My trip to the corneal specialist

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My trip to the corneal specialist

Postby Betty39 » Thu Feb 15, 2007 3:30 am

He was a very young doctor but very thorough. He told me stuff my lasik doc never mentioned. He said I had some haze under the flap of my right eye which was out of my field of vision and has now "settled down nicely." The other doc never told me that. He also said that my eyes looked a bit dry and that some people are just more bothered by the sensation and others can have very dry eyes and aren't bugged. Then he did that test with the paper in the eyes. My left eye came out a 2 and my right a 3. He said that normal was 10 so yes my eyes are quite dry. Then he stained my eyes with this stuff and looked at them with the lamp. He said I have healed very well and there are no dry spots and the E cells ( I don't know how to spell the word but you know what I mean) look very smooth. So that is good. Then he gave me a prescription for Restatis and Lotemax. The Restatis I am to take 2 times a day and the Lotemax 4 times a day for 3 weeks. I asked him if I could then suddenly stop it and he said unlike other steriod type drops the Lotemax you could just stop taking and he said it will make the Restatis work better. He also gave me a brochure for Biotears but I guess you can only get it on the internet but he said it will work better than the flaxoil. I will call my doctor tomorrow and see if he will give me these prescriptions because if not the doctor said it's 100 bucks a month. I really liked this doctor I felt like he was telling me the truth. The other doctor for some reason always seemed vague like he didn't think I would understand or for some reason wouldn't really tell me anything.
Also the corneal specialist said that there was just this big conference of opthamologists and at this conference they had these papers with new findings concerning lasik and dry eyes. He said the new reports state that many patients are having dry eyes than previously thought and it can take 6 to 12 months for many of them to have it resolve. I asked him if he ever has seen a patient not have it resolve in his practice. He said no. But then again he is really young (30 maybe) or so he looks so how long could he have been in practice. He said the laser does not damage the nerves only severs them and that they will eventually grow back until they are like they were presurgery.
So that's how it went. What do you think Glenn does all this sound okay?
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Postby LasikExpert » Thu Feb 15, 2007 5:57 pm

This sounds like a comprehensive evaluation from a knowledgeable practitioner. Your tear quantity is poor, but it sounds like your tear quality is good. Restasis is an anti-inflammatory that will work toward opening up the channels that carry your tears to your eyes and that should help with the tear quantity issue.

As to the comments at the recent ARVO meeting, I guess "more than previously thought" depends upon what you previously thought. I have not been surprised by the current reports. They are consistent with what we learn from patient evaluations as a part of our surgeon certification process.
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nerves

Postby mike r » Thu Feb 15, 2007 7:05 pm

I dont mean to be abrupt...But I think the part stating the nerves would re connect back to pre surgery is quite a long shot...

Common sense dictates in any other circumstance of the human body in which nerves are severed is a far cry from the same even with microsurgery...


That type of overageration is the type of thing that can discredit a great deal of all else that is said...

<mike r>
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Postby Betty39 » Fri Feb 16, 2007 6:29 am

I think I should re-state that. He said my tearing function would return to pre-surgery in time. He didn't say the nerves specifically. I just assumed that. And if my tearing function comes back to whatever it was presurgery then I will consider my situation a total success as I am completely thrilled with my vision.
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Re: nerves

Postby LasikExpert » Mon Feb 19, 2007 9:00 pm

mike r wrote:I dont mean to be abrupt...But I think the part stating the nerves would re connect back to pre surgery is quite a long shot...


Corneal nerves are not like nerves in other parts of the body. Studies at the Mayo Clinic affirmed that nerve density returns to preoperative levels at around three years for surface ablation like PRK, LASEK, and Epi-Lasik and at around five years for Lasik. Nerve density is just one measurement of nerve regeneration. What is more important is functional sensitivity, which returns for the vast majority of patients within the normal six month healing period.
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Postby DryEye » Mon Feb 19, 2007 9:16 pm

Do the corneal nerves have anything to do with one's vision or tear function related to dry eye?
If not, then what do the corneal nerves do?
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Postby LasikExpert » Tue Feb 20, 2007 1:56 am

Corneal nerves send sensation messages to the brain. An example would be a bit of dust getting on the cornea, the nerves sending this information to the brain, and the brain responding with a flood of reaction tears. The corneal nerves help let the tearing system know when to make more or less tears for normal lubrication too.

Laser eye surgery disrupts or removes corneal nerve material and thereby can disrupt these signals. Not everyone is affected and those with surface ablation like PRK, LASEK, or Epi-Lasik seem to be affected less than those with Lasik or All-Laser Lasik.

Nerve density, shape, length, etc. is really secondary to nerve sensitivity and nerve sensitivity returns to functional levels within the first six months after surgery for the vast majority of patients.
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