Post-Op Complications PRK - Second Opinion?

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Post-Op Complications PRK - Second Opinion?

Postby gbush » Mon Jan 28, 2008 6:08 pm

Hi all,

I just had PRK done on both eyes on Jan 17th. The contact in my left eye slipped and had to be pushed back on the following day. Tuesday following the operation my left eye got very blurry and painful. I called the office and was told to take out my left contact. There was no improvement. I called again and mentioned to the doctor this time (talked to receptionists before). When I told him I could not see big newsprint and everything was cloudy, he told me to come in the following day. The next day he diagnosed keratitis and placed me on higher doses of steroids and antibiotic drops round the clock. Since then, he says the cornea has steadily improved. Today I have haziness which has gotten better overall, but not in the last couple days. My vision is very blurry in this eye. My right is 20/20, with some blur and ghosting which I suppose will improve. My question is what do I do now? Should I continue to trust the surgeon? Should I get a second opinion on the left eye. Am I screwed for decent vision in the left eye? I tried to look in the microscope today for work and could barely do it. Any ideas. I'm terrified that my vision is permanently disabled in my left. Thanks in advance.
gbush
 
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Postby gbush » Mon Jan 28, 2008 6:28 pm

By the way, I am pretty happy about my progress in the right eye so far. Just worried about what to do in the left. Thanks again.
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Postby Blindbat2007 » Mon Jan 28, 2008 10:38 pm

If it helps you any my left bandage contact popped out two days after surgery and didn't know it until a week later when they went to remove it. I also suffered a great deal of pain in my left eye. As of today, my left eye is seeing great during the day and ghosting at night. My right eye is ghosting equally as the left. I'm almost eight weeks past my surgery date.

So, I didn't experience any complications due to the loss of the contact. In fact it almost seems like the healing was accelerated. My right eye is still catching up and it had the contact in for 5 days. My doctor didn't diagnose anything, but he also said the cornea looked fine. I had very blurry vision for two weeks in both eyes. I just thought that was part of the healing process.
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Postby gbush » Tue Jan 29, 2008 1:42 am

Thanks for the share. Your story definitely makes me feel better. Did your eye ever get inflamed after the contact came out? My ghosting is there, but I'm keeping a good attitude and assuming that this will fade as time goes by and the epithelium heals.
gbush
 
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Postby LasikExpert » Tue Jan 29, 2008 1:45 am

Keratitis can have a slow recovery, so don't make any decisions about your final outcome just yet. A second opinon may be in order; for peace of mind if nothing else, but it sounds like things have stabilized and your doctor is on the situation.

Continue to report your problems to your doctor and let us know what hte next week brings.
Glenn Hagele
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USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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Postby Blindbat2007 » Wed Jan 30, 2008 10:29 pm

I don't know if it got inflammed. I just know that it felt like there was a piece of metal lodged in my left eye for a day or two. Just thinking about it makes my eyes water. It was very uncomfortable.

I have bad ghosting at night.

I will be posting my eight week update this coming Friday. Stay tuned.
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Postby gbush » Fri Feb 01, 2008 10:44 pm

Had a second opinion today and the doctor assured me that the white spot remaining on my eye (which makes everything hazy) represents delayed epithelial healing and may take several months to resolved. He said he didn't want to promise anything, but he would expect a big improvement in 2-4 weeks. Haven't seen an improvement personally, but I should probably hang on to this hope. My right eye appears to be progressing fine. I do get halos and ghosting. The double vision appears to get better with drops temporarily so maybe its due to dry eye. My left is still fairly useless. I can see, but everything is blurry and hazy, mostly in bright light, so I think the white area of healing is mostly responsible. I'm getting fitted for a new glasses prescription next week because of the difference b/w my two eyes. I get headaches trying to focus. Glenn, what is your experience with glasses helping vision during the early stages of recovery?
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Postby houstonman » Wed Feb 06, 2008 9:43 am

Im more worried that they told you to take your contact out yourself. My Doc would of never of let me do that.
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Postby gbush » Wed Feb 06, 2008 4:02 pm

