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Let's address your issues one at a time: 1. They are correct. If your pupil is dilating beyond the treatment zone your vision can become "fuzzy" I am sure that the laser they used treated the largest circle of cornea possible. It is not possible to treat your cornea from edge to edge with the laser.
2. That "discomfort" you experienced after PRK was one of the major motivating factors driving the invention of lasik -- much, much less pain with a quicker recovery time. As you mentioned, due to your high myopia and thin corneas you were not a candidate for lasik, which requires a thicker cornea for the same amount of refractive error correction then does PRK.
PRK is painful. There is no getting around that fact. It really has nothing to do with the settings on the laser, how fast they crank through the patients or what they charge for their services. If you are able to have an enhancement using PRK it is going to hurt just as much and, most likely, for just as long as it did during your primary treatment. Once again, however, your residual refractive error and remaining corneal stromal thickness will determine if you can safely have more PRK.
3. There is the possibility that you have already had too much of your natural near sightedness corrected to be a candidate for monovision (one eye for near, one eye for far). However, before you have this prescription "cut" into your cornea forever you should try walking around in contact lenses that mimic what you would expect after the PRK to do this. Some people love it, some people hate it and the only way to tell which group you are in is to give it a try. Personally, as a surgeon, I'd just wear the reading glasses.
4. It sounds like you are not happy with the doctor who did your first surgery and, no matter what happens if you go back to them, you won't be happy. So. My advice? Go somewhere else for another opinion on your current vision and options. What should you pay for this service -- the $500 or he $3,500? Well. How much is your vision worth to you? Is this REALLY the place you want to try and save a few bucks? When you do go for this second opinion, it is important to bring with you your pre-PRK data, your PRK treatment data, and your post PRK data from the first doctor so you can get an informed opinion from the new guy.
There is no way to insure that you will get the results you want. Eye surgery is not like fixing the transmission on your car; doing the exact same surgery on two patients may very well give two different results. Humans are not like machines when it comes to therapy. The only thing you can do is to make sure you first, go to a doctor you trust, second, ask around to see what others say about this doctor and , most importantly, be very realistic about what can be done with the treatment you are going to have and what type of things can go wrong.
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