Interesting Lasik experience

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Interesting Lasik experience

Postby Vannh9 » Tue Sep 19, 2006 2:54 pm

I had Intralasik exactly 2 weeks ago and the good news is I feel like my eye is healing, but I want to ask if any one has ever experienced anything quite like mine.

I did a lot of research on the facilty and the laser and chose a certain doctor and the Intralase method. I met with the doctor prior to surgery and felt completley confident that I made the right choice in physicians and practices. We agreed that distance was the best option because of my motion sickness sensitivity. They indicated that I was PERFECT candidate for Lasik and based on my research I agreed. My vision was r (-4.75) and l (-5.00) Corneal thickness was more that adequate and pupil perfect size..(so they said and it was confirmed by my personal doctor)

I arrived the day of surgery and did the 3rd round of preliminary testing..etc. I had chosed distance vision only..not mono and had my decision confirmed by my pre and post op doctor. After examining my eyes the doctor told me to reconsider distance vision. I said I was pretty confident that I had made the right decision...he continued to ask me to reconsider a slight modification (told me a long story about his son's teacher regretting distance...etc) I said OK --as long as I could have an enhancement if I wasn't happy...ABSOLUTELY. He said the didn't like going into surgery thinking I might want an enhancement, but he thought this was the best for me. As I took the pre meds and I told the nurse and admin that I had real concerns about modified Mono..wanted distance ONLY....I didn't want the doctor to be disappointed, but I really wanted DISTANCE..crisp clear...they said he would be fine...so the doctor comes back and continues to talk about this teacher....he wants me to see what it would be like with the modified..assured me I would still have 20/20 vison with both eyes...took me back in the examing room and I relented yet again for the modified mono.....on left eye -.25 (non dominant eye)

OK..so the surgery starts and all went well and in my opinion uneventful ..EXCEPT....from the time the doctor put the first suction on until the surgery was complete the Doctor talked to a nurse or colleaque that I had not met about something totally unrelated to ME or the surgery he was performing...he did not mention what was coming..what he was doing..quite unbelievable and when I would try and say something he would say "don't talk". As he got to my right eye and was lining up the laser the girl that was with him said something(couldn't really understand her words) and he said "go with it anyway"...don't know if that is even relavent except I still don't have 20/20 in that eye.

OK ..it is over...no real pain...little stinging...BUT ..I could not see very much with the right eye...first test was R (20/25) L (20./70). But I realized that it was day 1. They told me the doctor would call and check on my that night. I did go home...went to sleep, but was coherent enough to take a call or two..the doctor didn't call..I woke up at 3:00 am and my right eye was in severe pain. The next morning I went for my appt at 7:00 because that was the only time the surgeon could see patients becaues he had to be at another appt. in another town at 9:00.

We got to the center and there were about 10 people waiting to be let in at 7:00 and the doctor was not there. A business colleaque check my eye for about 30 seconds ..said OK all is well..I told him my right eye was killing me and could he put a numbing drop in..he did and told me to go home and rest..I didn't ask him where the surgeon was...I was a bit out of it..in pain...etc.

I go home and when the drop wears off the pain is worse...still no call from the doctor...??? Is all of this normal....Definitley a very arrogant man!!!

I called my eye doctor and he had me immediatly come in. Initial vision acuity was r(20/50 L(20/25) (together 20/25) He did a thourough exam and determined that I had a ring of severe bruises and hemorages from the suction ring...he also dyed the eye and determined that I had scratches in one place (also from the suction), BUT he did feel the flap was healing appropriately. He put numbing drops in my eye ..told me to continue with the Pre -Forte and Zymar 4 x daily. I went home and within 2 hours my eye was KILLING me..I called the center I had the surgery at(not my eye doctor) because I wanted them to know I was having issues. and asked for a perscription for pain meds....The doctor that had checked my eyes (not the surgeon) said he thought it was really odd that I would need pain medication bacause MY EYE DOCTOR sent a report that stated I had 20/20 vison and all was well. I was furious- why would my doctor withhold information????. He said that I would have to drive to pick up a perscription because it was a narcotic. What kind of doctor did I have?? We agreed to have the perscription picked up at my local doctors office..I had a friend pick up the meds and it has helped...

