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Hi Dr. Ashori here, please tell me what the reason is for the surgery, is it because your vision has worsened due to the scar? What was the reason for the scar?
The options are either laser or local excision.
It depends on the surgeon's skills and what they are most comfortable with. Laser is nice because it's accurate but because your corneal thickness is adequate either procedure would do fine.
Laser has a short recovery and local excision has a longer recovery.
Depending on how wide the scar is and how much granulation tissue you have around it 20/20 is quite likely. Sometimes you might need a second surgery but it usually is attainable.
Yes it's a risk but with very thin corneas, unlikely to happen in your case.
Even if it were to happen usually a good ophtho can see it, recognize it and treat it with steroids or other kinds of eye drops.
It can happen with either of the procedures you mentioned.
Though with a PRK a thin cornea wouldn't be much of a concern to begin with.
Though 500 and above is the range considered to be risk free quite a few patients fall well below that.
At 486 you still have plenty of stroma so your chances of good healing is quite good especially when it comes to managing corneal scars.
Well it depends on how much it is affecting your vision.
They prefer not to do surgery because it's hard to predict how patients heal. Some heal well and there is no problems, others end up with infections and worsening vision should there be complications.
So if the vision is very bad and worsened by the corneal scar then it's probably okay to take on the risk of the surgery. However, if you can control the vision with lenses then I too would recommend not having the surgery done.
So it sounds like with the visual defects you are experiencing a second opinion would be advisable.
I can't recommend anyone that would be a corneal specialist. However, I have had very happy patients who have seen corneal docs over at the UCLA Eye Center, you might consider that if that's in your neighborhood.
Best of luck with the surgery if you choose that route.
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