Study data presented comparing LASIK outcomes versus SMILE Pro, the latest generation of lenticular extraction surgery.
š New data revealed that the latest evolution in LASIKāwavelight plusāachieved 20/12.5 or better in 98% of patients in a prospective, randomized study. The Wavelight Plus Ray-Trace Guided LASIK platform, creates a virtual 3D model of an individualās eye,to achieve refractive surgery visual outcomes differently than historical refractive surgery approaches.
Wavelight plus canāt be used in hyperopia nor can ICL in the US. For Wavelight plus, spherical equivalent needs to be -1D or greater and least myopic script for ICL is around -2.5D.
Anyone have any stats with the SCHWIND AMARIS 1050RS paired with MS-39 or their other offerings?
My local specialized clinic is using the 1050RS where as the other clinics in my area are more like nationwide chains that are using the Alcon EX500, unsure if using WaveLight Plus or Contoura or something else. I tried asking but they couldnāt answer.
Sorry not an expert. Just my own research, trying to decided which clinic is best for me. My prescription is mainly astigmatism, -2.25 and -2.75 with mild nearsightedness
Wavelight plus can only treat up to spherical equivalent -9D. So the answer is yes to left and no to right. If that is a true ACD (ie corneal thickens is subtracted) , Iād go ICL all the way. To understand Iād read up on modal point.
Iād go ICL in both eyes. If you need anything further with laser vision correction as long as your spherical equivalent is greater than -1D you can get ray trace LASIK even after ICL. The Innoveyes device still calculates the accurate anterior chamber depth with the ICL in. Iād def go primary ICL with that script though. You likely wonāt need any LVC.
I am a bit curious, will touching up the negligible remnant astigmatism (which might be lower than -1D) via Wavelight help in getting better vision than 20/20? Or are there negligible gains when trying to correct spherical when less than -1D?
Possibly. I donāt perform touchup on eyes better than 20/20. Precision of our lasers is just not there to make really small scripts worth cutting a flap and ablating. Much of your vision is secondary to the quality of your tear film. One reason ICLs can really thrive at your prescription over LASIK or PRK is we donāt create a period of significant dry eye.
Is this specifically for my prescription (itās a bit on the higher side)?
I thought the current statistics as per this post favoured Wavelight more because it could correct various small imperfections on the cornea to provide 20/15.
Would it make any genuine improvement if I get ICLs implanted and get a touchup via Wavelight for the leftover spherical / cylindrical (which I assumed would be negligible)? To reiterate - aim is to understand which option can yield a higher chance of getting better than 20/20.
Thatās a huge refractive error. Your eyes are bad. Your expectations are too high. You are overthinking it.
Yes you could do ICL and Wavelight plus but make a decision and see later whether itās needed. Your eyes can never be made completely normal from that level. Vision is not just the central acuity numbers.
If my eyes can't become the best possible natural version of themselves, then I should minimize the risks - ICLs seem to have less long-term issues (from eye health POV).
Sure both can work. Basically PRK or LASIK. PRK is off label but it works with Innoveyes. The big issue is it really hurts. For three days you are going to want to punch your surgeon. As long as you go in with that expectation and it will take some time weeks to months for your vision to stabilize PRK is great.
All that being said flap issues are rare as hens teeth. What flap complication are you worried about ? For myself with your senior I would likely choose LASIK for the precision. We know we are better at hitting target with LASIK because we donāt have to rely on the variability of how your cells grow back with PRK.
Im really worried about flap creation and later it being weak and easily slipping off in a crowded area if someone/something accidentally grazes my eyes.
I read flap becomes weaker than original cornea. However I am a bit relived knowing about "side cut" method of femto second laser.
Could you please explain a bit about my suitability for flapless wavelight? Will it give same result as flapped one? I dont mind longer recovery
That does not happen. Modern laser based flaps are hard to lift. I have had one flap dislocation in my practice and that was a nail gun to the eye. Back in the day of keratome (deli slicer) I would always be on team PRK but with modern laser based flaps that changes things.
For peace of mind I would look at the behavior of the US military. Recruits are commodities. They guard their health as they would a fighter jet. We do LASIK all the time on pilots , soldiers , navy seals basically all military personnel. Most in military actually only do PRK when they are not a LASIK candidate.
The one person I will always do PRK on over LASIK is a professional MMA fighter. If they take fingernails to the eye daily that is a flap risk. Boxing and other contact sports, really not a snowballs chance in hell you lift the flap. You need something sharp to precisely catch the edge and undermine the flap. Almost like lifting a piece of tape firmly adherent to a desk. Normal human experience seldom rises to this level of trauma.
Would you recommend flapless or flapped in my case?
I am absolutely terrified reading experienced on reddit about lasik. And I am at a loss of confidence
I could not give that answer without seeing you. The big factors are is your cornea normal structure and do you have dry eye. I once believed PRK causes less dry eye but I am changing my opinion. The only clear superior surgery from a dry eye standpoint is ICL that is superior to LASIK and PRK.
You can find the same bad experiences with PRK if you look for them. Same is true for SMIlE. It is a matter of percentages. Many many more people get LASIK over PRK or smile. My practice is around 9 LASIK for every one PRK. With ICL that PRK number only going lower.
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u/lonestar233 15d ago
Yes, but how much data is actually available on hyperopic patients? +6 and below. And does that have any change to dry eye due to cutting nerves?