Yeah, if he would have taken it out personally, the keratitis may have been caught earlier. So I'm in the middle of week three post-op. I find my vision is far more blurry in the morning than in the evening. I seem to have more trouble using the microscope in the morning than in the evening. My left eye still has a white spot in it. My check-up with the surgeon went well and he says the mound of epithelium is getting smaller in diameter and thinner. He put off the refraction for another week because he thinks the sight in the left will improve more as the week goes on. I think most of my focus issues in my right eye (20/20-20/30 at this point) are related to dry eye as the artificial tears help alot. Vision fluctuates from clear to blurry with ghosts in this eye which I assume will resolve. I'm mainly worried about my left and how soon the the haze will clear and whether there may be any damage which would lower my BCVA in my left eye. I'm 20/30-20/40 in this eye, but it is very difficult to see clearly. That's cause the hazy spot is right over the middle of my pupil. I imagine I'll probably need glasses after my eyes have stabilized. At this point, I can't see seminar slides or faces very well from a distance. The idea of glasses doesn't bother me especially if I'm just using them for just seminars and driving. The thought of losing BCVA in the left certainly does. Anyone have any experience with glasses after PRK? Are things like irregular astigmatisms very common after PRK?
gbush
 
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Postby BahamaPapa » Mon Feb 11, 2008 2:16 am

i agree with houstonman, that was pretty irresponsible of your doc to tell you to take out the contact. wow. :shock: just hoping for the best for you.
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Postby Pappy » Mon Feb 11, 2008 5:21 am

gbush wrote:Yeah, if he would have taken it out personally, the keratitis may have been caught earlier. So I'm in the middle of week three post-op. I find my vision is far more blurry in the morning than in the evening. I seem to have more trouble using the microscope in the morning than in the evening. My left eye still has a white spot in it. My check-up with the surgeon went well and he says the mound of epithelium is getting smaller in diameter and thinner. He put off the refraction for another week because he thinks the sight in the left will improve more as the week goes on. I think most of my focus issues in my right eye (20/20-20/30 at this point) are related to dry eye as the artificial tears help alot. Vision fluctuates from clear to blurry with ghosts in this eye which I assume will resolve. I'm mainly worried about my left and how soon the the haze will clear and whether there may be any damage which would lower my BCVA in my left eye. I'm 20/30-20/40 in this eye, but it is very difficult to see clearly. That's cause the hazy spot is right over the middle of my pupil. I imagine I'll probably need glasses after my eyes have stabilized. At this point, I can't see seminar slides or faces very well from a distance. The idea of glasses doesn't bother me especially if I'm just using them for just seminars and driving. The thought of losing BCVA in the left certainly does. Anyone have any experience with glasses after PRK? Are things like irregular astigmatisms very common after PRK?


The rewetting drops clearing up your vision might also be due to your epithelium still being "coarse" you are basically smoothing the light as it passes. So hang tight it might take up to 3 months for all that to settle down and your eyes will be healing for the next year.

I'd be more adamant about the hazy spot, do you know if they use Mitocycin C on you? I know steroids help with the haze and as you say they state it's an epethelial mass but I'd want a second opinion on it, that can still be corrected (if it's haze) now.

My vision does the same thing at the moment, better as the day progresses and in the morning I'm incrementally better than the day before (entering my 3rd week now and seeing about 20/30 both eyes, maybe a little better.)

Good luck and you should definitely seek a second opinion the "take your bandage contact out your self" statement sends red flags up for me.
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Postby gbush » Mon Feb 11, 2008 6:26 am

The second opinion I got was from an independent physician. He agreed that the focus of haze was epithelial and superficial stromal. He's the one who thought that it might clear up in 2-4 weeks, but could also take months. Overall, the second opinion seemed unconcerned and this would be a time issue. Mitomycin C was used in both my eyes. I'm also on Vit C and flaxseed suppl. daily. The second opinion doctor stated that this was a different "haze" from that which is seen is PRK late-post op and what I have represents delayed epithelial healing. The good thing is my doc will see me anytime during the week and he's been following me at least once a week for rechecks (I went twice last week cause I freaked out a little bit). Each time he says that the spot is getting smaller and flatter (slit lamp exam) My last recheck I was 20/25 in the right (fairly easy) and 20/25 in the left (pretty difficult). The hazy spot is less than 1 mm in diameter now (I can see it with my right eye in the mirror). I specifically asked about irregular astigmatism and BCVA with both docs and they seemed to respond that the chances were low. My surgeon all and all seemed very optimistic and stated that I likely would not need an enchancement. Any ideas or opinions concerning astigmatism or BCVA? Any other questions to ask?

By the way, my right is progressing very well. I just wish my left would catch up. The one spot is causing all the trouble, I think. I started -6.00 OD and -5.75 OS, pre-op.
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Postby gbush » Mon Feb 11, 2008 6:27 am

I'll share more after my 4 week check up this Wed. Any input would be appreciated before so I can be prepared. Thanks.
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