ICL vs Lasik

[JonathanSmith]

I live in Atlanta, GA. I have been wearing glasses for the last 25 years (since I was 8 years old). I love playing sports and swimming and my glasses have always been an issue. I have always wanted to get some treatment done but my number kept increasing. This year (now I am 33), my number stabilized and I started exploring options. I went to EmoryVision (with Dr. Randleman) and got my eyes examined for Lasik. My number is
OD (right): Sph -8.00 cyl -100, Axis:002, Thinnest: 527 um, pupil diameter: 3.7 mm
OS (left): Sph -8.25 cyl -075, Axis:050, Thinnest: 537 um, pupil diameter: 3.6 mm

I have been told that I am a good candidate for Lasik. I don't have any other current issues with my eyes. EmoryVision used Custom guided lasik. Even though they have Artisan ICL option, they never mentioned about it. For a second opinion, I went to Woodhams Eye Clinic (Saw Dr. Trevor Woodhams) who checked my eyes and told me that my better option was getting ICL (woodhams used Visian ICL). Dr. Woodhams kept emphasizing that ICL does not involve reshaping of the cornea, is reversible and the process has reduced risk. I became confused and started to do some research online. On the web most of the marketing material around ICL is quite positive till I came across this forum and found about Iridotomy issues (Even though many people achieve 20/20 or 20/40 vision, but there are frequent occurances of glare and double vision caused due to iridotomy hole.  The only solution being sutures or colored Tattoos). Need some guidance as to which treatment would be benefitial for me in my circumstances and if you know of a good doctor in Atlanta. Thanks.

[roboxtz]

There are so much complications associated to lasik and prk as glare,halos,loss of contrast sensibility,the doctors use to not let you know about that,i would go with ICL if it is an option.

[jetguy]

I think the risks of Staar's ICL are not as bad now, although very dependent on the skill and experience of the surgeon.

[walkietalkie]

I had Lasik 12 yrs ago. My power was -8. Lasik was still new then so my doctor (now a professor and prominent reseacher) made my eyes slightly under-corrected  to -0.5. Throughout the years my power regresses a bit and am now about -1.75. Which is fine, now that I am at the age mentioned by Dr Hagan. I had some side effects but they diminish with time. I had retinal tear few years ago but that has been taken care of. I am an active person who likes to swim so I can emphatise with you. Yes go for it. Lasik technologies have improved tremendously since then that you are spoilt for choice now.      

[JonathanSmith]

As per your recommendation, I have eliminated the option of ICL. After reading about other options, I have some more questions:

a) Which is preferred - Allegretto Eye Q Laser System with mechanical MicroKeratome or Visx S4 Custom Vue Laser System with IntraLase
b) Which is preferred - Lasik (with the better option from a) vs Advance Surface Ablation (either LASEK or Epi-Lasek)
b) Is SBK (sub-Bowmans keratomileusis) same as using any Femtosec laser for the flap like IntraLase laser, VisuMax etc which keeps the flap to around 110 microns?

[John C Hagan III, MD, FACS, FAAO]

No I do not have a specific surgeon to recommend, do your own due diligence.

If you had lasik and it corrected you to "Plano"  0.00  no need for glasses at all for distance your progression through presbyopia would be like any other person the same age that was blessed with no need for glasses at distance.

Now many of the happiest myopes are people like me, in my 60's but with -2.50 myopia I can read and use my computer without glasses.  Some high myopes opt to leave one eye in the area of -1.50 to -2.00 if they are near 40.

That is a form of "monovision"

JCH MD

[JonathanSmith]

Dr. Hagen - appreciate your advice. Would you recommend a specific doctor in Atlanta? I am aware that eventually I would have presbyopia and would need reading glasses. Does having Lasik would have any adverse affect on presbyopia? What I mean by that is when you have glasses, the power starts small and increases (w/ age and straining of eyes till it stablilizes around ~30). However, due to my eye history and then lasik, would it happen that I would need a high power reading glasses to begin with or a small power to start with just like others.

des900 - I agree with you on these side effects of lasik. But I have talked with 10 different acquaintances who have had lasik and even though some of them have had the problems you listed, none have repented their decision about lasik. The problem (like dry eyes etc) do exist but are minor. However, after reading various forums, the effect of Iridotomy are quite severe where patients are repenting their decision to get ICL and had to undergo subsequent procedures from a highly skilled opthomologist to get sutures or a colored tattoo. Some people have quit working because their vision has gone really bad. That has made me panic and lean towards lasik.

[des900]

Lasik undergone people often complain about quality of vision which include poor night vision, seeing halos, glare, sometimes even dry eyes & increased no of floater's also may of them still need glasses.

So you should properly decide before undergoing any surgery as its effects are mostly irreversible.

[John C Hagan III, MD, FACS, FAAO]

I trained at Emory and I know Dr. Woodhams. I would recommend lasik. I would not have an ICL put in my eye or any family member. I never recommend it to my patients. However lasik is something I would allow any of my family to have.

Realize if it works perfect you will still need reading glasses about age 41-43 and as you get older your near vision will deteriorate and you will also need glasses for shopping, computers, reading, etc.

JCH MD