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How to treat eye power that is not stable over the years?

Q: I do wear spectales of power -2.75 (left eye) and -4.0 (right eye) with cylinder,rotation etc., Since I wear the specs for the past 14 years, I am looking for an alternate method. I don't like the concept of contact lenses. My collegue suggested Lasik Operation in Chennai, who has undergone successful operation there and doesnt wear specs now. Recently I visited one of the best eye hospitals in Bangalore for consultation. Doctor suggested for the Lasik operation, but he cautioned about the possibility of wearing power glasses (with less power) even after the operation. Im worried as power keeps on increasing since beginning. It is supposed to stop at the age of 19 or 20. In my case it didnt happen.Looking forward for your advice.

A:If your power is changing i.e it has not been stable over at least one year (that is more than 0.50 change compared to last years power), then it is advisable to wait until the power stabilizes. LASIK can be performed in your eyes even now, but if the power changes you will either need to wear a small prescription glass or have an enhancement surgery (reoperation to increase the effect). Enhancement can be done safely even 1 to 2 years after initial LASIK surgery. In some individuals power changes until mid to late 20s and that is not very unusual. So do not worry on that aspect.Your doctor is absolutely right in saying that after surgery there will always be a slight prescription that if placed in front of your eyes (as eyeglasses or contact lenses) will improve your uncorrected vision. The extent of improvement may be small and for all practical purposes you may not wear that prescription at all. Remember that the reason why you are having the surgery is to reduce your dependence on glasses so that you are able to function without glasses. The surgery purpose is NOT to eliminate glasses. Of course there is a more than 60% chance that you will end up with about 6/6 vision - but when you consent for surgery think about the reason why you are having the surgery very carefully. The cornea is a biological tissue - not a piece of plastic - and there are many healing factors that determine how much treatment effect is produced by the laser. So your power will be reduced substantially - it will reach close to zero power after surgery - but achieving zero power should not be your reason for surgery. Your aim and the reason for surgery should be to reduce not eliminate your dependence on glasses.The other issue you may want to discuss with your doctor is the possibility of performing LASEK. In this form of laser vision correction there is no flap cutting as in LASIK, therefore is safer. You have low power and so you can have LASEK. LASEK is a form of surface treatment where the epithelium is lifted off as a sheet to expose the corneal stroma for laser treatment. This is different than LASIK where a microkeratome is used to cut a corneal flap, which is then lifted to expose the corneal stroma for laser treatment.

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