Had Ilasik six week back. Facing problems.

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Had Ilasik six week back. Facing problems.

Postby chere » Fri May 22, 2009 1:36 am

I had iLasik on April 11, not quite 6 weeks ago.I was a whopping -6.75 right and -7.00 in left eye pre-surgery.
A week after the surgey, I was a very crisp 20/20 in both eyes.I was thrilled.

After three weeks my vision became blur, not clear. I Got myself back to doctor to verify. He told it is a healing problem and asked me to wait some more time.

My present prescription is now -1.75 right and -.75 left.
Is it a regression or some other problem?

Any feedback would be much appreciated
chere
 
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Postby chere » Fri May 22, 2009 2:07 am

Hi Glenn,
please help me.
chere
 
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Postby chere » Sat May 23, 2009 4:51 am

Hi Glenn,
again..

Is there any possibility to vision with epithelial in growth or DLK after 3 weeks of surgery. Could you let me know the symptoms of epithelial in growth or DLK?
chere
 
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Postby chere » Thu May 28, 2009 12:15 am

Hi,

I went another doctor to check the eyes. Doctor told that it might be probem with Corneal Ecstasia. could you please advice.
chere
 
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Postby It's Just Me » Sun Jun 07, 2009 5:57 am

Doesn't this problem involved lifting the flap and cleaning?
Why isn't your doctor telling you anything about this?
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Postby chere » Sun Jun 07, 2009 7:09 pm

Thanks for your reply.
My eyes prescription is worsing week by week. My lasik doctor was telling its healing problem. But another doctor told that its cornoreal ectasia problem. I am in full confusion. What might be problem. I am much fearful. I am going to visit Corneal specilist this week.
chere
 
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Postby LasikExpert » Mon Jun 08, 2009 3:48 am

What Lasik Does

Lasik reduces the need for glasses and contacts by reshaping the cornea. For someone myopic (nearsighted, shortsighted) like you, the cornea is flattened in the center by removing corneal tissue with an excimer laser. About 12-18 microns of corneal tissue are removed for each diopter of correction needed. For your left eye, about 84-126 microns of corneal tissue would have been removed.

The Lasik Flap

The first step of Lasik is to create a thin flap of corneal tissue. This flap is moved aside, the laser energy is applied to the exposed inner cornea, and the flap is then repositioned over the treated area. By applying the laser energy in the center area of the cornea, the eye is “fooled” into not realizing it has had surgery. This mutes the healing response. That means virtually no pain and a quick visual recovery. Most Lasik flaps today are between 100-120 microns thick.

Corneal Thickness

Combining the maximum amount of tissue removal with the probable amount of flap thickness, about 246 microns of your cornea have been disrupted by removal or the Lasik flap. About seven decades of practical application has shown that a healthy cornea will remain stable so long as at least 250 microns of corneal tissue remains untouched (more is always better). So, if your corneas were about 496 microns thick or thicker and healthy, then your corneas would be expected to be stable after surgery. Your surgeon undoubtedly measured the thickness of your cornea prior to surgery.

Healthy Cornea

All these assumptions are based upon you having a healthy cornea. Do you have any personal history or family history of systemic disease, chronic disease, Keratoconus, corneal disease, or corneal transplant?

Regression, Ectasia, Inflammation

It is very common for regression of effect to occur with someone who has more than about 6.00 diopters of refractive error corrected. For your 7.00 D of correction, regression of 0.50 to 1.25 would be a reasonable expectation. It is possible to have more or less regression, depending upon how your cornea reacts.

Corneal ectasia is a forward vaulting of the cornea due to corneal instability induced by disrupting too much corneal tissue. True ectasia is quite rare, but can be clinically observed by repeated measurements of the back side of the cornea (posterior float). Some posterior float is common after nearly all Lasik, but normally a relatively small amount. A large amount or progressive amounts would indicate ectasia.

