Lost flap/thin flap

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

Lost flap/thin flap

Postby bsaseyes » Sun Aug 19, 2007 6:19 pm

I had Lasik attempted about 10 days ago in one eye. They cut the flap too thin and had to abort the procedure. To make matters worse, they said they lost the flap or were not able to place it back on my Cornea. I live outside the US (international assignment for work) and while the Dr was reputable, I am very worried. I have had a 2nd and 3rd opinion here and everyone said the eye would heal and my vision would be back to normal. After 10 days the eye has supposedly healed, but my vision in this one eye has not improved. Its very blurry even with my glasses on. I am concerned that the shape of my cornea is permanently damaged and that I will have to have a cornea transplant. They plan to do a map of my eye next week and I should know more. The Dr. says there is no way I will need a transplant, but I don't think he has much experience with these complications since they are so rare. If anyone has any advice I would appreciate it. If things do not improve I plan to go back to the US to have this evaluated by an expert. I have found little information out there on my specific problem. Thanks for any support.
bsaseyes
 
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Postby DryEye » Mon Aug 20, 2007 2:27 am

I read this article last week in Ocular Surgery News about how some surgeons handle losing a flap http://www.osnsupersite.com/view.asp?rID=23169
http://www.osnsupersite.com/ Home Page for website
Hopefully, Glenn will answer this soon for you as he probably knows more than anyone here about this topic
Try seeing someone for a second opinion like a corneal specialist or top refractive surgeon.
Stay positive.
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Lost Flap - Need advice

Postby bsaseyes » Mon Sep 03, 2007 1:21 am

Going on 4 weeks and no improvement. I am having a topography performed this week which I hope will tell me more. If this keeps on I plan to go back to the US for a 2nd opinion. I have been reading about a guy in Nashville who I might go see.

Glenn - if you are out there I would appreciate any advice.

Thanks
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Postby DryEye » Wed Sep 05, 2007 1:39 am

I think i know about the doc you are referring to in Nashville
He was one of about 4 or 5 that I came up with earlier in the year
I eventually went to see the Doctor in Kansas that is a part of this site
I have been to Kansas lots of times, so for me it was an easy do even though it is a little over an hour flight
Dr. D in Kansas
Dr. S in Houston
Dr. W in Nashville
Those were the three I came up with and have heard and read good things about
Dr. D I saw and he and his entire staff are excellent
You owe it to yourself for piece of mind
I'm sure Glenn knows all of them and many others quite well
Let us know & Best of Luck
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Postby bsaseyes » Wed Sep 05, 2007 2:57 pm

THANKS. You´re the only one responding so this may indicate I´m in trouble!! I am working with my company´s medical department and I checked with my insurance in the states and a consultation would be covered 100%. I might go back to Michigan just because that is my home base and if I end up needing surgery or additional work it would be easier to do it in Michigan. So, do you know of any experts in MI? I am originally from Kansas City and have also read about Dr. D. I am going to see about experts in MI but if you know of anyone I´d appreciate it.
Thanks for taking the time to respond.
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Postby DryEye » Wed Sep 05, 2007 3:12 pm

Glad to hear your from KC - A GREAT Town with awesome people
Not sure about Michigan, but I don't think you can go wrong with any of the three and being that your from KC you should at least go back home and see if they can do something or at least give you better guidance.
He was able to tell me what was going on more so than any of the others I had been seeing. These TOP guys have seen and done more than any of the others plus in the case of Dr. D they do research and write about it in the publications. I threw out a few names to all I was seeing and his name consistently was agreed upon by all to see.
You could try emailing or calling their offices for their opinions before going to see them - It may help in settling your nerves. They may even know or have trained someone in the country you are in. Worth exploring until you can see one of them.
You could also try emailing Glenn on his thoughts - He usually responds maybe he has been busy of late.
The publications above that I mentioned are pretty good and should give you more guidance in addition to this site.
I hope things work out for you.
Let us know how things progress
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Postby LasikExpert » Tue Sep 11, 2007 1:44 am

Your long-term prognosis greatly depends upon the nature of the corneal bed where the flap of tissue was removed. If it is relatively even, then it is very likely that the epithelium (pliable outer layer of corneal cells) will thicken and smooth the area. This will give you regular vision quality, but you will undoubtedly need corrective lenses to see well.

Another issue is your pupil size. A normal Lasik flap created with a mechanical microkeratome is meniscus in shape - it is thin at the edge, thick in the mid-periphery, and thinner in the center. The meniscus shape of a flap is not normally a problem because the shape "fits" when the flap is repositioned over the treatment area. It is reasonable to expect that the refractive error in the center of your cornea is different than at the edge. The epithelium will attempt to balance the meniscus feature of your flap-less cornea, however you may have greater vision difficulty if your naturally dilated pupil is large. Conversely, you may have better vision quality with small pupils. The use of a medication the causes your pupils to constrict, such as Alphagan P, may be recommended for temporary use if vision in bright daylight is improved.

A slow vision recovery would be expected. If you have read the experiences of people who had PRK, you will see that they often don't have very clear vision for many weeks. In addition to the normal healing issues with epithelium removal, you also have refractive error.

Your refractive error will undoubtedly continue to change over the next couple of months, but you need to see now. It is very unlikely that your refractive error today is the same as it was before surgery. Your old glasses will likely not provide very good vision. You should seek a refraction (which is better, one or two?) and get new lenses.

I suspect your doctor(s) will recommend PRK or similar surgery to reshape the corneal surface and reduce irregularities as well as try to correct your refractive error. This is a decision that probably will not even be presented until at least three months postop. It is very good to hear that additional opinions have suggested a high probability of a good outcome.

If you will be coming to the US I can do research for a stateside surgeon, but there are many surgeons much closer to your Iceland location than Michigan. Feel free to email me at glenn dot hagele at usaeyes dot org for some suggestions.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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