Author Topic: Lasik: custom or conventional  (Read 6040 times)

ljp555

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Lasik: custom or conventional
« on: November 14, 2013, 06:47:03 PM »
Hi everyone,

I'm trying to decide what type of lasik to get. The surgeon always recommends custom lasik, which costs $4600 and 98% of people see 20/20 or better. He did say that conventional lasik is an option for me, which costs $3600 and 80% of people see 20/20 or better, also slightly higher risk of complications like seeing halos. My prescription is not very strong, only -1.25/-0.75, so I'm more likely to have a good outcome than someone with worse vision (less benefit to going with the custom option).

I feel like that I have a high probability of success with either surgery, so I don't want to waste $1000. Still if I don't have a great outcome, it seems penny wise and pound foolish to take the riskier option for $1000.

Any thoughts? Has anyone else looked at these options? Thanks in advance!

catccc

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Re: Lasik: custom or conventional
« Reply #1 on: November 14, 2013, 07:21:19 PM »
I have considered lasik in the past, but decided against it.  Probably not the answer you are looking for, but I say avoid the surgery all together.  Esp if your rx is so light.  Just bring your glasses to the movies. 

IMO risks are not worthwhile.  Make sure you are informed of all the potential risks.  I think the complications are more widespread than recorded, because I can see a lot of people not wanting to admit that lasik was not all they thought it would be.

http://www.npr.org/templates/story/story.php?storyId=122360078

JessieImproved

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Re: Lasik: custom or conventional
« Reply #2 on: November 14, 2013, 07:26:25 PM »
I had lasik over a decade ago, so I'm assuming it was "conventional".  Didn't have any complications and I see better than 20/20.  Night vision is good.  My vision was worse, -4/-3.75.  Best thing I ever spent money on, IMO.  Nothing beats the freedom of being able to see. 

Jwesleym

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Re: Lasik: custom or conventional
« Reply #3 on: November 14, 2013, 07:44:26 PM »
I don't know the difference between custom and traditional, I assume it might be the way they cut the flap. The old way was a knife, which was less precise and had more complications. The new way is a laser which is way better for your eyes.

With your prescription, I wouldn't recommend surgery because the risks are still there. Your risk does not change based on how much your prescription must change. You are at the same risk level as anyone else and don't let them sell you on a false pretense.

I had lasic done at a military hospital with higher success rates than most civilian clinics because they aren't motivated by money. They won't perform surgery if you aren't a good candidate.  They only use the laser cutter, femtosecond laser (I think). BTW, they won't see patients with <-1.00 because it isn't worth the risk. Here is a link to their website with some video of the surgery, I shouldn't have watched it before I did it. 

http://www.tamc.amedd.army.mil/offices/Ophthalmology/

So, I'm with catccc, but if you must do it I recommend the new method.

jba302

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Re: Lasik: custom or conventional
« Reply #4 on: November 14, 2013, 07:47:12 PM »
I believe mine was conventional. I started with 20/200 and 20/250, now it's 20/20. My night vision is good enough for driving but I see halos in certain contrasts. I have trouble seeing in bars at night, but I am married and hate bars so it's no longer a concern.

Given the option I'd probably opt for the better version. For about 9 months after my surgery I was at 20/15, my golf game was phenomenal and I could see every leaf for a mile.

JessieImproved

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Re: Lasik: custom or conventional
« Reply #5 on: November 14, 2013, 08:02:41 PM »
I don't know the difference between custom and traditional, I assume it might be the way they cut the flap. The old way was a knife, which was less precise and had more complications. The new way is a laser which is way better for your eyes.

If that's so, they've been doing the new way since 2002, because they cut my flap with a laser.

dadof4

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Re: Lasik: custom or conventional
« Reply #6 on: November 14, 2013, 11:02:21 PM »
I don't know the difference between custom and traditional, I assume it might be the way they cut the flap. The old way was a knife, which was less precise and had more complications. The new way is a laser which is way better for your eyes.
No, the knife method preceded lasik (which, as the name suggests, was always with a laser).

The new "custom" method involves a new way to measure the eye prior to surgery. The measurement is the added expense.
The actual procedure is supposed to be the same.

dragoncar

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Re: Lasik: custom or conventional
« Reply #7 on: November 15, 2013, 01:10:38 AM »
DIY - I think I saw one on instructables

Ishmael

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Re: Lasik: custom or conventional
« Reply #8 on: November 15, 2013, 07:36:07 AM »
No, the knife method preceded lasik (which, as the name suggests, was always with a laser).

The new "custom" method involves a new way to measure the eye prior to surgery. The measurement is the added expense.
The actual procedure is supposed to be the same.
The LASIK I had used a knife - essentially a micro-razor blade - to cut across the eye, creating a flap that can be folded back; then the laser shaped it. After that, the flap was put back in place and healed over very quickly.

There's another type of procedure that didn't cut a flap, and just burned right from the front but there were (unsurprisingly) more complications and healing time.

Not sure if you're getting these mixed up?

Mega

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Re: Lasik: custom or conventional
« Reply #9 on: November 15, 2013, 09:14:11 AM »
You only have one set of eyes.

