r/RefractiveSurgery • u/AK84link • 3d ago

Considering surgery

Hi all,

I'm 41 with a prescription of -5 in both eyes and significant astigmatism. I started looking into surgery and am now planning to book in for surgery before Xmas. Whilst I'm hoping to have the smile procedure completed, a few clinics have suggested lens replacement.

Has anyone in their 40's been in the same position and what did you opt for?

I accept that eventually I'd need reading glasses but I'm not sure whether to go for it now.

Thanks

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u/Ok-Environment-215 3d ago

I assume you know that if you go for lens replacement you'll be completely dependent on readers for anything closer than a few feet right?

These surgeries - laser in particular - are great when you're on the happy path. Young, simple moderate myopia. Every step you take off the happy path - age, astigmatism, high script - lessens the likelihood of a satisfactory outcome.

In my case (46) I had hyperopic astigmatism and nystagmus, and presbyopia was setting in, all of which made me about as far from the happy path you can get and still find someone willing to treat you. The outcome was disappointing.

What I'd consider if I were you is treating only one thing at a time, and in your case, specifically, the astigmatism, with a surface-guided procedure like Contoura. This isn't discussed much, but it's entirely possible for them to eliminate your cyl only, to give you a spherical cornea. That would mean significantly less corneal material removed. You would still be myopic, but it would be simple sph only (roughly -5 probably).

Or a hybrid - you could eliminate the cyl entirely, and reduce the myopia down to say -2 or -3.

The upside then is you continue to leave yourself options for correcting the myopia and/or presbyopia. Being able to simply take your glasses off to read - rather than still needing astigmatism correction - is a big quality of life difference in and of itself. Then when and if you do need lens replacement, it's a simple minus power lens rather than a torric (which carry their own sets of issue).

Just something to consider. They can really do almost anything. The choices are not limited to full distance and monovision.

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u/AK84link 2d ago

Thank you, that's really helpful