I had wavefront optimized LASEK with Allegretto Eye-Q

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I had wavefront optimized LASEK with Allegretto Eye-Q

Postby RobyRob » Sun Oct 22, 2006 12:31 pm

I had left eye done on September 26th and right on October 3rd 2006.
My prescription was:
Left: -2.50 -1.00 14
Right: -2.50 -0.75 176
My optical zone was 7.00mm and treatment zone 9.0mm.

Day of surgery:
Although surgery didn't hurt I could still feel everything and it was very uncomfortable (pressure from trephane, super blur, cold alcohol and BSS,...).
The laser makes a buzzing sound and it also has a loud plume evacuator.
It didn't smell bad, however I could feel like water is being sprayed above my face.
One hour after surgery I removed the plaster and started taking drops. My operated eye was very red and the other one was also a bit red.
Pain started aprox. 4 hours after surgery and lasted for around 8 hours. It was extreme. I took all 3 pills and they didn't help. I was also given drops but I didn't take them because they stop the healing. Putting ice on operated eye helped the most.

Day 1 and 2:
I could see that myopia and astigmatism are gone, but vision was still a bit blurred. The contact lens was very uncomfortable.

Day 3:
The contact lens was removed. The eye felt much better. Vision however was super blurred. Epithelium met exactly in center and formed something similar to a scar.

Day 4:
Vision was improving from hour to hour. In the end it was close to clear.

Day 9:
I woke up with extremely bad and unstable vision. I saw blurred, double, triple and it was changing from hour to hour. I even felt dizzy. Topography showed that epithelium has a weird irregular formation in center of cornea.

In left eye vision became perfectly clear 14 days post-op. In right eye it is still not clear even 19 days post-op but it is improving, very slowly however.

I must add that my vision is very unstable. I wake up with perfect vision but rest of the day it is blurred, double,... Artificial drops help only for a short period. It seems that I have dry eye but I don't feel it.

Hope this will be helpful to someone. I will post more as time goes by.
RobyRob
 
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Postby LasikExpert » Tue Oct 24, 2006 6:32 am

Do keep us informed, and in this thread if convenient.

The fluctuation through the day sounds sounds like you do have temporary dry eye induced by Lasik. We have an article about Lasik Dry Eye that you may find helpful. It includes links to suggested treatments.

I personally had a similar epithelial scaring. My epithelium was damaged during contact lens removal after PRK, in part because I had overused topical pain medication and toxified the epithelium. My epithelial scaring had a tri-star shape like the Mercedes Benz logo, which is somewhat common after PRK. In my case it took several weeks for for the scaring to disappate.
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Postby RobyRob » Tue Oct 24, 2006 6:57 pm

Yes, I will update this thread.

I went back to work as a programmer yesterday. It is very difficult. My vision is everything but clear especially in front of computer, but a large LCD solves the problem. I use lubricating gel.

My epithelial scar had form of a vertical line and disappeared in day or two. PRK must hurt like hell, I know LASEK does...
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Postby RobyRob » Sat Nov 04, 2006 8:53 pm

1 month post-op:

Left eye:
Near vision: perfect!
Distant vision: very blurred

Right exe:
Near: blurred (I have serious problems with accommodation due to astigmatism)
Distant: very blurred

My estimated manifest refraction:
Left: -0.75 SPH 0.00 CYL
Right: -0.25 SPH -0.50 CYL

I have no side effects, except dry eye related.
I am very unsatisfied with my distant vision. Driving is almost impossible. My surgeon says that this will improve but I don't think so. I will most likely demand enhancement.


Glenn, can you please answer a few questions for me:
1.) Can undercorrection of myopia really improve with time?
2.) What do surgeons usually enter into the laser for myopic people: manifest or cycloplegic refraction?
3.) What should they enter if the patient needs good distant vision?
4.) What should they enter if this patient has a huge difference between manifest and cycloplegic refraction?
5.) What is the maximum and average difference between manifest and cyclopegic refraction?
RobyRob
 
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Postby LasikExpert » Sat Nov 04, 2006 9:09 pm

RObyRob wrote:1.) Can undercorrection of myopia really improve with time?


Absolutely. At one month postop you may still be dealing with edema (swelling) issues and the dry eye can exacerbate the situation. Lasik is more of a six month process than a 20 Minute Miracle.

