LASIK and loss of near sighted vision

KD, thanks for the ongoing blog. I am seeing more evidence that one gains back his far vision and the expense of short distance (reading) vision. I have a coworker that just had the lasik surgery about 3 months ago. His vision was pretty bad prior to the surgery but he could read without his glasses up close really well. Post correction, he is now very happy with seeing the clock on the wall and things at distance but tells me that the food on his dinner plate is no longer clear. Reading or computer work is pretty much impossible for him.

I currently wear contacts to correct -3.75 in one eye and -4.0 in another and have no problem reading small print. Making out my finger print pattern is about as fine as i can see with my contacts. With no contacts I can see even better close up. My big worry is close up vision getting worse than i have now with contacts. What do you think?

I am under pressure to do the surgery this year because I signed up for 5K FSA for this year prior to doing the proper homework on the procedure. If i don't do the surgery, i lose the money :(.

Is your coworker over 40? Did he/she have LASIK with either a wavefront-guided or optimized system? I'm curious to know more about this.

In my small sample size of individuals who had LASIK, no one has reported this. However, that doesn't make it non-existent. In my research, I've came across occurrences of this. For many with nearsighted, it takes a while for the muscle in the eyes to adjust. Here is another thread where users reported issue that eventually cleared up. Here's an experience that or may not be similar to your friend's. Then again there are these two who still had blurred vision at 5 months.

I wish I could tell you that LASIK is perfect and you have nothing to worry about. If that were the case, you wouldn't need to research into it. Unfortunately, LASIK is a type of surgery and there are possibilities of complications. The human population is not uniform and there are slight variations in individual's physical attributes. There will always be a percentage of the population whose eyes react differently to the surgery. I wish I can tell you that your LASIK surgery will be perfect and there will be no complications. However, that's not necessarily true. Even my wife's surgery is not perfect even though she's thrilled with the results so far. As far as I  know, her vision is not 20/20 but she doesn't have blurred close up vision.

You should discuss your concerns with your doctor and make the best decision you can with the information available.

What I can tell you is that like you I was concerned about the implications of LASIK surgery gone wrong. I was the one that did all the research. The more I read about horror stories, the more I was hesitant to tell my wife to go through with it. Well, she didn't care and was very gung-ho about it. She was going to do it regardless the potential complications. Ignorance is bliss.

What I recommend is that if you're not comfortable with it, then don't let the money be a consideration. It's better to lose the $5000 than to be pushed into surgery if you're not comfortable with it. For my wife, she could barely see without her contacts so the surgery was worth it and the decision to have LASIK was an easy one. For someone who has good vision nearsighted, it's a more complicated matter and only you can answer that after discussions with your doctor and your family.

References:
http://www.healthboards.com/boards/lasik-eye-surgery/900495-post-lasik-near-vision-blurry.html
http://www.healthboards.com/boards/lasik-eye-surgery/731500-post-lasik-despair-blurred-vision.html
http://www.healthboards.com/boards/lasik-eye-surgery/833757-my-lasik-tale-long.html
http://www.healthboards.com/boards/lasik-eye-surgery/870134-four-months-post-lasik-blurred-vision.html

FSA

In 2013 the flexible spending account will be reduced by half to $2500. However, it's still possible to use all two year's worth of FSA for LASIK if you plan ahead. Now, this is only possible if your enrollment date is the normal late year enrollment. If it's midyear enrollment, you may be out of luck.

The trick is that by law, FSA spending can be spent up to three months into the next year. For example, 2012 FSA money can be spent up to the middle of March 2013. Therefore, it is possible to combine your $2500 from 2012 and $2500 from 2013 for a grand total of $5000. Normally, you would have two debit/credit cards for the FSA. The practice can just split the charges in half, one toward the 2012 card and the other onto the 2013 card. The only downside is that you wait until Jan 1 2013 before you start your procedure. There's no need to rush. Spend that time and research more about LASIK (and check with your clinic to see if they can split the charges. It should be no problem).

Reference: http://en.wikipedia.org/wiki/Flexible_spending_account#Plan_year_grace_period

June Update

This is just a quick  update for those still following this. I've been quite busy and almost forgot about this blog. If you're researching LASIK, I suggest you go through the archives and read it.

Here is a fairly recent study between VISX and Wavelight. There is also an ongoing Stanford study between the two technologies. I'm starting to think that other than HOA, there is really no significant differences between the two of them. If you are clearly in the camp that believe the two technologies are equal, then Dr. Bindi's iFS150 and the Allegretto Wave are clearly the two best combined technologies. Bear in mind that the VISX S4 IR has the largest market share and the longest used laser in the United States. The Allegretto Wave, due to it requiring only a 1 phase (no wavescan check up) is clearly gaining ground. I believe it is the most popular in Europe and around the world. Dr. Bindi and Hyver both switched to the Allegretto Wave. It's no surprise because the less time spent between patients means more eye balls can go through the machines which means more profits. I'm not saying that's a bad thing, but the 1 phase pre-check up with one less machine may eventually win out. VISX used to dominate the market but now I see all these new Laser Centers popping up and they go with Allegretto first as it's a more economical model than the VISX.

The wife is really happy with her results so far. I'm not. She doesn't want to redo her eyes even if she doesn't hit 20/20 because she's "happy with it." For the money she spent, I'm going to make sure she goes back if her vision isn't perfect (or as perfect as the guarantee contract states which is 20/20). She's going to get another check up in July to see if there are any issues delaying her healing.

This is one of the reasons why you want to get your eyes done locally. Most people get great results the first time, but just in case you fall within the 5-10% where complications occur, you want your doctor local and have a guarantee that it gets fixed. However, if you're interested in saving money, I know for a  fact that you can get the Allegretto Wave laser in Los Angeles for half the price of the doctors up here in the Bay Area. For some people $2500 is a lot of money and my advice can be thrown right out the window. Just be careful. The doctors here will reject you if your eyes are not ready. I'm not too sure about those other guys. Educate yourself before you make the commitment!

By the way, if you have questions, post it in the blog. If I no one is reading this, I may not continue to update it. Let me know if you guys are still reading this.

References:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198407/
http://clinicaltrials.gov/ct2/show/NCT01454843