn.hageleSTOPSPAM[at]USAEyes.org> wrote in message
news:3pbhp1li26k4ckjtcajvpcp188s511e6ls[at]4ax.com...
- quote -


I've been looking at his beautiful green eyes through the lenses of his
glasses for over a quarter of a century. I understood he always hated them.
It was not just a cosmetic thing, he really wanted ALWAYS to be able to see
without glasses.

I wear contact lenses (or rather, I used too). Years ago, I found I needed
reading glasses. Unlike my husband, I could not just take off my glasses to
read. First, I ordered a pair of reading glasses. But using them and keeping
them on-hand was problematic. (Nothing says middle-aged like glasses on a
chain around your neck).

So, I gave up wearing contacts except for 'special occasions', and the
glasses I used when my eyes were tired or when I just didn't feel like
wearing the contacts, were replaced with new ones with progressive lenses.

I TOLD my husband bifocals would be an issue. But since his eyesight was
different than mine, he felt his issue was different than mine. And his
doctor did nothing to disabuse my husband of his wrong thinking.

Your perscription sounds almost exactly like mine. I had my LASIK
surgery on November 30th. I could see clearly within 3 to 4 hours
after surgery. When I went in for my 1 day exam, my eyesight was 20/20
in both eyes. Yes, there were halos, starburst, and some glare. The
doctor said that would go away as the swelling went down. They have
lessened quite a bit and probably will go away just as the doctor said.

Good luck and let us know how everything turns out.

Mark

I dont know why the paragraph format got all weird. I paste it here to
make reading easier.


im in agreement!


exactly. Doing both eyes is a benefit for the surgeon as he can save
lots of his valuable time. The benefit for the patient is there but its
not always in his best interest. if something goes wrong, better to
mess up one eye than both. Of course theres the anisometropia issue but
if youve worn contacts, then its a nonissue other than the dicomfort of
contacts which prompted you to get lasik.




Nah, hes just a high myope whos had lasik and ive never seen him say
anything bad about it. I think he had dry eyes for a few weeks but its
back to normal. Hes 20/20 and has nothing to complain about and hes one
of the lucky ones who doesnt need glasses for now till presbyopia sets
in. Hes a young guy with an unusually high accomodative amplitude. For
most people, lasik does not free them of glasses, just reduces their
dependancy. If your expecting to be free of glasses, dont get lasik or
youll be setting yourself for disapointment.



and I plan to keep it this way. I will still need glasses after lasik
plus I can kiss my night vision bye and look forward to increased eye
dryness among other things like increased aberrations. The only real
benefit is ill be closer to plano but the tradeoffs make lasik a moot
point for me. I know my expectations and I dont think ill be much
better off than sticking with glasses plus lasik is a risk where I have
little to gain and more to risk. I am aware that for some people, the
benefits of lasik can be huge. For me, its small. I have chosen to be
neutral to lasik. Neither anti-lasik nor pro-lasik because I can see
both sides to lasik, both good and bad. For the right people and if
everything goes well, they can enjoy reduced or even eliminated
dependancy on glasses. I am aware of literally millions of happy people
and I am happy for them too. I however extend my consolences to the
tens thousands who arent happy. Some people are more likley to be
happy(see relistic expectations) others must have perfect vision or
they wont be happy! Its all about knowing what to expect and make an
informed decision. I know what to expect and I think ill enjoy my clear
vision with the sometimes hassles of glasses. Its just something ill
have to deal with and besides, everyone will have to deal with glasses
at some point in their lives.


I dont ignore them! They told me to see an optometrist and ive pretty
much convinced dad to take me to one for various testing. I self
diagnoise as well, its my eyes and I want to see at my best. I believe
in eye exercises and have noticed improvements!



so does everyone with presbyopia(or low accomodation) which is what I
have. I undercorrect myself for the computer and around the house. You
probably wont understand unless they simulate presbyopia with
cycoplegic agents then your glasses will be useless for near and
intermediate. Rather than wear bifocals, I find it much more convinent
to wear a seperate pair around the house and wear a stronger pair when
I go out. Contact lenses are useless(I dont like monovision)


It depends on the person and their lifestyle. One eye at a time is not
for everyone but its an option that only you can decide. What if you
have a bad lasik experience? Youll at least still be functional in your
virgin eye with a contact. If you have a good experience, get the other
eye lasered then.


you never mentioned what pescription he was before lasik. Whats your
pescription now?

