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Custom LASIK over correction

Q:

Kera-gurus:

I have a 52 year old guy who had Custom LASIK one month ago for myopic astigmatism (OD -3.00 + 0.25 and OS -3.25 + 1.25). He is slightly overcorrected with refraction of +0.50 + 0.25 in each eye. He’s doing fine for distance activities such as soccer and driving. But he is a little blurry watching TV and in the 5-20 foot range. He is fine using +2.50 readers for computer and near activities.

At this age and after this amount of treatment, is any regression likely to occur to bring him back closer to Plano?

Would the Contact lens and Acular treatment be at all useful this far out from surgery ?

Curious how others in the group would manage this?

Thanks as always for your expert advice,

Mike

Bellevue, WA

A:

Mike

Put him on diclofenac QID for a month. Will hit Plano. Stop when Plano. QID more effective than less frequent dosing. Works much better than Acular. CL isn’t necessary. Mechanism is Epi hyperplasia.

I’ve tried every NSAID over 15 years. Voltaren works best

I’m going to anticipate people saying QID dosing is risky and can cause a corneal melt. Simply not true. Wish that article never got published BC it’s prevented hundreds of MDs from treating thousands of pts like this safely BC of a bad batch of generic NSAID with a bad vehicle that’s no longer on the market and hasn’t been for a decade

How do I know? BC I’ve used NSAIDs to regress about 1,000 pts over the past 15 years w zero complications

Works better in ASA than w lasik. Can get up to 1 D regression in ASA. In lasik only .75 max. Must start therapy within a month postop or it doesn’t work very well. Can take up to 3 mos so need to be patient ie effect might be .25 D/yr. effect is permanent

If you guys think I should publish my results BC this modality isn’t widely known I’ll have my fellows do so

Hope this helps and good luck

Emil William Chynn, MD, FACS, MBA

Harvard/Columbia/Dartmouth/NYU/Emory-trained

1st eye surgeon in NY to get LASIK himself (1999)

Performed 5,000 LASIKs from 1996-2002

Switched to non-invasive LASEK in 2003

Have performed more LASEKs than any MD in US

No other laser vision correction surgeon in New York….

No other laser vision correction surgeon in New York....

...offers you the opportunity to have a Free Remote Consultation with the surgeon! Ask Dr. Chynn your main question or concern, and will answer, personally, within 2 business days!

Unsure whether you're a good candidate because of a lot of astigmatism? Large pupils? Dry eyes? Maybe you were rejected by LASIK surgeons due to a “thin cornea” or high prescription.

Take advantage of this incredible opportunity to find out if LASEK is an option for you from Dr. Chynn, our famous, cornea fellowship-trained, Columbia & Harvard graduate who’s in MENSA & was the 1st eye surgeon in NY, NJ, CT & PA to get LASIK, & has performed 1,000 PRKs, 5,000 LASIKs, 10,000 LASEKs, and 5,000 epiLASEKs

But please be considerate. Dr. Chynn gets paid $1,000/hour as a consultant for expert networks & expert witness, so please limit yourself to your most pressing question or concern, as he’s doing this for free on a trial basis to help interested patients.

Please include the information below in your email so Dr. Chynn can answer your question specifically.

Age:
Approximate prescription (if known):
Occupation (the more specific the better):
Main barrier or concern:

  • This field is for validation purposes and should be left unchanged.

Tell Dr. Chynn your main barrier so he can help overcome it😉👌

Email us at dr@ParkAvenueLASEK.com
Text us at (212) 691-4221

Contact Dr. Chynn

x

Tell Dr. Chynn your main barrier so he can help overcome it😉👌 Email us at dr@ParkAvenueLASEK.com Text us at (212) 691-4221

No other laser vision correction surgeon in New York….

No other laser vision correction surgeon in New York....

...offers you the opportunity to have a Free Remote Consultation with the surgeon! Ask Dr. Chynn your main question or concern, and will answer, personally, within 2 business days!

Unsure whether you're a good candidate because of a lot of astigmatism? Large pupils? Dry eyes? Maybe you were rejected by LASIK surgeons due to a “thin cornea” or high prescription.

Take advantage of this incredible opportunity to find out if LASEK is an option for you from Dr. Chynn, our famous, cornea fellowship-trained, Columbia & Harvard graduate who’s in MENSA & was the 1st eye surgeon in NY, NJ, CT & PA to get LASIK, & has performed 1,000 PRKs, 5,000 LASIKs, 10,000 LASEKs, and 5,000 epiLASEKs

But please be considerate. Dr. Chynn gets paid $1,000/hour as a consultant for expert networks & expert witness, so please limit yourself to your most pressing question or concern, as he’s doing this for free on a trial basis to help interested patients.

Please include the information below in your email so Dr. Chynn can answer your question specifically.

Age:
Approximate prescription (if known):
Occupation (the more specific the better):
Main barrier or concern:

  • This field is for validation purposes and should be left unchanged.