2 weeks later you can still see where the suction ring was placed on my eye..there is still on prominent red dot and a grey area where the ring was, and I still have intermittant pain occasionally. Last vision check (1 week ago) was r(20/40) L(20/25) I go back to my doctor on Thursday and I am going to have a discussion with him about my experience and try and determine what is normal and what is not about they way they have responded to this situation. Needless to say I am not excited about an enhancement to my modified mono eye, but don't have that crisp vision because my other eye is not 20/20. Now I realize that it is still early in the process, but I feel like my concerns are valid. 5).

1) Why would a surgeon pressure a patient to have modified mono when you have a patient that has clearly indicated their preference of distance?

2) Is it common for the surgeon to never contact or examine your eyes post surgery?

3) Why is my personal doctor withholding info from the surgery center? (I have seen the partnership bill which is $900.00) Could it be the financial component???

4) Have you ever heard of a case where the Intralase suction created such an issue?? (2 weeks later the bruised ring area is still visible) Why would one eye be so unaffected and the other has such trauma??

And feedback is greatly appreciated!

Thanks for taking the time to read this lengthy thread:-)
Vannh9
 
Posts: 8
Joined: Mon Sep 18, 2006 8:34 pm
Location: Raleigh NC

Re: Interesting Lasik experience

Postby LasikExpert » Tue Sep 19, 2006 3:52 pm

Vannh9 wrote:1) Why would a surgeon pressure a patient to have modified mono when you have a patient that has clearly indicated their preference of distance?


Because in that doctor's experience the majority of similar patients realized better overall results with modified monovision than with distance vision. I concur that for moderately presbyopic patients this is generally true, however we recommend a monovision trial for several weeks with contact lenses so the patient can experience monovision.

Vannh9 wrote:2) Is it common for the surgeon to never contact or examine your eyes post surgery?


Comanagement with other professionals is an accepted method to provide pre and postop care. Comanagement has the advantage of multiple doctors managing care (built-in second opinion), and the disadvantage of the possibility of poor communications between those doctors or care provided by less-qualified doctors.

Vannh9 wrote:3) Why is my personal doctor withholding info from the surgery center? (I have seen the partnership bill which is $900.00) Could it be the financial component???


I'm not quite certain what information is being "withheld". It is common for the comanaging doctor to provide a final report to the surgery center after the healing process is complete, but at two weeks postop you are far from complete. Due to your brusing from the microkeratome suction ring it would seem that there may be more communication with the surgery center, but this may not be required if the comanaging doctor has adequate experience with this problem.

Every provider needs to be paid for his or her services. You would have paid a single global fee for comanagement, surgeon, and facility. Those three entities would determine who gets how much based upon the services each provides. Of course there could be financial influences, but you have not described anything that indicates this is present in your pre or post surgical care. Keep in mind that the comanaging doctor can comanage with just about any surgeon, so the influence may not be great.

Vannh9 wrote:4) Have you ever heard of a case where the Intralase suction created such an issue?? (2 weeks later the bruised ring area is still visible) Why would one eye be so unaffected and the other has such trauma??


All microkeratomes can cause bruising and/or sub-conjunctival hemorrhage. They look terrible, can hurt like mad, and tend to take a long time to resolve, but normally resolve fully. It could be that more pressure was placed on one eye or one eye was more susceptible to bruising.

The bruising and red ring you describe will undoubtedly resolve in 3-6 weeks. The vision quality problems sound very normal at this stage in recovery. You should not even consider enhancement surgery until about three months postop or when your eyes have fully healed. Then and only then can your eyes be evaluated to determine if enhancement is needed or appropriate.
Glenn Hagele
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Lasik Info &
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I am not a doctor.
LasikExpert
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Postby Vannh9 » Tue Sep 19, 2006 8:42 pm

Glenn,

Thank you for your honest and open feedback. My eye is actually a bit better today and I am hopeful that my sight will eventually be at 20/20 together.

Thanks for all the time and energy you put into this. It has been helpful and has helped me work through my panic moments:-)

Thanks again,

Vann
Vannh9
 
Posts: 8
Joined: Mon Sep 18, 2006 8:34 pm
Location: Raleigh NC


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