I am glad to see your research is
paying off. Having one eye done at a time will be beneficial to your
ability to function. After surface ablation like LASEK,your functional
vision will be compromised for a few days to weeks. Doing one eye at a
time means that you will have one fully functional eye at all times.
That can be very helpful.


im in agreement!


"Yeah.. trust the doctor who makes a fee for each eye. The doctor who

can
move so much quicker if both are done at the same time. Who saves time

AND
makes a greater profit."


exactly. Doing both eyes is a benefit for the surgeon as he can save

lots of his valuable time. The benefit for the patient is there but its


not always in his best interest. if something goes wrong, better to

mess up one eye than both. Of course theres the anisometropia issue but


if youve worn contacts, then its a nonissue other than the dicomfort of


contacts which prompted you to get lasik.



"Let me guess.. you do lasik eye surgery.

Am I a psychic? Or could it be that folks whose income might be

threatened
by the truth tend to dismiss and debase posts with warnings."


Nah, hes just a high myope whos had lasik and ive never seen him say

anything bad about it. I think he had dry eyes for a few weeks but its

back to normal. Hes 20/20 and has nothing to complain about and hes one


of the lucky ones who doesnt need glasses for now till presbyopia sets

in. Hes a young guy with an unusually high accomodative amplitude. For

most people, lasik does not free them of glasses, just reduces their

dependancy. If your expecting to be free of glasses, dont get lasik or

youll be setting yourself for disapointment.


"This boy Ace hasn't had any
refractive surgery"


and I plan to keep it this way. I will still need glasses after lasik

plus I can kiss my night vision bye and look forward to increased eye

dryness among other things like increased aberrations. The only real

benefit is ill be closer to plano but the tradeoffs make lasik a moot

point for me. I know my expectations and I dont think ill be much

better off than sticking with glasses plus lasik is a risk where I have


little to gain and more to risk. I am aware that for some people, the

benefits of lasik can be huge. For me, its small. I have chosen to be

neutral to lasik. Neither anti-lasik nor pro-lasik because I can see

both sides to lasik, both good and bad. For the right people and if

everything goes well, they can enjoy reduced or even eliminated

dependancy on glasses. I am aware of literally millions of happy people


and I am happy for them too. I however extend my consolences to the

tens thousands who arent happy. Some people are more likley to be

happy(see relistic expectations) others must have perfect vision or

they wont be happy! Its all about knowing what to expect and make an

informed decision. I know what to expect and I think ill enjoy my clear


vision with the sometimes hassles of glasses. Its just something ill

have to deal with and besides, everyone will have to deal with glasses

at some point in their lives.


"And he ignores the advice of his eye care
professionals and self-diagnoses."


I dont ignore them! They told me to see an optometrist and ive pretty

much convinced dad to take me to one for various testing. I self

diagnoise as well, its my eyes and I want to see at my best. I believe

in eye exercises and have noticed improvements!


"He wears glasses that are the wrong
prescription."


so does everyone with presbyopia(or low accomodation) which is what I

have. I undercorrect myself for the computer and around the house. You

probably wont understand unless they simulate presbyopia with

cycoplegic agents then your glasses will be useless for near and

intermediate. Rather than wear bifocals, I find it much more convinent

to wear a seperate pair around the house and wear a stronger pair when

I go out. Contact lenses are useless(I dont like monovision)


"Ace: Surgery on one eye and contacts on the other is a weird idea.
Contacts work fine for me during the day, but if I stay out long they
get dry and annoying. Besides, contacts have popped out during
Brazilian
Jiu Jitsu, kickboxing and boxing. It would also be nice to sleep
anywhere without always bringing "contact lens equipment". Contacts on
one eye would be almost as bad as on both."


It depends on the person and their lifestyle. One eye at a time is not
for everyone but its an option that only you can decide. What if you
have a bad lasik experience? Youll at least still be functional in your
virgin eye with a contact. If you have a good experience, get the other
eye lasered then.


"Few people in their right minds would pay thousands of dollars and
risk
their eyesight to trade distance glasses for reading glasses. And yet
this
procedure is performed daily on folks with just that result. Patients
who
are relying on their doctors advice as to what is best for their care."


you never mentioned what pescription he was before lasik. Whats your
pescription now?