William Trattler, MD

You should speak to your surgeon to see whether you are a candidate for PRK. The advantage of PRK over LASIK in your case is that the procedure is more superficial - so the corneal thickness is less of an issue. Assuming that your corneal shape is normal - your surgeon should be able to correct your vision all the way to 20/20 or better.
Again - without knowing other aspects of your eye exam - it is not possible to know if you are a good candidate for laser vision correction. So that would be up to your own surgeon
Best regards
Bill Trattler, MD
Miami, FL

The cost for LASIK depends on a variety of parameters. Centers will have their cost for patients to undergo the procedure - and the prices can vary by the technology the centers offer, as well as whether they include adjustments (if needed) in the future if the vision is not on target - which thankfully is uncommon.
Your best bet is to call the local LASIK centers - and ask for their price. You should of course also get an exam to see if you are a candidate

Medical insurance does not cover laser vision correction, no matter what the reason.  They do not cover PRK even in patients who have had corneal transplants and can only see with a contact lens.  Please speak with your doctor, as laser vision correction is my preferred treatment for patients who have had cataract surgery and require a fine-tuning.

I hope this helps

Bill Trattler, MD

Both PRK and LASIK work well to correct patients' vision, and the results with both procedures are similar at 3 months.  With LASIK, the visual recovery is much faster, so patients can often drive their car the next day.  With  PRK, patients may be able to safely drive 5 or so days after the procedure.  It is important to note that some patients may be eligible for PRK but not LASIK based on the shape of the cornea, presence of corneal opacities, or other conditions.  The good news is that in general - both procedures work well for patients.

From the numbers that you have presented - both LASIK and surface ablation are appropriate procedure options for you.  The advantage of LASIK is faster visual recovery (you can typically drive your car the next day).  Surface ablation - such as LASEK - is also effective - but 4-6 days are required typically for the vision to improve for driving a car after the procedure.  The good news is that by 3 months - the results of LASIK and surface ablation (such as LASEK) are identical - including visual results and tests for dry eyes.   The big advance since the late 1990's is the switch by many surgeons to the all laser LASIK procedure - so that the flap that is created works better to provide crisp vision and not induce as much dry eye as the older-style LASIK flaps.  That is why the studies that have looked at LASIK and surface ablation have found that both are excellent options with similar long term results.

I hope this helps

Bill Trattler, MD

Miami, FL

Both surface ablation and LASIK are appropriate options based on your initial description of your condition.  However, a complete exam including corneal mapping is required before one can determine whether you are a candidate.  Both procedures (LASIK and surface ablation) provide excellent visual results and are equally safe with your prescription.  

Bill Trattler, MD

Miami, FL

1.  We do not know your level of myopia.  If you have a low amount of myopia - you can have PRK and later on return for an enhancement.  However - if you are very, very near-sighted - then it is possible  the doctor could be right and you would be treated only once.  There is no way to answer this part of your question without more information

2. Patients with thin corneas who are otherwise normal CAN have LASIK.  All of the peer-reviewed articles on LASIK in thin corneas have demonstrated that LASIK can be done safely and effectively.  However, the topography has to be completely normal.  Feel free to google my articles on LASIK and thin corneas

3. There have been no conclusive studies that have proven that any form of surface ablation:  PRK, LASEK, or Epi-LASIK, provides superior visual results, faster visual recovery, or less risk.  Dr. Chynn's comments are unfortunately incorrect.  I have worked with 2 Epi-LASIK companies and performed LASEK for many years.  The fact is - all surface ablation procedures provide the same visual results - and thankfully the results are quite good - equal to LASIK at 3 months.

Best regards

Bill Trattler, MD

First - you can have LASIK if you see an eye care specialist - and identify and treat any underlying dry eye.  This is the most common reason for contact lens intolerance.  Speak with your doctor about punctal plugs to raise the tear film, restasis, etc.   Assuming your dry eye is treated - you should be eligible for LASIK - assuming everything else about your eye is normal (normal corneal shape, etc)

  Just to mention - for LASIK - there is no contact lens.  

Best regards

Bill

This is an excellent question.  The key issue is to make sure that you work with a local doctor that would be happy to see you for postop visits.  That can sometimes be a challenge.  The main issue with LASEK is that there is a 4-5 day healing process where there is a risk of infection - so you need to have someone close and available to see you.  once you are through the first week, you would want to be seen a few times over the first 6 months to make sure that the results are as expected.  The doctor would check you for dry eye and any other issues.

As some of the other doctors noted - LASEK is a varient of PRK - and is a safe and effective procedure.  There is actually no studies that have demonstrated a significant advantage to LASEK over PRK - but regardless - LASEK works (like PRK) and is an option for patients like yourself.

I hope this helps

William Trattler, MD

Miami, FL