Post PRK haze ( hyperopic astigmatism )

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Post PRK haze ( hyperopic astigmatism )

Postby sarvarsandhu » Sun May 17, 2009 1:22 pm

I am 30 years old and I had PRK (surface ablation) last year in both eyes(15 months to be exact).

here's my current prescription :

Right eye :-0,25 sphere , + 2,25 cylinder ( or +2,00 sphere, -2,25 cylinder @93)

Left Eye : almost plano

I sought opinion from two doctors . First doctor told me that right eye is hyperopic and has some corneal scar.
He told me both can be treated using secondary PRK .
Second doctor told me that eye has some post prk haze,astigmatism is mainly because of that haze and put me on FML eye drops .

I am really confused whether I should go for enhancement
as advised by first doctor or not ?

Can haze be underlying cause of hyperopic astigmatism ?
is there any test that can identify type of astigmatism ?

And can someone tell me the difference between haze and corneal scar?



I would realy appreciate your comments.
sarvarsandhu
 
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Re: Post PRK haze ( hyperopic astigmatism )

Postby LasikExpert » Thu Aug 13, 2009 7:58 pm

sarvarsandhu wrote:I am really confused whether I should go for enhancement as advised by first doctor or not ?


Corneal scaring can cause an irregularity in the cornea that may present as astigmatism. The scaring can create false errors because of the way the light is blocked and bent when passing through the scar tissue. What may be measured as astigmatism in a manifest refraction (which is better, one or two?) could conceivably be caused or exacerbated by the corneal scaring. In other words, the physical irregularity that would normally be called astigmatism may not exist, but the symptoms normally caused by astigmatism may exist because of the corneal scaring.

sarvarsandhu wrote:Can haze be underlying cause of hyperopic astigmatism?


It can be the cause and can exacerbate existing astigmatism.

sarvarsandhu wrote:is there any test that can identify type of astigmatism?


To my knowledge there is no testing that can "neutralize" the effects caused by the corneal scaring and thereby create a clear and true reading.. Unfortunately, all tests that I know use light or sound, both of which can be affected by irregular density or opacity of a cornea.

sarvarsandhu wrote:And can someone tell me the difference between haze and corneal scar?


Corneal scaring can cause the cells to opacify. These opaque cells would present to the doctor as a hazy area of the cornea and could present to the patient as hazy vision. Vision at the location of the scaring would be similar to looking through frosted glass. Hazing is simply the manner in which scaring presents itself.

Haze after PRK is the cornea's wound response. FML is a steroid that can reduce inflammation and control the patient's healing response. It does not seem likely that you would receive much relief from a steroid regimen so long after surgery, however there is little downside if properly monitored.

Correcting the astigmatism now is a difficult decision, but really is about your ability to function. Even if the astigmatism may change as your cornea heals, your vision may currently be so poor that you require enhancement surgery just to be functional. If you are able to get by with glasses or contact lenses, then waiting may be the best treatment. Corneas have a very good history of clearing even after very bad scaring if given enough time. Enhancement PRK surgery on a clear cornea would seem the least risky.

An additional possible treatment is the application of Mitomycin C to the cornea. This would be a very aggressive treatment and probably would not be wise unless the scaring is very severe and you are nonfunctional. The Mitomycin C may resolve the scar tissue, but it may cause enough side effects to make matters even worse.
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Re: Post PRK haze ( hyperopic astigmatism )

Postby sarvarsandhu » Sun Aug 23, 2009 5:38 am

Thank you for such a detailed reply. I guess waiting would be the best bet for me .
thanks again.
sarvarsandhu
 
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