Go with the all laser LASIK, that is what I did and you should too.

The difference between all laser and the conventional lasik is how the flap is created. Conventional uses a razor blade. "Custom"/all laser lasik uses a laser to create the flap.

Given the massive difference in outcomes and complications, I am shocked that anyone is still doing Lasik with a blade.

There are other options, such as direct burn on your cornea, but they all have higher complications / worse drawbacks.

ljp555

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Re: Lasik: custom or conventional
« Reply #10 on: November 15, 2013, 09:33:02 AM »
I'm leaning towards doing the custom lasik the more I read about it. Seems worth $1000 to improve vision and reduce complications.

I know there's a good argument that my vision isn't bad enough to warrant surgery. I can get by around the house with no glasses/contacts--still I need them to drive and watch TV, and prefer to wear them for using the computer, walking the dog, etc. I usually end up wearing glasses or contacts all day every day, so in that way I would benefit just as much as someone with worse vision. Risks of visual aberrations from surgery is less for people with less refractive error.

Neither of these options are the bladeless lasik, which adds an additional $700. They would use a surgical tool to cut the flap. The benefits to the bladeless seem minimal to me. The custom lasik does additional mapping so that the laser can treat a wider range of visual imperfections (beyond just nearsightedness and astigmatism). Here is the link http://www.tlcvision.com/learn-about-laser-eye-surgery/types-of-lasik-eye-surgery/custom-lasik/

clutchy

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Re: Lasik: custom or conventional
« Reply #11 on: November 15, 2013, 09:58:19 AM »
you only have 2 eyes.


whenever it comes to things that aren't replaceable I never try to cut corners based on cost alone.

kids/eyes etc...

Rust

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Re: Lasik: custom or conventional
« Reply #12 on: November 15, 2013, 10:06:48 AM »
I'd go the glasses route, but this is also coming from someone who's never known what it's like to have "normal" vision.  Corrected I'm 20/100 in the left 20/50 in the right.  It doesn't get any better for me.  I'm basically monocular. 

Glasses provides an additional level of protection from potential trauma which could occur (low likely hood high impact) 

For those who see 20/50 without correction, how much of an improvement is putting on glasses/contacts to see 20/20?  What am I missing out on?

TGod

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Re: Lasik: custom or conventional
« Reply #13 on: November 15, 2013, 11:27:00 AM »
I had surgery done about 2 years ago. I did the PRK rather than lasik. PRK is when they remove the top lay of your cornea using a laser (the regenerating layer) and then ablate the under layer (the one that doesn't regenerate) thereby changing the shape of you eye. I had originally intended to get lasik (the flap), but at the intake interview with my surgeon he said I was a good candidate for both but he would recommend the PRK (same price so I took him at his word), and that if he could have his surgery done over again he would do the PRK.
The long term results are supposed to be than lasik, but the healing time is longer. It probably took me about 2 weeks before I didn't feel like I was straining my eyes to see at work, and about 2 months before my vision really started to even out, whereas people I know who had lasik had a much faster recovery time.
My only complaints are dry eye, which I was told about up front would probably be an issue, and floaters. I've always had floaters, but I would say that they've gotten worse.
But...I'm extremely happy and glad I did it. 34 years old, glasses since grade 6, struggled with both glasses and contacts, had -4.5 in one eye and -3.75 in the other.  It's a big decision, and I agree with the sentiment that it's your only set of eyes, but I've always hated the idea of being helpless if I lost my contacts while I was away from home.
One less thing to worry about if there's an apocalypse....

projekt

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Re: Lasik: custom or conventional
« Reply #14 on: November 15, 2013, 12:58:29 PM »
Try talking to an ophthalmologist who does not do LASIK. They will probably have an opinion about which procedure is better.

I remember reading an article when I had it done that said that the biggest thing to consider is how many surgeries the surgeon has performed. They recommended the surgeon have at least 1000 procedures under their belt.

acroy

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Re: Lasik: custom or conventional
« Reply #15 on: November 15, 2013, 01:09:24 PM »
Shop around - for extra opinions, and to get a better price.
Wife and I got ours 7yrs ago for $2500 each. 'Conventional' at the time used a knife to lift the top layer, lazer to burn the lens, then top layer placed back down. Worked perfect.
Co-worker got his for 2750, 'conventional' whatever that means now. She sees better than 20/20 about 3 months after the procedure.
I recommend the procedure, don't worry about the fancy version, but shop around first!

ljp555

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Re: Lasik: custom or conventional
« Reply #16 on: November 15, 2013, 04:47:41 PM »
Thanks everyone for the info, especially reminders to shop around. The surgeon I'm talking to here in the bay area seems pretty top-notch (i.e. he's done 35,000 of these procedures). However I'm travelling home to NC for the holidays, so I called a reputable surgeon there--cost would be only $3700 for the custom, bladeless LASIK (compared to $5300 in San Jose). I'm going to keep researching so I know all my options.

Jwesleym

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Re: Lasik: custom or conventional
« Reply #17 on: November 15, 2013, 06:02:40 PM »

One less thing to worry about if there's an apocalypse....

+1

Contacts won't cut it, and glasses can be taken/broken/eaten by zombies.