Posted my experience

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.

Posted my experience

Postby tintin » Thu Feb 08, 2007 2:53 am

I just finished posting the story of my Epi-Lasik / Lasek procedure from January 18/19 including the complications and description of what all happened. It's on my blog at http://www.heretohere.com

The good news is that each day is getting better (generally) and at least I'm back to work for half days.

C.J.
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Postby tootingbec » Thu Feb 08, 2007 7:22 am

"It was like a Pink Floyd show"? Really? The visual part of my own procedure was as dull as doornails. An orange ring with a little red LED in the middle of it. Sometimes I could see it, sometimes not. There was absolutely no fancy special-effectage. No laser beams zooming around, no marching hammers, no flying pigs.

Sorry your procedure was so unpleasant.
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Postby LasikExpert » Thu Feb 08, 2007 12:25 pm

I often need to remind folks that this is a surgery by people, not by machines. Your very different experience with two different technicians and how that affected you illustrates my point.
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Nine weeks later... more trouble.

Postby tintin » Fri Mar 09, 2007 6:04 am

Ok,

I thought I'd update my initial post here with a bit more information.

Pre-op was +3.25 in each eye.

I fainted during Epi-lasik and then had to have LASEK done on my left eye.


Four days post-op I was at about -4.00 to -5.00

They had me slow down the drops (Maxidex) to once per day v. three times daily.

Went in eight days later, -1.50 in each eye with astigmatism of some sort in my right (epi-lasik) eye. They told me to stop the Maxidex drops altogether.

Went three weeks later (now two weeks ago) and had a decent exam... -0.50 in each eye. Still some astigmatism, but no big deal. I thought things were great!! I was told to get in to see them if I had any problems between that appointment and my next one, scheduled for one month later (March 22).

Yesterday I felt like my vision was never really clear and my eyes were trying to focus all the time. Sort of an autofocus camera lens that doesn't know what to look at. So I got an appointment for this AM.

Went in, I'm now +.50 in my Epi-lasik eye and -.25 in my LASEK eye. I've gone past 0.00 altogether.

They told me to use the maxidex again in my Epi-Lasik eye - twice daily for two weeks and then once a day after.

I am so stressed about this and they are giving me a sort of, "well, the intention of the maxidex is to slow your healing"

I don't understand how the drug can take you backward from where you were. I just don't understand and I've already been trhough the hardest weeks of my life with this.

Anyone have any thoughts? Glenn, I know you are great at providing some insight.

Thanks folks.
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Postby LasikExpert » Fri Mar 09, 2007 7:01 am

It's probably not the drug that made you regress.

Epi-Lasik and LASEK both mortally wound the epithelium (soft outermost layer of the cornea). The epithelial cells will die and regenerate.

Hyperopic (farsighted, longsighted) laser eye surgery involves removing tissue in a circle around the outer portion of your cornea. This creates a "moat".

Normal wound response is an attempt to make things as they were before the event. As the epithelial cells regenerate, they try to fill the moat. They consider this new shape a problem and try to corrected it. The cornea does not know you want a moat.

The underlying tissue reacts in much the same way. It assumes that you don't want this new reshaped cornea and the wound response is to resolve the "problem". This process is called regression and is very common with hyperopic laser eye surgery.

To deal with expected regression, surgeons will often overcorrect a hyperope into myopia so regression does not take you all the way back to where you were before surgery.

The eye drops can control the speed and amount of regression by controlling the wound response. As your eyes heal, the doctor can regulate and to some degree control the regression.

Surface ablation techniques like LASEK and Epi-Lasik are more a process than an event. Hyperopic correction is always a process.
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the drops

Postby tintin » Fri Mar 09, 2007 2:54 pm

Thanks for the response Glenn,

My concern is that I've gone past myopia and back into hyperopia without using the drops. They are thinking the drops are going to swing be back to 0.00. It makes sense that they slow the healing process, but I don't understand how the drops could take me "backward" if you know what I mean.
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Postby LasikExpert » Fri Mar 09, 2007 4:26 pm

They may not, but they will likely change the wound response from what it has been doing and will hopefully at the very least stop any further regression.
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March 22 update

Postby tintin » Mon Mar 26, 2007 4:30 am

Ok, so another update for folks.

I went back for another test on March 22. To recap, surgery was January 18/19

I had been taking the steriod drops twice a day in my right eye which was registering at +0.5 and taking them once every second or third day in my left eye which was at -0.25.

Now, two weeks later (March 22) I am seeing with -1.00 in my right eye and no change at all in my left eye.

It looks like the drops have been doing their job and now we are going to ease off of them to once per day for two weeks to see how that goes.
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Postby LasikExpert » Mon Mar 26, 2007 6:37 am

Steroids do a good job of inflammation control and can be used to manipulate regression. Let's hope you are able to resolve your residual refractive error with just the meds.
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Postby JPD » Mon Mar 26, 2007 2:55 pm

LasikExpert wrote:Hyperopic (farsighted, longsighted) laser eye surgery involves removing tissue in a circle around the outer portion of your cornea. This creates a "moat".

Normal wound response is an attempt to make things as they were before the event. As the epithelial cells regenerate, they try to fill the moat. They consider this new shape a problem and try to corrected it. The cornea does not know you want a moat.


Wouldn't use of one of the prolate lasers such as Allegretto and the newly FDA approved Zeiss mel 80 solve this problem? Or would the prolate only be helpful for a myopia correction?
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Postby LasikExpert » Mon Mar 26, 2007 4:27 pm

The issue of leaving a prolate shape of the cornea after refractive surgery relates primarily to myopic (nearsighted, shortsighted) correction, not to hyperopic (farsighted, longsighted) correction. Hyperopic correction actually creates a more prolate shape.

The prolate or oblate shape will not greatly affect the healing response of the cornea and the attempt to "fill in the moat" with epithelial cells.
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Eye Update!

Postby tintin » Wed May 09, 2007 3:17 pm

I wanted to give everyone here an update now nearly four months post-op.


Here are my test results over the past while...

Before surgery was +3.25
Four days after surgery -4.00 (off the drops!)
eight days after that, -1.50
two weeks after that -1.00
three weeks or so after that +0.50 back on the drops!
two weeks after that, -1.00
two weeks after that -0.50
two weeks after that -0.25 in one, -.0.50 in the other
two weeks after that -0.50 in one, -0.25 in the other
two weeks after that -0.50 in one, 0.00 in the other

And that's where I stand right now. -0.50 in my non-dominant, LASEK eye, and 0.00 in my dominant, epi-LASIK eye.

I'm totally off the drops now and no longer have any significant dry eye issues. (My eyelids used to stick to my eyeballs overnight.)

Thank goodness!

I really want to thank everyone on this board that helped guide me, send me kind words and give me hope that things were going to get better. Now I can focus my attention on my world motorcycle tour (Called the Here to Here World Tour benefiting Street Kids International). If you want to learn more, visit http://www.heretohere.com

Thanks again everyone!!
C.J.
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Postby LasikExpert » Wed May 09, 2007 4:05 pm

Congrats CJ. Your new vision will undoubtedly make your 'round the world tour much more enjoyable.
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