Inflammation of the cornea is common, but normally controlled with steroids and non-steroidal anti-inflammatory medications. Remember how I said Lasik reduces refractive error by removing corneal tissue? This thins the center of the cornea. If inflammation thickens the center of the cornea, then you will have the temporary effect of regression. Inflammation does not normally cause posterior float. In fact, aggressive inflammation will have the opposite effect.

What It Could Be

Based upon the very limited information we have here, you could be dealing with normal regression, inflammation, inflammation with regression, or ectasia. At this point in time and with the symptoms you describe, all could be possible.

Where To Now

You need an exam by a corneal specialist. I highly recommend that you ask your Lasik surgeon for a referral and ask that your records be sent to the corneal specialist in advance of your exam. Don't worry about your Lasik doctor influencing a corneal specialist. Corneal specialists tend to be pretty independent and your vision health history in the Lasik doctor’s files will be very important for a proper diagnosis. You can also expect a frank discussion of your situation from a corneal specialist. That is one of their traits too. Personally, I like corneal specialists. No Bovine Fertilizer.

Why a Corneal Specialist

You are getting conflicting information from doctors who may not know what is actually happening. Your stress level must be through the roof. Stress is not going to help your situation and may cause you to make poor decisions about your care. What you need more than anything is the peace of mind of knowing exactly what is going on, what you can expect, and how to treat the situation.

Worst Case Scenario

The worst case scenario would be full-blown ectasia resulting in a corneal transplant. Corneal transplants are nothing to be desired, but tens of thousands are performed each year with very good results. You are not going to go blind because of ectasia, but if ectasia is what you have then you will have a bumpy road for a while.

Probable Scenario

Statistically, you probability have inflammation combined with normal regression. This may be aggravated by an unusual response to the anti-inflammatory medications or other issues. I highly suspect your eyes will stabilize at some point and then you will need to evaluate where you are and what you want to do about any residual refractive error.

Feel free to take this along with you to your corneal specialist to discuss these issues.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Postby chere » Mon Jun 08, 2009 11:23 pm

Hi Glen,

Thanks you reply and support.

It seems my prescription got changed now. I am feeling more blurry than last checkup. Iam going to Corneal specilist on June 10th and I will discuss with him all what you mentioned.

I got below letter from my lasik surgeon and asked me show to any doctor.

Dear..
You came to me on 2nd of April 2009. Examination on the day right -6.75/-0.50 x 130 = 6/9, left -7.0/-0.50 x 50 =6/9. The anterior and posterior segments were normal. The Intra ocular pressures were 18 in each eye. Pachymetry was 509 right and 510 left. An 'A' scan was taken. On 11.04.09 a zyopitx tissue saving intralase Lasik was done. A 90 micron flap was raised and all your power was treated. Immediate post op on 04.12.09 you had a visual acuity of 6/9 in each eye, both flaps were clear with mild sub conjunctival haemmorages. on 04.14.09 the right eye was 6/9 left was 6/18 with +1.5 Dsph it was 6/9. I advised you to stop FML as it is on the + side. On 04.18.09 it was 6/6 in both eyes. It is quite possible after Lasik some people have varying healing pattern

Regards,
Dr.

Thank you very much Glen for your support.
chere
 
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Postby LasikExpert » Tue Jun 09, 2009 3:20 am

Ask your doctor to forward to your corneal specialist a copy of your medical record, including color copies of color-indicated charts. This will be helpful for the specialist. Your doctor may charge for a copy of your file, but I doubt it.

Please let us know what the specialist says.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby chere » Thu Jun 11, 2009 7:31 pm

Hi Glen,

I went to Corneal specilist yeturday. He checked all and told that it is healing problem not corneal ectasia. Now my tense got reduced lot.

Thanks Glen for your suport.
chere
 
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Postby LasikExpert » Fri Jun 12, 2009 10:54 pm

Hooray! Not that you have a healing problem, but that you don't have ectasia.

Please keep us informed of your progress and you are most welcome for any helpful information I may have provided.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California


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