Lasik Surgery for High Farsightedness?

Question

I am 48 and considering wave-front lasik surgery to correct my farsightedness.I currently wear progressive glasses at +4.25. I have a lot of cornea tissue (620 micrometer) and my pupils are below 6mm. I am reading many sites that do not recommend lasik for my level of farsightedness. Is Lasik successful for someone in my situation? Can regression take me back to a high prescription? Thanks

Michael K. Tracy, MD · Answer

Very farsighted patients generally do well with LASIK surgery, but it is not as easy a course as for nearsighted patients. With custom LASIK 98% of nearsighted patients generally are 20/20 or better, while with far-sighted patients it is closer to 90%. It also takes longer for farsighted patients to see their vision stabilize after LASIK. Farsighted patients often improve for a year after LASIK. Typically right after surgery, farsighted patients are over-treated, meaning they are temporarily nearsighted so reading is very clear while distance is blurry. Then over several months the distance vision gets better and better.

Anthony J. Kameen, MD (retired) · Answer

An eye that is farsighted is an eye physically shorter than average from the front of the cornea to the back of the eye. As a result, when we correct farsightedness with an excimer laser, we need to "lengthen" the eye, and there are limits as to how much this can be done. The corneal thickness is rarely an issue, as the laser treatment is performed on the outer part of the cornea, which is the thickest portion of the cornea.

	I have used numerous excimer lasers over the 20 years I have been performing PRK and Lasik, and I find the laser I am currently using, the Wavelight 400hz excimer laser, to be the best laser for the correction of farsightedness. That being said, about the upper limit of hyperopic correction I will perform using any laser is about +5.00 diopters. Of course, there are exceptions after all of the data is analyzed, but, certainly, +6.00 is an absolute upper limit.

	In your case, your hyperopic severity is within my limits, however, you don't mention your corneal shape(keratometry), which would allow me to be more specific. All in all, given your age, I feel hyperopic Lasik on the Wavelight would serve you well. You would also be well treated with a Clear Lens Extraction, which is very similar to cataract surgery(although you don't have a cataract), with the implantation of a synthetic lens to take away your farsightedness. The positives of CLE are that it involves the removal of your human lens, so you will never get a cataract. In addition, the lens put in its place can be chosen to specifically address your distance, intermediate and near issues on a permanent basis. The negatives of CLE are that it is a procedure performed inside the eye, rather than on the surface like Lasik, thus, it is more invasive and more expensive. This is about as specific as I can be given the information provided. I hope this helps.

Lasik Surgery for High Farsightedness?

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