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pippistrellodaqua
pippistrellodaqua, Optometrist
Category: Eye
Satisfied Customers: 134
Experience:  Specialty in contact lenses, medical eye management, LASIK
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I have HIgh myopia of - 13 I read were they have a visx star

Customer Question

I have HIgh myopia of - 13 I read were they have a visx star s4 laser that can treat people up to - 14 ? Also if not would PRK be safe to shade some diopers bc I cant fit into glasses or contacts
Submitted: 1 year ago.
Category: Eye
Expert:  Camille-Mod replied 1 year ago.

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Customer: replied 1 year ago.

Did you find someone ?

Expert:  Camille-Mod replied 1 year ago.

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Expert:  pippistrellodaqua replied 1 year ago.
I am happy to assist you with your question.

The VISX Star S4 is an eximer laser which can be used to perform LASIK and PRK. We use the VISX S4 in our office and we can successfully treat up to -14.00 diopters of prescription with the traditional approach. There is a custom approach which integrates a scan of the front surface of the eye and only treats up to -11.00 and would not likely be the best option for you.

The real question would be related to the thickness of the front surface of the eye (cornea.) LASIK and PRK are permanent procedures that burn away cornea. We'd need to be sure that you would have enough cornea to properly function throughout life. PRK can allow us a bit of wiggle room in cases of a thinner cornea, but with -13.00 diopters of power that would need to be corrected, it is imperative that you have enough corneal thickness. In most cases of high myopia I will recommend PRK, but your eyes should be evaluated individually for all factors related to the surgery. In addition to corneal thickness and the amount of power of the prescription, the health of the eyes needs to be evaluated.

I will be available to answer any follow-up questions you may have.

Please don't forget to offer a positive rating once your question has been answered fully.

Also, please note that the information here does not replace an examination and should be used as educational purposes only.

Customer: replied 1 year ago.

I am 23 years have had a detached retina in my left eye . Legally blind in that eye . My right eye is my only good one I have left . But i cant keep going through life with contatcs keep bothering me . But I am scared of somehting happing with the laser to cause me to go blind . MY question I know there is always risk . but With Prk is there a high risk of retinal detachments with this and have u ever seen them with the laser ? Also I dont think a IOL would be smart do u agree ?

Expert:  pippistrellodaqua replied 1 year ago.
With essentially just one eye pulling the weight I don't think the potential benefits of PRK or an IOL would be worth the potential risks. It is rather rare to see severe complications with LASIK or PRK, but most surgeons will not perform these types of procedures on patients who have essentially one good eye only. The risk of retinal detachment occurring should not be affected by a procedure like PRK or LASIK. Retinal detachments occur in high myopes due to a thinning of the retina of the eye. PRK or LASIK would be much safer than something like an IOL because the surgeon doesn't go anywhere near the retina. I agree with your risk assessment of a clear lens exchange IOL or even an INTACS lens because both options require cuts into the cornea which can increase your risk of retinal detachment. Custom LASIK will not likely be able to correct the full amount of prescription for you. PRK would likely be the best option in theory. Again, the trouble may be finding a surgeon who would be willing to perform the procedure. The liability may be too great. I would recommend obtaining a second or even third or fourth opinion regarding any possible option. I am a more conservative doctor when it comes to LASIK or PRK. There may be doctors out there who would perform PRK, but I would question it. I hope this helps further address your question. Please don't hesitate to contact me again if needed. Please consider leaving a positive rating. Thanks.
Customer: replied 1 year ago.

