from 20/20 to 20/60 in 3 yrs. after lasik

[Tony.]

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hi,

just a question:
my friend got LASIK 3 years ago but now he is seeing 20/60. his ophthalmologist told him that because he was READING too much, the muscles in his eyes "changed" a little bit. my friend was instructed to wear glasses until the muscles in his eyes "changed" back to their original position so he'd be able to see 20/20 again.

what is going on here? is LASIK still not 100% effective?

 

[Andrew_Doan]

Think of refractive surgery as being a permanent pair of glasses. If a patient's refractive error changes, then he/she will need a refractive surgery "touch up" or glasses. Hence, refractive surgery is not ideal for patients with myopic progression or for those requiring yearly changing of mRx.

 

[Tony.]

thanx dr. doan,

my friend got the surgery when he was 24 y.o
is there an ideal age to get this "refractive surgery" ?

 

[Visionary]

It's less about "ideal age" and more about swiftness of progression of refractive error. Before undergoing LASIK, the progression of one's refractive error should be tracked over a period of time. If the progression is rapid, LASIK is discouraged (though not contraindicated), as "touch-ups" will be needed sometimes within years after the surgery (as in your friend's case). If the progression is slow, LASIK is a good choice. Naturally, undergoing LASIK at a younger age makes the likelihood of needing "touch-ups" is higher (i.e., your refractive error will eventually change, no matter how slow your progression). Hope this helps.

 

[Tony.]

visionary, thank you for your reply.


but how could LASIK be discouraged BUT AT THE SAME TIME NOT be contraindicated?

 

[Andrew_Doan]

Originally posted by anothertony
visionary, thank you for your reply.


but how could LASIK be discouraged BUT AT THE SAME TIME NOT be contraindicated?

Contraindications are conditions that would lead to corneal decompensation after LASIK, e.g. active keratitis, severe dry eyes, keratoconus, pellucid marginal degeneration, etc...

Discouraged means that LASIK may not be the best for a patient with gradual myopic progression. If the patient understands that future touch-up procedures or mild prescription glasses are a possibility, then the patient may have the procedure done. A minus 12 myope may still want to have the procedure even if the final refraction is 20/40 or 20/60. At least this individual will be able to navigate without glasses.

For those with high refractive error, it's quite disabling when they can't find their glasses or contacts. For instance, soldiers in the field may want to have refractive surgery to help keep them safe and effective while in hostile environments. It would be horrible to be in the midst of a firefight and lose your glasses.

 

[Tony.]

Dr. Doan,

thank you for your reply. you make things easier to understand when you give me examples ( i.e soldiers etc.) .thankx.