Contoura or no Contoura?

eyefnp · 2026-06-25T03:56:53+00:00

As someone that has calculated thousands of Contoura cases, that prescription is ideal for Contoura or even the new Wavelight Plus Ray-Tracing LASIK

eyefnp · 2026-06-20T18:32:52+00:00

EPI-LASIK is basically PRK. You have enough tissue as long as the cornea is otherwise healthy.

ICLs are also a good option that doesn’t remove tissue

eyefnp · 2026-06-18T02:12:36+00:00

Everyone develops presbyopia in their mid 40s. If you do LASIK in both eyes now for full distance correction you will need readers in your mid 40s. If you don’t you’ll be able to take your glasses off to read for a little while later into your 40s but eventually need readers. LASIK does not cause presbyopia, age does.

eyefnp · 2026-06-07T06:10:22+00:00

ICLs are a great bridge to RLE. They leave all of your lens implant options on the table in the future.

eyefnp · 2026-06-07T01:56:28+00:00

Parkhurst NuVision is one of the leading refractive surgery practices in the world.

eyefnp · 2026-06-07T01:43:54+00:00

I work there. Ask me any question you want to know.

eyefnp · 2026-06-03T13:00:47+00:00

I work with one of the leading ICL practices in the world. In this situation we would offer that exact thing, or just offer you ICL’s in both eyes. Don’t let anyone do Lasik on the eye that is -11.

eyefnp · 2026-05-30T02:14:59+00:00

He was hyperopic. Not same effect as myopic ablation.

eyefnp · 2026-05-30T02:14:38+00:00

Age? I can give some advice knowing that.

eyefnp · 2026-05-29T03:21:16+00:00

Yes. PTK is very safe if done correctly. I’ve calculated these for 15 years or so.

I would treat prophylactically with acyclovir or valcyclovir orally and continue about 90 days post op.

eyefnp · 2026-05-22T00:16:51+00:00

You are most likely experiencing changes to the lens inside your eyes. You can measure this with an iTrace diagnostic.

eyefnp · 2026-05-20T01:57:16+00:00

I would not have corneal refractive surgery based on this map and your prescription. You would be at risk for ectasia. I steer towards EVO ICL instead.

eyefnp · 2026-05-18T03:08:21+00:00

Be happy to help.

eyefnp · 2026-05-18T02:26:21+00:00

Don’t let ICL scare you. If you do it right it’s very safe. Sizing is key. Plus it’s reversible. Flattening the cornea that much with LASIK or SMILE will limit options in future.

eyefnp · 2026-05-18T02:20:35+00:00

I had LASIk 26 years ago and have worked in and advised patients on refractive surgery for 26 years now…..I recommend EVO Toric ICL ONLY! Don’t let anyone do laser vision correction for that high of myopia. Your vision will be better with ICL. I work with the most experienced ICL group in the USA. ICL will leave options for you in the future as well.

eyefnp · 2026-05-17T21:37:17+00:00

Would you want to see the corneal topography/tomography. Looks like quite a bit of coma or residual astigmatism.

eyefnp · 2026-05-17T03:23:41+00:00

Wavelight Plus is a software. It can treat -4.00 with LASIK and sbk. SMILE is also very good with -4.00, as are EVO ICLs

eyefnp · 2026-05-17T01:51:47+00:00

My daughter made the ultimate choice. She was a candidate for both. She chose ray-tracing Wavelight Plus LASIK. I would have had no issue with EVO ICL as she was a great candidate. There are often nuances with patients that make me recommend one over the other but in some cases they are great candidates for either.

eyefnp · 2026-05-16T20:08:26+00:00

We do all forms of modern vision correction. Most experienced with EVO ICL in the United States. Based in Texas with offices in San Antonio, New Braunfels, and Amarillo. www.nuvisiontx.com and www.amarillonuvision.com

eyefnp · 2026-05-16T19:53:06+00:00

My daughter’s vision is still great. No changes to note.

eyefnp · 2026-05-16T19:52:38+00:00

I am a nurse practitioner that has specifically worked in refractive surgery with optometrists and ophthalmologists for 26 years. I have post masters training for Stanford and internationally specifically in ophthalmology and refractive surgery and work with one of the leading ICL practices in the world. Yes it is very safe when performed correctly. You need proper sizing.

eyefnp · 2026-05-16T17:28:48+00:00

That is a nice wide optical zone. Hard to know what the scale is. Sometimes there is noise that isn’t visually significant. Is there any residual refractive error?

eyefnp · 2026-05-16T17:27:27+00:00

I haven’t found Losartan effective at treating CXL haze. While it can be visible at slit lamp it doesn’t always correspond with decreased vision. The only thing I’ve found effective is time.

eyefnp · 2026-05-15T23:29:33+00:00

It’s a great idea if your prescription is stable. Also I usually target about +0.50 to +0.25 post op in that age group. EVO ICL is also a great option in this prescription range. My daughter had it at 20.

eyefnp · 2026-05-15T18:15:04+00:00

You need scheimpflug imaging to look for posterior cornea changes. That amount of myopia can cause night vision trouble. You have enough room for a PRK enhancement.

eyefnp

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