Jose was definitely a challenge. He is a commercial truck driver who was very extremely nearsighted (above -10.00 range), and had very large pupils (in the range of 8.0mm, both eyes). As if that weren't enough, his left eye is slightly "lazy" and cannot be corrected better than 20/40 in glasses or contacts. He was very interested in what could be done to improve his vision.
I told him that in my opinion, considering his high prescription, pupil size, and occupation (demanding very good quality night vision; with no glare, halo, or decrease in contrast sensitivity) I would not recommend LASIK. I suggested either phakic lens implantation using the Artisan lens, or removal of his natural lens and replacement with an implant lens more appropriate to his visual needs. He chose the latter option.
Unlike LASIK, where we can do surgery for both eyes at the same time, with intraocular surgery (any procedure that makes changes inside the eye) we would do only one eye at a time. We treated Jose's left eye first, as that was the "lazy" eye. He was so pleased with the results that he asked us to proceed with the right eye as soon as possible thereafter. We did, and are thrilled that the surgery went just as expected in both eyes. On the first day after surgery, Jose's unaided vision was 20/25+ in the right eye and 20/30+ in the left.
We did warn Jose that this type of surgical care would hasten the need for reading glasses, and that he would need them essentially right after surgery. With a pair of dime-store +2.25 power "cheaters" he can read the tiniest print on our reading charts.
We will follow Jose closely to make sure that he maintains his excellent vision for years to come. His wife and two beautiful children are delighted with the results of his care, and are happy to see him never use those "too-thick" glasses ever again!