RObyRob wrote:2.) What do surgeons usually enter into the laser for myopic people: manifest or cycloplegic refraction?


Depends on the surgeon, the patient's refractive error, the age of the patient, the type of laser, the type of ablation, and many other variables. The greater the difference between the cyclopegic and the manifest refractions, the greater the concern. I personally feel the cyclopegic is the better of the two, but that is not true in all instances.

RObyRob wrote:3.) What should they enter if the patient needs good distant vision?


Target plano (no refractive error).

RObyRob wrote:4.) What should they enter if this patient has a huge difference between manifest and cycloplegic refraction?


It varies from doctor to doctor. My personal preference (remember that I'm not a doctor) is between cyclopegic and halfway between the two.

RObyRob wrote:5.) What is the maximum and average difference between manifest and cyclopegic refraction?


That varies greatly too. Hyperopes tend to have more difference because they are often constantly "focusing around" hyperopia. In my view, anything over 1.00 diopter between tests (wavefront, manifest, cyclopegic, automated, etc) is cause for consideration and reduces the predictability of the outcome.
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Glasses

Postby RobyRob » Fri Nov 24, 2006 6:42 pm

Glenn, my surgeon prescribed me -0.50D SPH glasses for driving.
What kind of glasses should I buy that would have UV protection?
Opticians told me that I need antireflective coating because it also has UV filter. Is that true? This coating is very expensive...
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Postby LasikExpert » Fri Nov 24, 2006 7:04 pm

I am not at all familiar with eyeglass lens materials. The optician should be able to provide information regarding the ultraviolet (UV) protection proterties of the lens material with and without antireflective coatings. You may want to check with several opticians including large discount chains like WalMart and large box stores like Sam's Club or Costco.
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Postby RobyRob » Sat Dec 02, 2006 8:52 pm

2 months post-op:

No big change. I have minor dry eye problems and big problems with undercorrection.

My estimated manifest refraction:
Left: -0.75 SPH 0.00 CYL
Right: -0.75 SPH -0.25 CYL

P.S.
Glenn, is there some way you can change my nick from RObyRob to RobyRob? I made a mistake when I registered but I can't fix it myself.
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Postby LasikExpert » Sat Dec 02, 2006 9:35 pm

Your username has been changed as requested.

If you are at or near age 40, do not be too quick to have that small amount of myopia removed with enhancement surgery. Read Sudden Presbyopia to learn how this may be an advantage for you.
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Postby RobyRob » Sun Dec 03, 2006 3:40 pm

Thank you for your kind help with my username Glenn.

I understand your concern but I am 26 and I do a lot of physical activities outdoors, so this undercorrection is quite a problem. My surgeon says enhancement can be done 1 year after surgery so I have plenty of time to think.
RobyRob
 
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Postby LasikExpert » Sun Dec 03, 2006 5:51 pm

There is nothing wrong with waiting. The enhancement surgery can be done at any time.
Glenn Hagele
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3 months post-op

Postby RobyRob » Tue Jan 02, 2007 12:32 pm

3 months post-op:

No change in refraction since last month.
Dry eye has improved. Almost don't need drops.
No other side effects.
Undercorrection is annoying so there is a 99% chance I will have enhancement in October 2007.
I am still very pleased with the surgery. It's like a miracle.
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Postby LasikExpert » Tue Jan 02, 2007 7:37 pm

Thanks for keeping us up to day. Be sure to let us know if you proceed with enhancement surgery and its result.
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6 months post-op

Postby RobyRob » Sat May 12, 2007 7:56 pm

6 months post-op:

My estimated manifest refraction:
Left: -0.50 SPH 0.00 CYL
Right: -0.50 SPH -0.25 CYL

Doctor says I will have another examination in November. We will make exact measurements and discussions about enhancement then.

I have no side effects. Dry eye is gone. My vision with -0.50 SPH glasses is perfect, even at night.
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Postby LasikExpert » Sat May 12, 2007 8:49 pm

With those glasses you know the difference in vision, so you know what would be the potential beneifit. Discuss at length with your doctor if the relative benefit of enhancement surgery is worth the relative risk.
Glenn Hagele
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