Sorry, forgot to post. Last appointment was on 24 Oct.
- My assessment going in that I shared with the surgeon/staff was that OD was doing pretty great, but would appreciate more mid, and that OS had lost the range between 15’ and 32” that I used to have prior to removing the cylinder in LDD adjustment #2 (this is bothersome as that is a sweet spot for computer work, and car dash, etc). I think the reason is so bothersome is the OD is only getting J7 - hence the lack of overlap between the two eyes in an area that is so useful to most of us.
- OD VA was 20/15 and J7 (J7 same as last four refractions - not particularly happy with it, but appears to be what it is)
- OS VA was 20/25-2 and J1+ (the J1+ was at about 12”)
- Refractions:
(Staff) OD Plano OS -2.25 +0.50 (SE -2.50)
(Surgeon) OD Plano OS -2.25 0.0 (SE -2.25)
AR OD +0.25 +0.25 OS -1.75 +0.50 (SE -2.00)
- Discussion:
1. OS – refraction shows myopia increased, hence the loss of VA in the 15-32” range. No change in PCO – surgeon said could wait and do Nd:YAG at any time as it does not usually affect much (Bradley Barnett). Still a bit dry, so gave me Xiidra samples. Decided to wait another two weeks, and if consistent to dial myopia back to around -1.50 (this would be the third adjustment). I had provided a graph with Spherical Equivalents plotted from the time of surgery - while not definitive, it helped support the discussion and aligned with numbers and my subjective assessment.
2. OD – not sure doc agrees I should be seeing J3/4 and although only seeing J7 should wait to assess in a couple of weeks prior to doing anything else. He tried to set expections considering how really good I was seeing with OD - really solid 20/15 and not able to make it any better at the phoropter. No evidence of clinically significant PCO.
3. My thoughts - I want the 15-32” area back - if the final adjustment gets back closer to -1.50D sphere, and nothing else changes, I think that will be about right. Since I am former PRK, and have data from multiple refractions showing that as the sweet spot since I don’t want to wear glasses for anything

Note - we did not adjust. Another appointment on 7 Nov- I may try wearing a contact lens on the OS at around -1.25 to assess if a lesser blend is substantively better than the -2.25 ... better would be retaining the J1+ while buying back some of the 15-30" acuity. No hurry.