Thanks for ur input . It just sucks being so young with one eye and that I i cant get any good contacts tried everything . been evey were my eyes cant tolerate them anymore . I had prohalytci laser 360 done on my good eye to stregnthen my retina . I am just researching everything but I was thinling if they could do Prk shade some diopters do u think its possible being -13 to get me to 20/30 bc with contatcs I am 20/25 but WHat are the big risk with PRK and do u ever see them . IT just sucks bc I dont know what to do bc I cant keep wioth contatcs but PRk would be great but dont want a retina tear :( and every docotr agrees with u on the IOL that it ould be crazy but the prk they dont see me a big risk even though I know with my luck

Expert:  pippistrellodaqua replied 1 year ago.
I completely understand your frustration. No, I have not seen patients who have developed retinal detachments due to PRK or LASIK. PRK problems that do arise are usually on the cornea or front surface of the eye. To perform PRK we need to burn away the outermost 10% of the cornea with a solution. We then apply the laser correction to burn away the central part of the cornea. A bandage contact lens is applied to the eye to promote healing and the outermost 10% of the eye then heals over the next week or so. Serious complications can arise during that exposed timeframe and, very rarely, severe infections can occur. Inflammation of the eye during the process can also cause lasting complications. Again, these problems are rather rare, but in cases of just one eye need to be seriously considered. Again, I am a bit more conservative than many doctors and don't like to take risks when it comes to vision, but that is my professional opinion. Contact lenses in this high range can be problematic (as you already know.) Sometimes, especially when our options are limited, a certain amount of potential risk can be outweighed by the potential benefits of a procedure like PRK. I feel that you are absolutely doing the right thing by researching your options, however. There is no such thing as a patient who is too informed/educated regarding the risks and benefits of laser eye surgeries. I hope this has helped. Again, I am speaking in general as each case needs to be evaluated individually. It certainly wouldn't hurt to obtain a PRK evaluation. Most doctors will perform this evaluation, often including the scans of the front part of the eye, for free. This will at least allow you an individualized opinion to add to your decision making.
Customer: replied 1 year ago.

Do u know how to find the best person to do PRK ? and do u recommend doing a PRk on my high myopia ? or is ther any new technology that u know of ? How long do ur patients have to wait to see good with PRK

Expert:  pippistrellodaqua replied 1 year ago.
When looking for a surgeon I suggest finding out how many procedures they have performed. The doctor I refer to has done 20,000 something eyes. I know he does things right. I do recommend PRK for high myopia, but again, in your case without knowing anything other than what we have discussed, I'm a bit reserved. No other procedure can safely correct for very high amounts of prescription except for clear lens exchange or INTACs which I would not suggest due to risk of retinal detachment. Usually PRK patients end up at 20/20 within a few weeks. Really it's the first 3-5 days that are rather blurry as the front 10% of the eye heals. Inflammation remains for a few weeks to about a month, but the vision improves greatly during that time-frame. Do you have any additional questions or concerns?
Customer: replied 1 year ago.

Last question I have is whats the doctors name that u refer to patients

Expert:  pippistrellodaqua replied 1 year ago.
I'm not sure if JustAnswers allows for us to offer specific names. We're not supposed to help establish a patient-doctor relationship, but I will always recommend starting at well known university clinics. These clinics are usually referral sources and receive the more interesting cases which require the best of doctors. If a large regional university has an ophthalmology department I would suggest starting there. Ask for the actual doctor to perform the procedure and not a resident. These attending doctors will have huge amounts of experience, especially in the more challenging cases. I hope that helps.
pippistrellodaqua, Optometrist
Category: Eye
Satisfied Customers: 134
Experience: Specialty in contact lenses, medical eye management, LASIK
pippistrellodaqua and other Eye Specialists are ready to help you
Customer: replied 1 year ago.

I have another question . I have read online if u have higher myopia its a longer time of recovery with PRK ? Also PRk do u have to be out of ur contatcs before surgery like a week or anything ? I developed PVD like 5 months ago and still have floaters will that mess me up with PRK or does it matter ?

Expert:  pippistrellodaqua replied 1 year ago.
The higher the myopia, the more laser that would be applied, and theoretically the more damage done, and therefore the more healing that would need to take place. So yes, the first statement you asked about is correct. I do recommend that you stay out of contact lenses for at least 2 weeks prior to surgery, unless the contact lenses are RGP or hard contact lenses in which case you should be out of lenses for 3-6 months prior to the surgery. PRK would not affect your floaters or the PVD. These findings take place inside the eye where PRK really only affects the cornea or the outermost part of the eye.

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